Thursday, February 13, 2014

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.

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