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1218 posts

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  #2512041 25-Jun-2020 10:39
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"Lean Six Sigma" is a methodology used in factories/workshops/airlines etc to improve efficiency. One aspect of it is that everything (from tools & vehicles to rubbish bins) has a marked home and when it is not in use, it is returned to its home. It is a good system for keeping workshops tidy, and means you can (in theory) easily find equipment/tools when it is not being used. Efficiency is improved because staff don't waste time looking for stuff and also you may not need to buy as much spare stuff once everyone can find the stuff you already own. It relies on people keeping each other honest/managers kicking the arse of people who don't tidy up after a job.


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  #2512046 25-Jun-2020 10:49
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tripper1000:

 

It relies on people keeping each other honest/managers kicking the arse of people who don't tidy up after a job.

 

 

This.  Having the right culture together with some simple physical solutions (like shadow-boards) is likely to negate the need for a complex engineered solution.

 

In my experience of the health system (reasonably extensive), there are many 🤬s not given for organisation and efficiency.





Mike

 
 
 
 


Hmm, what to write...
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  #2512050 25-Jun-2020 11:08
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I remember the "co-tag" system (I think) from the 90's  the idea was a loop around every controlled door. Each item of equipment had  a tag and each person also had there normal access tag if you tried to move an item from the room without the appropriate person tag the door refused to open.

 

 

 

not quite what you are after but at least you know who moved it.





Matthew


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Master Geek


  #2512478 25-Jun-2020 19:33
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MikeAqua:

 

Adamanski:

 

Does each piece of equipment have a home that it should be returned to?  We have been making our own foam shadow boards to organise our small tools, has saved a huge amount of time looking for things that are so commonly used, and we now check the boards first thing and track down anything missing before work starts.  

 

 

@Adamanski Would you mind sharing how you cut those foam panels out so neatly and precisely? I'd love to do that for my toolbox drawers.

 

 

 

 

Hey @MikeAqua, I have a flat bed CNC knife cutter which we use for cutting acoustic panels, turns out it cuts foam nicely!  I take a photo of each tool then scale to size and trace in CAD, pretty quick process and looks slick. Probably something that could work remotely - if you sent photos of your tool and layout it wouldn't be hard to digitise and cut. Post a photo of what you would want in a drawer if you like and I'll see what would be involved.


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Master Geek


  #2512484 25-Jun-2020 19:50
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Personally I don't like the idea of enforcement to keep things organised, but we're a small company and I understand my POV is different from those in bigger companies. It needs to be considered an investment in people by allocating time and leading by example. There are so many benefits of having a culture of culture of continuous improvement, in having your people fix the things that bother them, and generally those improvements don't cost much more than time - which is often made back with interest.

 

One good resource that helped with our lean journey was an audiobook that's available on youtube, Paul Akers - 2 second lean, worth a listen if you're interested.


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  #2512485 25-Jun-2020 19:54
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PolicyGuy:

Bung: There seems to be many asset tracking systems aimed at hospitals. Maybe North Shore tried one in 2010.
http://www.stuff.co.nz/technology/3648679/Hospital-opts-for-RFID-tags

With 20 DHB in NZ there's probably that number of separate attempts to find a solution.


Probably each private hospital and each medical school also have 'solutions' of varying capability and usefulness.
Dozens of systems, probably few of them very reliable or effective.



  1. If money is no object, you just buy one of everything for each operating room
    The staff will love it, the accountants will need a lie down

  2. Or there's the bureaucratic solution: all the equipment is held in a central store and must be checked out from the store when needed and checked in again as soon as it's not required.
    Doing a direct room-to-room transfer or failing to immediately return a device to The Store is a severe disciplinary offence.
    The staff will hate it, but it will work, provided that The System is rigorously enforced.

  3. If you want a technical solution (and this is GeekZone!) then you are also going to have to spend quite a lot of money.
    At least one RFID patch on each device, a network of RFID readers on every door (each one needs cabling) and a central server to catch all the messages from the readers, 'know' what's where, and serve up the data in a digestible form. I think that big highly active warehouses are using this kind of technology, but I imagine the specialised software is very far from cheap.


 



RFID isn't much use for this type of application. The range is too short and you don't get reliable reads.

It's fine for bin based location tags but for a hospital it's practically useless.

Active tags (usually BLE for a hospital) with ceiling mounted beacons are significantly more reliable but you need to spend reasonable amounts of money.

We've got several thousand deployments of this type of technology and work with a number of the other players in the space.

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  #2512488 25-Jun-2020 20:05
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Adamanski:

 

Personally I don't like the idea of enforcement to keep things organised, but we're a small company and I understand my POV is different from those in bigger companies. It needs to be considered an investment in people by allocating time and leading by example. There are so many benefits of having a culture of culture of continuous improvement, in having your people fix the things that bother them, and generally those improvements don't cost much more than time - which is often made back with interest.

 

One good resource that helped with our lean journey was an audiobook that's available on youtube, Paul Akers - 2 second lean, worth a listen if you're interested.

