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ASSEMBLY LINE LOGISTICS
Picking Supplies: Case Carts,
Custom Packs & Center Core
Pamela
Bevelhymer,
RN,
BSN
Before its recent expansion, Elkhart (Ind.) General Hospital's assembly-line case cart system
worked like this: Sterile processing techs hand-picked supplies for each case and placed them
onto carts, which then worked their way to the OR, picking up additional supplies from unorgan-
ized storage areas along the way. When the hospital added 10 ORs, a hybrid OR and 3
endoscopy suites, Pamela Goddard-Dunfee, RN, MSA, CNOR, executive director of surgical and
cardiovascular services, and her team refined the case cart system. Sterile processing techs
still pick supplies needed for each case from the sterile processing storage area and load them
onto the case carts, but a couple of key changes have made picking cases easier.
First, Elkhart added custom procedure packs for certain procedures. The custom packs,
which include all necessary supplies for such common cases as a total hip repair or a general
gynecology procedure, are housed on shelves in sterile processing. "The techs just grab the
labeled custom pack off the shelf, load it onto the cart and it's ready for surgery," says Ms.
Goddard-Dunfee. "It's greatly streamlined our picking process."
The hospital also updated its "center core" area, where staff pick instruments, gloves, suture
and other specialty items needed for the case that aren't included on that procedure's standard
case cart. The center core is organized by specialty, with supplies kept in clearly labeled bins.
"We also ensured that our carts were small enough to move easily between the aisles, which
makes picking the cases that much easier," says Ms. Goddard-Dunfee.
Before the expansion, staff spent months organizing and standardizing the old center core
and sterile processing storage areas. "We created supply carts that were tagged with where
exactly the materials should be placed to work with our assembly-line system," she says.
They also built in some extra space between supplies in the center core to store new instru-
