Innovation
practice, the robot will not run at its full capacity because most CSSDs are not operational 24/7 and/or the flow of cleaned medical instruments to be processed is not constant. For the Dutch hospital market, an internal case study was created for a medium-sized hospital that processes 105,000 instrument trays on an annual basis. In the case study, the labour costs of the wrapping process were calculated in two different scenarios. In scenario 1, instrument trays are wrapped completely manually. In scenario 2, 90% of instrument trays are wrapped robotically. For scenario 1, figures representative of the
Dutch hospital context were used. The annual employer costs of a CSSD employee in this scenario amount to €55,000, and the salary increases by 2.5% annually. Furthermore, a 36- hour work week and an average of 30 days off per year (vacations and public holidays) and 5.55 other non-deployable days (in-service training) were taken into account. On an annual basis, one FTE (Full Time Equivalent) in a Dutch hospital represents 1195 workable hours. In practice, employees are not fully
deployable during these workable hours to wrap instrument trays due to, among other things, consultation and other support activities. In scenario 1, therefore, a reduced productivity (20%) has been calculated. Also taken into account is absenteeism (6.5%). This is a lower absenteeism rate than the national average in the Dutch healthcare sector in 2023.10 The average wrapping rate of a CSSD
employee is 28 trays per hour, including related logistical work. On an annual basis, a full-time CSSD employee is able to wrap 33,473 instrument trays by hand. Therefore, the total labour-related cost of manually wrapping 105,000 instrument trays (scenario 1) over ten years is €2,485,158. The total cost (purchase, transportation, placement, installation and maintenance) for robotic wrapping of 90% of the instrument trays in scenario 2 amounts to €781,449 over 10
years. The total savings in labour costs when a medium size hospital switches to robotic wrapping thus amounts to €1,703,708 over 10 years. This calculation does not take into account positive side effects of robotising the wrapping process on labour productivity. For example, the described workflow with conveyors and/or automated guided vehicles decreases the number of walking movements, which contributes to a calmer environment in the CSSD. Also, robotic wrapping of instrument trays
decreases the ergonomic strain on employees, contributing to lower absenteeism due to musculoskeletal disorders. Additional, long-term research is needed to quantify these benefits. A second benefit of robotic wrapping of instrument trays is the savings in wrapping material and the reduction in the amount of medical waste, which has to be burned. When manually wrapping instrument trays, employees often use more wrapping material than strictly necessary. Consumption figures from hospitals working with the robot show that, on average, the
robot uses 15.7% less wrapping material. On an annual basis, this means that a medium-sized Dutch hospital needs 2,825 kg or 27,756 m2
less
wrapping material. At a wrapping price of €1.45 (with tax) per sheet in the mix, this results in annual savings of €21,538. The reduction in the use of wrapping
materials contributes to reducing hospitals’ CO2 footprint. CO2
the direct reduction in the amount of wrapping material, but also by indirect factors. Less transportation is required for the supply and removal of wrapping materials. Less wrapping material has to be burned after use. Finally, the
reduction in the number of FTEs reduces CO2 emissions from employees. CO2
material (Virgin PP) are 1.7 kg CO2 PP material.11
produces CO2 Netherlands.13 Burning the wrapping material
produces an environmental impact of 2.5 kg CO2 per kg of wrapping material.12
emissions of 3 kg CO2
of wrapping material. Human CO2 are 9 tons of CO2
The total CO2
Transportation per kg
emissions
per person per year in the reduction when a
Consumption figures from hospitals working with the robot show that, on average, the robot uses 15.7% less wrapping material.
April 2024 I
www.clinicalservicesjournal.com 77
emissions for the production of wrapping per kg of
emissions are reduced not only by
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