Back in 2015, my frustration over finding so many empty hand-sanitizer dispensers in my hospital visits led to me writing this blog post where I brainstormed the idea of a “two-bin” system for dispensers, since two-bin kanban systems are a simple, yet effective, method for making sure hospitals don't run out of supplies in other settings.
Here is a past post of mine that shares a video from a health system in Pennsylvania:
Kanban systems, with bins or without, are also effective in a veterinary medicine setting, as my friend Chip Ponsford, DVM blogged about just the other day. Here is a photo from a clinic he helped:
Anyway, here was my post about applying this concept of kanban systems to hand sanitizer and the important issue of hand hygiene:
I offered to let any company run with the idea and I finally got some interest from Spencer Fullerton from Maxpert Medical, which makes a number of products, including different devices that create visual signals for when to restock supplies, such as this “Bin Flag” stock indicator that attaches to the front of a supply bin (shown at left).
That's clever, although I'd generally challenge a team to first try creating a visual signal that doesn't require somebody to manually move a slider over. Two-bin kanban systems are great in this regard because the empty bin is a simple, automatic, binary signal that says it's time to replenish something.
We traded emails, which led to Spencer creating a mockup and a prototype of such a device… and I asked him to write about it. Here's what he wrote…
“Two Bin” System for Hand Sanitizer Dispensers Anyone?
By Spencer Fullerton, Maxpert Medical
Common and annoying.
These two words describe what happens when you walk into a medical center and go to the hand sanitizer dispenser on the wall to follow proper hand hygiene and then low and behold nothing comes out of the dispenser.
Yes, it is empty.
It happens all too often, making it common and it is annoying because the purpose of having dispensers strategically placed is to follow precautions and ensure clean hands. With emphasis on infection prevention and hand washing being a key factor, it would make sense to always have hand sanitizer available when needed.
Employees in some facilities rely heavily on sanitizer dispensers as they come and go through different areas and in and out of patient rooms. With hand hygiene compliance being a key factor in any infection prevention program, it is critical that employees have hand sanitizer available when needed. Otherwise, they might skip this step because they have tried the dispenser to find it empty and do not have the time to go to another area to sanitize their hands.
Visitors are also affected. There are many signs and stations around the hospital encouraging them to use hand sanitizer from one of the many dispensers — especially during flu season. Again, when the dispenser is empty, the rate of compliance goes way down because people may not search for the next and decide it's OK to not sanitize their hands.
What to do?
There are some really good systems in hospitals for ensuring supplies are available for patient care when needed. One highly effective system is a “two bin” supply system in which Items are consistently stocked from the back, using the First-In-First-Out (“FIFO”) approach. When the first bin runs out, the employee who uses the last item places the empty bin in a common area. Then, the label on that bin is scanned the same day, activating a new order of supplies that will fill up that bin. While the team waits for the new supplies to arrive, there's still another full bin on the shelf — it's been there waiting behind the previous bin — and it's ready for the next employee who walks in. When the new supplies arrive, they're placed in the empty bin, and the bin filled with new supplies is stocked behind the current bin.
With such a system, the supplies are available when needed. This helps make the organization's employees have trust in a system that gives them what they need, when they need it.
What if the ‘two bin” approach was used for hand sanitizer dispensers?
Imagine for a moment a small cabinet system in which two dispensers were mounted side by side, one active and one reserve. The reserve would have a sliding door covering it so the active dispenser would be used until out of sanitizer.
Once the active hand sanitizer dispenser has been depleted, you'd simply slide the door across to access the reserve dispenser, leaving the first dispenser ready to be replaced with new stock.
Even better is that, when you slide the door to access the reserve stock, a TripFlag turns from green to red indicating that reorder is necessary, as pictured below in this concept mockup:
Now if you've activated the TripFlag, each dispenser that is empty around the hospital is easily identified, yet they have reserve supply to use. Once the appropriate personnel see the red flag and reorder, they flip the red flag to a yellow flag to alert everyone that the new sanitizer has been ordered. When the sanitizer refill is brought to the dispenser and it is ready for use again, the TripFlag can be turned back to green indicating all systems are good to use.
So, common and annoying are words that can be removed from the conversation when speaking about hand sanitizer dispensers. This simple concept could not only eliminate aggravation but support infection prevention practices that start with clean hands.
As a company, we feel we are in a position to solve challenges with creative products. We see that hand sanitizer availability is important in today's world and we could potentially offer a solution if users feel like it is a big enough challenge that calls for a solution.
We wish to share with hospitals and other medical facilities that we have simple products that will aid in their process improvements and goals toward lean healthcare. Maxpert would be interested in providing a product solution for the market. Our interest would be a cabinet and indicator flag system.
What do you think of this concept? Would you consider using a “two-bin” approach to hand sanitizer in your hospital?
The tweak I would make, from what's shown in the video above is that I'd follow this process:
- If the left dispenser is empty, slide the cover left to expose the right dispenser (which is full)
- Flip the indicator to be red, meaning it needs to be filled
- Within a daily cycle, materials management / supply chain would see the red and either
- Refill it and move the indicator green (if they're roaming with canisters)
- Signal that it needs refilling and move the indicator to yellow (meaning it's on order) and then refill it during the next delivery cycle
- When the empty is refilled, keep using the “active” dispenser until it's empty and then slide the door over to cover the empty one, exposing the full container
If you don't think this approach would work, do you have other solutions to this problem that you'd share with fellow LeanBlog.org readers?