At busy hospital blood banks around the country, the most indispensable technology for day-to-day operations is not necessarily the newest, cutting-edge equipment. Rather, it may be something that was invented more than 100 years ago — a pneumatic-tube delivery system.
Composed of a network of delivery stations strategically located throughout a hospital connected by steel tubes hidden within the building's infrastructure, a pneumatic-tube system uses air and the simple principles of vacuum and pressure to send and receive critical medical supplies.
Tube systems are designed for high-speed transport of small materials (e.g., blood products, lab specimens, pharmaceuticals, and supplies). The latest pneumatic-tube technology transports materials at speeds up to 25 feet per second, or just over 17 miles per hour. A pneumatic-tube system can complete a delivery in a fraction of the time that it takes to walk a blood product from a blood bank to another floor or another building. In large institutions where daily pneumatic-tube system deliveries number in the thousands, hospitals may save over a million dollars per year in staffing costs.
But do not picture fragile and valuable blood products speeding through a pneumatic tube unprotected. Items are placed in impact-resistant plastic carriers with available foam inserts to cushion the ride. Pneumatic-tube advances also include a braking system that reduces the air pressure pushing a carrier through the pneumatic tube just prior to the carrier's arrival at the station which slows the carrier and softens its landing.
Tube systems are not only a faster, safer, and more cost-effective alternative to human couriers, but they help maintain the specific temperature requirements of blood products, notes Becky Lofland, a medical technologist and account executive with a Baltimore-based company that manufactures, installs, and supports hospital pneumatic-tube systems. “Packed red-blood cells (PRBCs) have to remain at or below 10^0 Celsius until the time a blood transfusion is administered,” says Lofland. “If someone physically picks up the blood product and walks it to where it is needed, there is a greater chance the temperature restriction will be exceeded. Better to send the blood product through the tube system, which is a quicker way to get it to the patient without exceeding the temperature restriction.”
Security and reliability are additional benefits to using tube systems to transport blood products. The system's software tracks and documents each delivery through the closed system in real-time. And the latest pneumatic-tube stations include easy-to-use control panels with 20 dedicated short-cut keys for frequently accessed destinations to minimize user error.
If greater security is needed for high-value blood products or medications, tube systems include a secure “send” function which holds the carrier just above the destination station until an employee enters a release code. In public areas, security doors can be added to a pneumatic-tube station to restrict unauthorized access to deliveries and protect patients' privacy.
Barcode technology also is used to provide an additional layer of accountability. The barcode on a blood product is captured by a scanner and combined with pneumatic-tube system software data to record when a blood product is sent by the blood bank and when it is received at its destination. Delivery confirmation is sent to the blood bank in real time via a mobile PDA or a wall-mounted device providing a delivery receipt, much like those received with overnight mail shipments. This barcode-tracking technology establishes an audit trail for the dispensing of blood products — a regulatory requirement for labs and blood banks, says Lofland.
Dennie Bledsaw, customer-support manager for the same pneumatic-tube company, worked for 15 years in a hospital that used its pneumatic-tube system extensively for transporting blood and specimens. “Speed was the primary benefit,” he says. He estimates his lab processed over 4,500 transactions a day and delivery times were typically less than four minutes. Bledsaw points out, “The system allows you to do more with less staff.”
Pneumatic-tube systems come in both 4-inch (accommodates a 350-cc bag of PRBCs) and 6-inch diameters (accommodates a 1,000-cc bag with room to spare). The trend in hospitals throughout the nation is toward 6-inch diameter systems. Both small and large hospitals can benefit from these cost-efficient systems. Smaller point-to-point systems can be installed to service single destinations (e.g., blood bank to operating room or emergency room). Larger hospitals, which occupy several buildings on sprawling campuses, often use pneumatic-tube systems with up to five miles of steel tubes connecting 100 or more stations.
Abigail Green is a freelance writer in Baltimore who interviewed Baltimore-based Pevco employees Becky Lofland and Dennie Bledsaw for this article.
