Opened in 2014, Lady Cilento Children’s Hospital in Brisbane is the largest, most advanced paediatric hospital in Australia, following a merger between the Royal Children’s Hospital and Mater Children’s Hospital into one single facility.
The medical gas supplier for the hospital is BOC Healthcare, delivering hundreds of full medical gas cylinders each month to 49 hospital departments that support 359 beds across 12 floors. Christopher Collie, Facilities Coordinator at Lady Cilento Children’s Hospital, says: “Both previous hospitals had longstanding partnerships with BOC and this has continued at our new facility. Their team has been working with us to meet our gas needs including a new cylinder management solution that is already making a huge difference.”
Bringing together medical professionals from two separate hospitals naturally meant staff had slightly different approaches for certain tasks. One area was in the way that clinicians and medical staff were projecting their gas usage.
“After opening we noticed an over-projection of gas cylinders right across the hospital with some wards ordering up to three more medical cylinders than what they actually needed,” says Collie. “There didn’t seem to be an established confidence in ordering so the result was a large oversupply of gas in our storage cage and a lot of unnecessary cylinder rental fees.”
With days of stock at 76 days, well above the hospital industry average of 35-45 days, the Facilities team was keen to explore options for improving its ordering efficiency and ensuring greater traceability of cylinders throughout the hospital.
“We knew with the size of the new hospital that more accurate ordering was needed, along with the ability to pinpoint the location of each cylinder at specific departments.”
As the hospital’s medical gas supplier, BOC implemented Qi Tracking (Quality Improvement), a cylinder management solution that allowed the hospital to obtain accurate data about the location, availability and supply of all its medical gas cylinders through a barcode identification system. After analysing the entire structure of the hospital, BOC set up 49 individual department accounts in the system with unique codes to ensure internal traceability between locations within the hospital and to accurately assess stock usage for each location moving forward.
As part of the implementation, BOC and hospital staff worked together to locate and scan all cylinders into the new barcode tracking system. They then discussed suitable safety stocks starting with the high-utilisation departments such as theatre, emergency and PICU departments.
To support the hospital staff in the transition, a BOC Qi Tracking Manager was placed in-house for an initial six month period to manage the ordering, stock keeping, internal transport and tracking of medical cylinders within the hospital. The Qi Tracking Manager worked closely to educate key people such as Medirest, clinicians and nurse unit managers about the new system and determine the actual safety stock levels for each ward.
Every morning and afternoon, the Qi Tracking Manager reconciles cylinders being used at each ward to ensure continuous supply. Cylinders and transactions are tracked through a smartphone app, BOC MyAgent Mobile, which allows barcodes to be scanned in and out of the gas storage cage to individual departments. If a cylinder is required when the Qi Tracking Manager is not on site, Medirest is able to assist. However, since the hospital has accurate safety stock levels, this will happen rarely – for example when an emergency case requires large amounts of portable gas cylinders.
Whenever a cylinder has been scanned out of the main gas cylinder storeroom and into an individual department, it is automatically reordered and replenished by BOC. Lady Cilento can then log in to MyAgent Mobile to view every transaction that took place within the hospital and in addition all transactions are itemised on a monthly invoice supplied by BOC.
“Senior management saw immediate value in this solution,” says Collie. “It was approved because it offered better stock management and dedicated onsite support from BOC.”
Three months after the Qi Tracking solution was implemented, Lady Cilento was able to reduce its days of gas cylinder stock by 36% and more accurately forecast the gas requirements of each department. Being able to work collaboratively with Qi Tracking Manager during the transition was a key factor in getting Qi Tracking successfully implemented across the hospital’s complex environment.
“The Qi Tracking Manager has been marvellous and was the critical element we needed to make this work,” says Collie.
One factor that has been particularly helpful was the deployment of an in-house BOC person in a role dedicated to medical gas, according to Collie: “She has been able to accommodate the needs of nurse unit managers and department managers, and has been very tactful in the way she has helped clinicians and staff reduce the amount of gas ordered. The vital part has been helping change behaviour and ensuring everyone understands how it is used – the education part has been important. She has kept the lines of communication open and sat down to discuss any issues with stakeholders.
“Feedback has been positive with BOC ensuring a seamless supply of gas which is essential for us. We are also getting positive feedback from Medirest who have commented on the support and training provided to ensure they understand the new system.”
The Qi Tracking Manager has also identified ways to make the overall cylinder management set-up more efficient. One benefit was reallocating partially used cylinders to other areas of the hospital. Due to hospital protocol, as an example when a patient moves from ICU, a full cylinder is required for each patient. In some instances to avoid almost-full cylinders being returned and marked as empty, BOC now reallocates them to other areas of the hospital such as the wards, where a full bottle is not always required for patient transportation.
Lady Cilento improved its inventory management through a reduction in the number of gas cylinders that each department has in their stockpile. Empty cylinders can now be scanned and removed off each ward’s account daily, helping to reduce cylinder rental fees.
“Since Qi Tracking has been implemented, our stocks have reduced significantly and BOC’s team has always delivered our gas in time – everything runs like clockwork,” says Collie. “Ordering used to be really cumbersome especially with lots of demands in my working day – I look after cleaning, porterage, pest control and many other areas, not just gas. I used to closely monitor the gas storage everyday but having a person dedicated to managing the gas usage has now freed me up for other important activities.”
Since the Qi Tracking solution was implemented, Lady Cilento has also seen improved safety in its gas storage area and processes within the hospital.
“Cylinders are now stored appropriately in the main gas storage area,” says Collie. “Our in-house BOC person has been proactive with safety and continuously monitors the gas cage and provides advice for the safe storage of gas in the wards.”