pneumatic tubes vs human based transport

Something which often goes unsaid in much writing about the wonders of pneumatic tube technology, is that they are used in many places to replace staff. Or, as described in one Indian press release, "human based transport" (or HBT, as it is abbreviated to). There have been a few articles from India that I have come across describing how pneumatic tubes can replace (or displace) work performed by individuals such as ward boys, orderlies, patients' attendants and relatives. For example, Healthcare Express reports some of the problems of HBT:

1. Delays: "Hospital's staff carrying the materials may get diverted to a corner for a quick cigarette or a bidi or even choose to have a quick cup of tea with his or her friends - not realising the critical life saving time being wasted".
2. Mistakes: "During the physical carrying of test tube samples, the carrier staff member suddenly trips over and the samples/materials fall off and break" (again loosing critical life saving time). Also, samples and materials may become mixed up, in this "conventional mechanism", which may have grave consequences.
3. Theft: "A universal problem, invariably theft is very common during transportation of drugs, instruments and other materials".
4. Exposure: Confidential and classified materials could be exposed to "unwanted personnel".
5. Biohazard: Carrying a sample involves risk of exposure and cross-infections
6. Personnel: "over-hiring of staff etc"
7. Energy: "Use of dumb waiters and elevators for running such errands causes high consumption of energy".

In the Hindu Business Line, readers are asked to imagine the following possibilities:

Situation A: Someone in your family is admitted in hospital. The patient obviously will need an attendant by his/her side to buy the medicine prescribed (if not anything else) from the pharmacy located (invariably) within the premises. Imagine climbing the stairs or waiting for the lift every time a prescription is issued. While this gives the attendant some respite from the confines of the room, from being near the patient all the time, it may also involve a lot of running around. 

Situation B: The patient has to be moved to the Intensive Care Unit (ICU)/Operation theatre. Imagine the time that one needs to wait before the stretcher or wheel chair is brought in to help move the patient. As seconds tick, the attendant's blood pressure tends to rise. If only technology can help solve such issues….

Technology is there to the rescue - pneumatic tubes obviously. Each of the two articles above propose pneumatic tube technology as the solution to these human transport based dilemmas. At Kovai Medical Centre and Hospital, pneumatic tubes are reported in the Hindu Business Line to have led to a much quieter hospital: “With the installation of the PTS, the working atmosphere at the pharmacy and laboratory has become strangely silent since the number of encounters by staff in service areas and conversation with patients' assistants have vanished,” says the hospital president. The pneumatic tube system now makes around 600 transportations a day, replacing the trips made by ward boys/girls. The tube system in Kovai is also viewed as correcting human errors made with mixing-up samples, and most importantly, preventing cross-infection, as, according to the hospital president, "the patient assistants or ward staff need not move in and out of the patient area in their street shoes,”. The final line of the Hindu Business Line article alludes to where all of these human based transporters (called the unskilled workforce) may potentially be deployed: in distributing linen and instrumentation sets at the nursing station.

Image of Nigel Rapport's beautiful ethnography of hospital porters, Of Orderlies and Men.

crash course in pneumatic tubes

In New Dehli or Ottawa, or at least nearby?

Here are a couple of courses which might take your fancy:

The International Institute of Healthcare and Medical Technologies is offering a three day crash course in August about pneumatic tubes.

Who should attend? Hospital administrators, hospital engineers, biomedical students, hospital consultants, hospital architects, and pneumatic tube ethnographers perhaps? Visit http://www.iihmt.org/ for more details or email info@iihmt.org.

The Canada Science and Technology Museum is offering a five day course on reading aftifacts also in August, where participants get to explore using artifacts as resources for research and teaching, explore material culture methodologies and learn conservation, cataloguing and collection techniques.

Who should attend? Graduate students, post-docs, faculty interested in teaching history through artifacts and scholars seeking to expand their research methods. Registration closes June 15th. For further information contact sbabaian@technomuses.ca.

Image my own, from the Post Museum in Paris.

new tubes for old hospitals

Hospital architecture has to constantly evolve with medical technology. It has been said that a hospital is already outdated by the time it is built. New imaging techniques mean new radiological suites, laproscopic surgery calls for different operating room spaces, and green star ratings requires modifications in temperature control, water management and waste disposal. Existing pneumatic tube systems are updated, and installed, adapting to the needs of the hospital.

New wards in hospitals are being installed with pneumatic tubes, such as at Vista Health System, in Waukegan, Illinois (USA), where a new pneumatic tube system in the Progressive Care Unit delivers "supplies and medical documents directly to the nurses station". In Kovai Medical Centre and Hospital, in Coimbatore, Tamil Nadu (India), a new pneumatic tube system not only "helped reduce medication errors, mix-up of laboratory samples, sample misplacement" but also supposedly "improved the working relationship amongst staff in the clinical support areas". Since the tubes have also led to a "silent" pharmacy and laboratory, with minimal interaction between staff and patient assistants (moving in and out in the street shoes), one can't help but wonder what other effects the technology may be having on working relationships in the hospital.

This photo, from Flikr, shows a steamfitter and foreman for SwissLog checking pneumatic tube piping for dents. It is part of a series of photos taken by Marc Barnes documenting the installation of pneumatic pipes and other construction work at the Fort Belvoir Community Hospital Oaks Pavilion, in Fort Belvoir, Virginia (USA).