It is no surprise that hospital foodservice directors are vigilant in protecting patient safety, but it may raise a few eyebrows to find out that one of their critical patient care concerns is keeping corrugated boxes out of their facilities. This topic was brought to light in a recent report, Hospital FSDs fighting a battle against corrugated cardboard.
“The fact of the matter is, cardboard is filthy,” Eric Eisenberg stated bluntly in the piece. Eisenberg is corporate executive chef for nutrition, catering, retail and conference services at Seattle’s Swedish Health Services,
The issue with corrugated containers for hospital food storage operations is that the paper-based structures are porous. They can absorb and retain liquids, not to mention any contaminants they make incidentally contact on the truck or at the loading dock. Additionally, hospitals have a concern that they may become infested with insect pests as they move along the supply chain.
At Swedish Health Services and other facilities, products are de-boxed from corrugated outer cartons to eliminate these risks. Another health group following this protocol is the UC San Diego Health system. Foodstuffs are removed from shipping boxes upon receipt and placed in large plastic containers. Christopher McCracken, director of nutrition services, said that the state of California directed their new facility to have a de-boxing room.
The solution is not without challenges, however. McCracken noted that with de-boxing, there is a greater reliance on staff to make sure that stock in containers is being rotated to ensure that oldest items are used first. Additionally, he expressed concern about how to identify specific production lots in the case of a product recall.
In spite of the issues, the hospital foodservice directors are looking to keep corrugated out of their facilities. “We’re a long way from having a perfect solution—but I think [de-boxing] is going to become a part of people’s regular process,” Eisenberg noted to Food Service Director. “I think, in healthcare, the idea of cardboard will go away.”
Corrugated Poses Other Challenges for Hospitals
Aside from foodservice, the threat of cross-contamination and insect infestation is also top of mind for medical supply storage. As a result, some hospitals also mandate de-boxing requirements for those operations.
For example, a training document from Ontario’s University Health System states “Corrugated boxes are NOT appropriate as storage units in medical or clean supply rooms...Corrugated boxes may harbor dust, bacteria, and insects that may have entered the box during shipping.” The document instructs staff members to remove products from boxes and place them in plastic bins.
In addition to cross-contamination, another challenge for hospitals is simply dealing with the storage, flattening and removal of empty boxes. In recent years, hospital loading areas have become increasingly cramped for space, driven in large part by the waste generation associated with disposable medical items as their usage has grown.
One increasingly popular solution to dealing with solid waste as well as the threat of cross-contamination is the use of an off-site warehouse facility to perform the de-boxing duties, placing only the required amounts of product in plastic containers on a “just-in-time” basis. This approach eliminates the need for the hospital to remove products from corrugated boxes, and because stock levels are minimized, it reduces concerns about stock rotation or the tracing of recalled product. Stanford University Hospital, for instance, receives two truckloads of supplies daily, packed in plastic totes to service its various department and stocking locations.
When it comes to providing the best in patient care, hospital administrators are increasingly looking to packaging selection as part of the cure. In this regard, they are not alone. Other industries, such as perishable products, are also exploring the positive role that transport packaging can play. RPCs, for example, are an alternative to corrugated packaging that not only preserves overall product quality throughout the supply chain, but which also provides dramatic environmental benefits and potential supply chain cost savings. How about your supply chain packaging – is it what the doctor ordered?