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1
Gesellschaft für Arbeits-,
Reorganisations- und ökologische
Wirtschaftsberatung mbH
Material flow management in hospitals Strategies
for cost reduction possibilities
Contact person Andreas Rebhan, Dipl. Ing.
Mülheimer Str. 43 47058 Duisburg E-mail
ar_at_aroew.de Tel. 49 (0) 203 346 91 -0 Fax 49
(0) 203 346 91 -20
2
Backgrounds
  • The deregulation of the health care leads to
    cost pressure in the hospitals
  • The introduction of the DRG's (Diagnosis Related
    Groups) sets a tight budget
  • Results from researches regarding hospital
    excess capacity increasingly constrain hospitals
    / clinics towards specialization
  • Environmentally conscious and recourse conscious
    action will be increasingly economically and
    corporately rewarded

3
EU-General Conditions
According to the 6th Framework Program of the EU,
from 2005 onwards the public purchase in the
consumption of resources should be
considered. This validation requires an
environmental management system for the public
purchase, amongst others also in hospitals. An
exact knowledge of the resource utilization and
its optimization is a necessary step towards a
successful environmental management /
environmental certification(e.g. according to
Ökoprofit, EMAS II), at which, additional to the
Eco-efficiency, a cost-efficiency will also be
reached.
4
Introduction Our services
  • Hospitals belong to the material and energy
    intensive enterprises. Furthermore, they are
    subject to specific requisites concerning
    character, origin, usage and disposal of the
    materials used, especially
  • Water, heat, energy etc.
  • Operating supplies
  • Hygiene and cleaning supplies
  • Aliment
  • Medicines and pharmaceuticals

This leads to considerable costs.
5
Solutions for the hospital
6
What benefit have hospitals and clinics?
  • Identification and conversion of the
    rationalization and optimization possibilities in
    the material flows water, energy, wastes etc.
    with maintenance of the quality of the medical
    care
  • Optimization of the material cycles and the cost
    control
  • Inventory reduction in the system (e.g remedies,
    additives)
  • Standardization of the information flows

Our experience of many years with material flow
analysis shows cost reduction possibilities of
the operating costs of the examined material
cycles between 3 and 8. In the areas waste,
water and energy, obviously higher savings (up to
50) can be achieved.
7
Business activities of ARÖW
  • Material flow analysis and cost evaluation in
    hospitals and clinics
  • Formulation of technical organizational measures
    for optimization of the consumption of resources
    (energy, water, material, remedies and additives,
    disposal etc.)
  • Simulation and evaluation of measures with regard
    to reduction effects
  • Development of an integrated system for the
    optimization of the material flows
  • Accompaniment in the preparation for
    certification / validation according to e.g.
    Ökoprofit or EMAS II

Firstly, through a rough analysis, the areas of
the reduction possibilities are being determined.
A subtle analysis, which emphasizes the results
derived directly from the rough analysis, shows
which concrete measures are necessary and which
savings are possible.
8
Thematic complex Technology Water and heat
Many aggregates work in not adapted working
areas, and therewith they are inefficient.
In this case an optimization of the efficiency
causes a cost reduction of 8.
9
Thematic complex Technology Water
Wäscheversorgung
For an ecological and economical optimization the
data have to be collected and assigned to the
respective cost centers.
A reduction within the top 5 of the points of
consumption means approx. 20 cost savings.
10
Thematic complex Individual behavior Handling
water
To realize an ecological and economical
optimization, the data have to be collected and
assigned to the consumers.
A sensitization of employees and patients can
lead to a cost reduction up to 15.
11
Example 1 Possibilities of saving water in
hospitals
12
Example 2 Technology Economization of water
and energy in the laundry
After
Before
Economized water 3,07 m3 per washing program
(300 kg laundry)Economized electricity 47,78
kWh per washing program (300 kg
laundry) Optimization by installation of a heat
exchanger, reduction of the main wash temperature
from 72 C to 62 C and application of rinsing
water in the primary washing.
13
Example 3 Technology Utilization of
water-saving equipment
By using modern scourers for plug-in basins a
reduction of the water consumption up to 60 can
be achieved.
14
Example 4 Savings by a change-over of technology
and organization
  • Raphaelsklinik Münster GmbH, 775 employees
  • Savings
  • Energy/emissions approx. 68.260 and 544.000
    kWh per annum
  • Waste approx. 20.963 and 4,4 t per annum
  • Water/waste water approx. 2.300 and 500 m3 per
    annum
  • Investment (one-time) approx. 54.197
  • Clemenshospital GmbH, Münster, 1.052 employees
  • Savings
  • Energy/emissions approx. 39.185 and 12.200
    kWh per annum
  • Waste approx. 30.166 and 4,4 t per annum
  • Investment (one-time) approx. 10.226

Examples from Ökoprofit-projects that were
realized in Münster
15
Cooperation offer
  • Starting points for a cooperation
  • Material flow analysis and optimization in the
    area of water, energy, waste, operating supplies
    etc.
  • Qualification / sensitization of the personnel
    for an environmentally conscious behavior/acting
  • Preparation and accompaniment of e.g. continuous
    melioration processes, validation / certification
    according to EMAS II etc.

16
Development of the project
  • Definition of the prior areas to be analyzed
  • Filling out of the basic checklists with
    well-known data from the different areas for the
    preparation of the first round of inspection
  • Common round of inspection with an expert from
    the hospital
  • Detailed project proposal with a specification of
    costs (offer)
  • Realization of the project

17
Gesellschaft für Arbeits-, Reorganisations- und
ökologische Wirtschaftsberatung mbH
Thank you very much for your attention!
Contact person Andreas Rebhan, Dipl. Ing.
Mülheimer Str. 43 47058 Duisburg Tel. 49 (0)
203 346 91 -0 Fax 49 (0) 203 346 91 -20
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