Hospital staff using TransLogic pneumatic tube system station

Optimizing Tube System Safety and Efficiency

Here's How to Maximize Your Tube System

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Robin Arnold | 16 November, 2023

Pneumatic Tube Systems Are Critical to Hospital Operations

Pneumatic tube systems have been around for many decades. They are a valuable technology that continues to be used by hospitals and other healthcare facilities to perform the function of transporting physical materials securely, quickly, and efficiently from one area to another.

Hospital tube systems play a critical role in connecting hospital workflows and offer multiple benefits – like reduced turnaround time for transport. Other benefits include a lower risk of material cross-contamination and biohazard exposure, as well as loss or human error (Patient Safety Authority). The automation of this process results in greater efficiency that helps provide a better quality of care to patients.

What are the Regulations Governing Tube System Transport?

The sensitive nature of the transported material demands that a stringent set of rules and protocols be adopted to ensure hospital safety and mitigate liabilities associated with contamination or improper handling of the materials. This is important both for both employees and patients.

Robin Arnold, protocol and training consultant with Translogic® has been working with hospital tube systems for over fifteen years. During this time, she has become familiar with the specifications and hospital materials transport requirements and has witnessed the passing of new regulations governing the use of medical materials, especially as they relate to transport.

She recommends that hospitals regularly conduct their own research to ensure they remain in compliance with hospital materials regulations and best practices. While many of these mandates are local and will differ state-to-state, the following are two key nationwide regulations that apply to all hospitals operating within the United States::

USP (U.S. Pharmacopeia) Chapter 800: This regulation outlines the responsibilities involved in handling hazardous drugs. It covers facility and engineering controls as well as procedures for deactivating, decontaminating, cleaning, and spill control.

OSHA (Occupational Safety and Health Administration): Part of the U.S. Department of Labor, OSHA has set forth a range of medical materials regulations for hospitals including the handling of hazardous drugs and materials in a manner that is safe for both personnel and patients.

More specifically with regards to pneumatic tube systems, OSHA has issued three levels of containment relating to transported bio-hazard materials:

They must be sealed in an airtight container. This can be achieved using a Zip N Fold® pouch before putting it into a carrier. New hospital tube systems, such as the Translogic NexSeal®, provide a full perimeter seal which protects against accidental spills.
They must be completely immobilized inside the container. This is achieved through special carrier liners that cushion and support payloads during transfer.
The carrier must be locked tight before sending. Newer carriers have been designed to include a tight one-step closure safety latch feature.

Additional Pneumatic Tube Safety Tips Include:

Segregation of carriers by function. This is often achieved through color coding. An extra level of security can be attained by using RFID to make sure that each type of carrier is sent to the correct destination.
Employee accountability. This can become a problem if there is no way of identifying who sent what. New systems, such as Translogic, provide a “signature” of who has signed out and signed in a carrier. Called WhoTube® the system reads a code on the employee’s badge.
Access safety. This can be achieved by ensuring that station access doors are locked to all but authorized personnel.

TransLogic pneumatic tube system transfer units — Pictured: TransLogic Transfer Units

To Tube or Not to Tube?

There will always be differing opinions by hospitals as to materials they approve for transport through a pneumatic tube system. The hospital leadership team is in the best position to determine the kinds of materials that are best transported by the tube system as opposed to manual transfer. That is why it is important for leadership to get together with key individuals and develop clear guidelines for what materials are approved to be sent through the hospital tube systems.

Two examples of highly sensitive materials that are often found on the “do not tube” list are blood and narcotics. This is understandable as many hospitals have concerns about contamination and safety of transfer.

For instance, blood has only been approved for transport through pneumatic tube systems as recently as the mid 1980s. Many hospitals continue to raise concerns about potential contamination which can create a range of issues that can seriously impact patient safety.

With regards to pneumatic tube transport of narcotics, divergence is a major concern among hospitals. Narcotics in the wrong hands can have serious, if not deadly, consequences.

As tube systems continue to evolve, however, new pneumatic tube carrier designs are more secure and tamper proof. Greater accountability is achieved through special safety protocols that require employee identification to be attached to every carrier. In view of these innovations, many hospitals are opting to revisit their current tube strategy to take better advantage of the efficiencies they provide.

Improper Use of Carriers is Often Due to Rushing or Insufficient Training

Regardless of published regulations and standards, there will always be instances of improper use of the tube systems that result in transport of unacceptable items [link to what not to put in a tube blog]. Sometimes it is a matter of ignorance, due to lack of sufficient training. Other times an employee may, in their rush to fulfill a need, fail to properly load or close the carrier. Occasionally it is due to mischief or more nefarious reasons.

These potential issues often support a hospital’s decision to err on the side of under-utilizing their tube systems. While this is understandable, leadership should consider the safety of newer tube systems and optimizing valuable employee time. As Robin points out, you may walk up to any station in any hospital and chances are there will be a notice posted as to what you can’t send through the tube system. Management should ask themselves “Why?”

There may in fact be a compelling reason behind the policy. For some hospitals, however, it may be a policy leftover from years past. It is important to achieve a good balance between risk and the time savings of employees who no longer have to walk a blood sample or a package of narcotics across a busy hospital campus. There are, after all, risks associated with manual transfer as well. Ultimately, their time might be better spent with patients.

Every hospital tube system policy should include regular evaluation of system efficiency as well as inspections to ensure that pneumatic tube carriers and the tube network remain clean and in good working order. These are valuable tools to move critical materials from one point to another quickly and safely and to lift the burden off clinicians. Optimizing their use and keeping them in good working order should be a high priority.

If you’d like us to help review your policies and share best practices as a leading supplier in this space, please feel free to contact us. We have installed over 3,000 pneumatic tube systems worldwide and have been actively helping customers maximize their workflows for over 100 years. As you can see, we’re more than just a tube system.