For two days a week in the past 6 years I have been working on material management as a consultant, in various Operating Room Theatre complexes. During this time I have been thinking and talking a lot about bills-of-material, storage capacity and layout, inventory levels, transport carts and all sorts of materials that I had never even heard of before. I don’t think I am exaggerating when I say Material Management is a largely ignored subject in hospital management. You may think: but hey, as a consultant you are being paid to work on the matter by at least someone! Point taken. The main reason I have been working on it, is because new hospital buildings are built smaller and storage space for materials is decreased – or even left out – and Just-in-Time has to do the magical disappearance trick. But as I am not a magician nor is anybody else who is involved with this subject, this material stuff easily shifts from a spatial puzzle into a wicked operational problem. The thing is that materials seem to be everywhere as soon as you start paying attention to them, not just in numbers, also in cost. And they come in all sorts: beds, gasses, medical equipment, linnen, food, medication, implants, blood samples, medical instruments, medical consumables, OR tables, uniforms, waste of all sorts, to name but a few. Someone once told me that the logistical network of a hospital has more links than the worldwide logistical network of a multinational like Cisco.
I think that might be true – I modelled several hospital networks and found thousands of distribution lines – but the funny thing is that, from my research, I now better understand why material management is somewhat overlooked. In my research I almost forgot about it myself. In this series of blogs I wrote about nurses, surgeons, secretaries, anesthesiologists and coordinators, but not about materials. Communication on materials is somewhat invisible in the big spaghetti social network diagram shown in the blog on nurses. Of the 31,499 communication links between the 635 people in the network only 134 are about materials. So if you have 99,6% communication links about people – patients and staff – , it makes sense that materials are not really in everybody’s top of mind. It’s not really anyone’s business. People in hospitals often say: materials just have to be there. And yes, materials are usually there, in great piles of inventory, disguised in hundreds of storage rooms, carts and cupboards and, ironically, still not always on time at the right place. But this comes at a cost. Approximately 40% of the total hospital cost relates to material management, according to literature.
Besides its cost, there is another reason why paying attention to material management is so important. Instead of anybody’s business, it’s everyone’s business. Besides a handful of material logistics workers, outpatient secretaries, surgeons, OR nurses, ward, holding and recovery nurses all deal with materials. Materials are ordered, stored, searched, picked, collected and prepared, in particular by nurses. In these times of high shortages of trained nursing staff, the major issue is to get Material Management tasks off their plate and have logistical professionals do the job. In order to succeed in this, Material Management must be made visible, even when that initially feels like tidying up an enormous attic (or rather, hundreds of them) or receiving shock therapy when reality, i.e., the cost of material management, really kicks in.