PowerPointPrsentation

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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. [phone] Fax 49
(0) 203 346 91 -20
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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

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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.
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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.
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Solutions for the hospital
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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.
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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.
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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.
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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.
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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.
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Example 1 Possibilities of saving water in
hospitals
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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.
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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.
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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
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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.

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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

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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 [phone]