 

 

I'm not disputing what you say but a hospital is one of the last places you can have impact with this. It's big, very complex, often chaotic and trying to change the behavior of consulting surgeons is like taming the tide. They are independent contractors and know it.

 

This particular use case is associated with equipment used for lots of different task, often within different departments. The people can be under considerable time pressure and think they are doing the right thing. It's not quite as simple as optimising a small business.

 

I worked in hospitals for a long time, in an infrastructure technology capacity. They are interesting places but very difficult to change.


 
 
 
 


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Master Geek


  #2512504 25-Jun-2020 20:26
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Handle9:

 

Adamanski:

 

Personally I don't like the idea of enforcement to keep things organised, but we're a small company and I understand my POV is different from those in bigger companies. It needs to be considered an investment in people by allocating time and leading by example. There are so many benefits of having a culture of culture of continuous improvement, in having your people fix the things that bother them, and generally those improvements don't cost much more than time - which is often made back with interest.

 

One good resource that helped with our lean journey was an audiobook that's available on youtube, Paul Akers - 2 second lean, worth a listen if you're interested.

 

 

I'm not disputing what you say but a hospital is one of the last places you can have impact with this. It's big, very complex, often chaotic and trying to change the behavior of consulting surgeons is like taming the tide. They are independent contractors and know it.

 

This particular use case is associated with equipment used for lots of different task, often within different departments. The people can be under considerable time pressure and think they are doing the right thing. It's not quite as simple as optimising a small business.

 

I worked in hospitals for a long time, in an infrastructure technology capacity. They are interesting places but very difficult to change.

 

 

 

 

Yep I can appreciate that! I worked for a bigger company before starting out on my own.  We had previously done Kaizen & 5S training but it didn't stick at the time, took a combination of things for me to appreciate the value in lean.  Back to topic I would be really interested in other tech people are using, I heard someone recently talking of Checkmate which is a NZ made product, NFC tags - wonder if this could work for recording where things are left?


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  #2512509 25-Jun-2020 20:31
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turb:

I work in a large suite of operating rooms.


My colleagues and I spend huge amounts of time and energy rushing around trying to track down scarce pieces of mobile equipment such as ultrasound machines and specialised anaesthesia monitors.


We've tried various ways of keeping track of them Eg a whiteboard where you write down where you're taking the kit etc, but it falls down when someone forgets to use the board. Even if it's recorded on the board, you still have to go to look at the board, and even then the board isn't going to help when the kit has been taken straight from one OR to another.


What I want is some kind of "Marauder's Map" that shows where everything is.


We've tried Tiles, but the map isn't good enough to be useful.


Any ideas?



Hey @Turb, Helping you solve problems like this is literally my job and funnily enough this problem is on my list.

Send me an email at the Ministry of Health and we can have a chat (firstname.lastname@health.govt.nz).

Jon

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  #2512510 25-Jun-2020 20:33
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NFC is just RFID and has the same problems. Without active tags the range is crap. It's fine for bins but practically not much use for asset tracking.

 

Take a look on youtube for indoor asset tracking. The main tech used is BLE tags with Beacons. You make a grid on the ceiling with beacons and then have active tags which tell the system where they are. There are a lot of providers in the space.

 

You can also use it for wayfinding and a few other use cases.

 

In warehouses and outdoors UWB gets used a bit as well.


462 posts

Ultimate Geek


  #2512537 25-Jun-2020 22:33
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@Adamanski where do you source your foam from in NZ?


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Master Geek


  #2512587 26-Jun-2020 08:49
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I've sourced foam thru A & E Karsten, good range and easy to deal with.  


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  #2512633 26-Jun-2020 10:08
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Would a private LoRa network be a new tech possibility for this old problem?

Excellent Range & penitration (compared to RFID)
Secure (ish)
& sensors/tags are designed to run off battery = long life

Use 2-3 basestations per floor(for triagulation purposes)
.
Set location polling to 3-4x the expected idle location time of the equipment. (If equipment only needed every 1-2hrs - triangulate location every 15min - if it's needed every 30min - triangulate every 5min)

& map it via a phone/tablet App.
Option to only view equipment on you current floor(to avoid info overload)

(It would need someone to develop it - I don't know of it used anywhere - should be easy'ish to redevelope a rfid solution & reprogram the backend for LoRa

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  #2512848 26-Jun-2020 13:42
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CMH have asset (patient) tracking using active tags. It might be worthwhile talking to their health informatics team to have a look.


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  #2512863 26-Jun-2020 13:51
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turb:

 

We've tried Tiles, but the map isn't good enough to be useful.

 

 

My company (software company) has created a system giving current room location and historic location information using a 4g based receivers and BLE sensors.  What you are asking is not an overly complicated pivot from what the original system was designed for (retail environment). The problem like most things is money.  If you legitimately wanted to solve that issue what kind of investment could actually be made, and is there a willingness to follow up the original deployment costs with ongoing support costs?  Ultimately a niche end to end solution would not be as cheap as Tiles, but equally Tiles arent specifically designed for your use case hence them not fitting into what you are after.  If you would like to discuss what would be possible and ball park costs feel free to send me a PM


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