Using Lean principles to fix one hospital’s tube system

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By Carly Baxter

If you think about it, hospitals’ pneumatic tube systems are pretty cool. Speedily transporting drugs or specimens through hidden pipes, getting them to their intended destinations quicker than any human can. Awesome.

But at Belleville General Hospital (one of four hospitals that comprise Quinte Health Care in south/central Ontario), the tube system wasn’t always quick and it wasn’t particularly awesome. Why? Departments didn’t have tubes when they needed them and they’d spend a frustratingly long time calling or visiting other departments, trying to track one down.

“We never had a tube when we needed one,” said Jean-Anne Hounslow, Team Leader, Endoscopy. “We would hoard them just to make sure we had one when we needed it.”

Recognizing there was a problem, a group of directors and managers chose to apply their Lean learning by taking on the daunting task of fixing what ails the tube system. They completed an A3 and SIPOC and collected data by “going to gemba.” They asked front line staff about their needs and how often they are without tubes when they need one.

With about 800 tubes going through the system daily, the initial audit revealed that about 500 times a week, someone didn’t have a tube available.

The team determined a baseline number of tubes that each of the 28 tube stations should have and then engaged with the manufacturer to optimize the operation of the system. Using programming capabilities that had not been implemented previously, they programmed the system to automatically distribute tubes where they’re needed, taking guesswork out of the equation. All staff have to do is put the tube back in the system and press “redistribute.”

“With our Lean process improvements we aim to make it easy for staff to do the right thing and difficult to do the wrong thing,” said Viviane Meehan, Process Improvement Coordinator.

Four months after implementing the automated system, people have a tube when they need one 90 per cent of the time. And the team is continuously doing audits and adjusting as needed.

“The change has been wonderful,” said Michelle Carlisle, a communication clerk on one of the nursing units. “It’s really rare that we’re calling other units to look for tubes, whereas that was constant before. We no longer live in fear that we’re going to run out.”

“The solution was always assumed that we need more tubes, but that wasn’t the problem – we just needed to organize what we have,” said Jeff Hohenkerk, Vice President. “That’s what Lean is all about – working smarter to solve problems, thereby making our jobs easier and ultimately improving patient care.”

Carly Baxter is a Communications Consultant at Quinte Health Care.