Logistics are Critical

Not much gets me as fired-up anymore as trying to optimize them. While I like to think that it’s because they are integral to our mission and are the ultimate weapon in our quest to go from “good to best”, it’s really just my borderline OCPD (just kidding…sort of).

Long story short, I spend a lot of time thinking about clinical and operational logistics in HEMS – it’s become my thing. My goal with this post is to share some of that thinking with others who might want to build off of our ideas in hopes that those colleagues (i.e. you) will share their ideas that they are really excited about with us at some point.

So in that stead, let me share our procedure kit idea with you…about 2 years ago we were fortunate to make the jump from BK-117 helos to EC-145s. During that transition, we completely revamped the way we carry and store our materials (i.e. our operational logistics). Part of this revamp included creation of procedure kits to store supplies needed to accomplish our core HEMS procedures. The ground rules were thus: (1) they had to be robust (2) they had to be uniform (3) they had to have everything you needed to do a procedure and nothing more (i.e. they had to reduce the cognitive load, not add to it).

So here is what we came up with. We built five kits that we vacuumed sealed using a food packaging system – goal #1 accomplished. The idea for doing this came from Jason Peng, one of our flight NPs. He was inspired by some observations he made while he was serving in the US Navy regarding how their materials came packaged.

Each kit has its own placard listing its purpose and all materials within (see goal #2). The placard also has a spot where the kit assembler can put their name and the kit’s expiration date (based on the soonest to expire component part).

The original five included: surgical cric (see video by Bill Hinckley posted a few months ago for much more on this), needle cric (see video posted by me a few months back for much more on this), finger thoracostomy, pericardiocentisis, and blind nasal intubation. If you take a look at my post on needle cric or Bill’s post on surg cric you will see what I mean regarding goal #3.

We have learned that these kits aren’t perfect in the couple years we have been making them. The names on the kits were a bit small to read and the placards were not color-coded…something newer iterations will fix. This tenant of operational hems logistics should not be overlooked – any system that cannot accept changes and evolve when improvements are concepted is doomed to fail.

In summary, if you think this is cool and you might want to make similar kits for your shop, I’m glad I was able to share this information with you. I hope to share more similar information soon.