Automated system transports instruments for surgery at SKH

The system delivers ready-to-use instruments directly to operating tables.

Singapore’s Sengkang General Hospital (SKH) is using robots and conveyor belts to store, retrieve and transport delicate surgical instruments to its operating theatres, doing away with manual searching and heavy lifting.

“The automated storage and retrieval system tracks inventory in real-time,” Moarie Grace Tan, assistant director for nursing and operating theatre services, told Healthcare Asia. “It is controlled by computer-operated cranes and shuttles that move along the aisles to pick and deposit items in storage locations.”

The system keeps a “first in, first out” method. “Manually maintaining this process is extremely physically demanding. The system helps minimise human error,” she said via Zoom.

Before, surgical instruments were stored in various places across the hospital, which made space management inefficient.

In a traditional central sterile supply department (CSSD), storage racks hold multiple sets, making it time-consuming to find a specific one, Tan said.

“Now, it’s much easier. Staff simply tap a computer screen for the set they need, and the system automatically retrieves it,” she added.

The storage system assigns each container a barcode, ensuring that these are sterilised before being stored.

“If a set has not gone through the proper procedures, the system automatically rejects it and flags an error,” Tan said. “Our CSSD must comply with strict health standards, including maintaining sterility and preventing cross-contamination.”

The system operates in a controlled environment, away from human traffic.

“There are barricades to prevent anyone from entering the area,” she said. “With this system, there is no human interference; only robots are working.”

Tan said SKH is transitioning to a system where instruments are delivered one to two hours before each surgery. “Previously, a full day of procedures in a single operating room required instruments for those surgeries to be picked and sent to the operating theatre in one batch.”

The high-tech storage system had to go through stakeholder engagement, feasibility analysis, and hardware and software development, said Jeff Tang, a senior executive at the Nursing Division, Central Supply Sterile Unit at SKH.

He said they have a warehouse management, listing, and tracking system that monitors inventory. “We had to synchronise all three to ensure the automated storage and retrieval system functions effectively,” he said in the Zoom interview.

“Once surgery is scheduled, the system synchronises data, allowing the system to deliver ready-to-use instruments directly to operating tables,” he added.

Precision engineering also had to be taken into account, because even a three-millimetre variation could affect the way containers move along conveyor belts.

“Even the slightest difference could cause unnecessary jittering,” Tang said. “We had to carefully strike a balance between ensuring smooth movement and preventing unnecessary damage.”

Another challenge was convincing staff, especially senior employees, that automation would ease rather than complicate their work. After training, they have become some of the strongest advocates for the system,” he added.

SKH is also in the implementation phase for automated mobile robots (AMR) to complement the system, Tang said. “These AMRs will handle the last-mile delivery of instruments retrieved from the automated storage and retrieval system, ensuring improved distribution speed and better accuracy.”