Surgeons work wonders today. Need a replacement for a knee, hip or elbow? That's not a problem for modern medicine and the medical device industry.

Behind these surgeries—and far, far from the public eye—are the distribution and sales people for the medical devices used. These people are worriers. They are concerned about making sure these surgeries proceed on the day scheduled. They work wonders, too. They supply, in a timely way, the right medical devices to the right hospitals and surgeons, ensuring the surgeon isn't empty handed in the O.R.

'A surgeon may schedule tomorrow's surgery for noon,' says Dave Johnson, director of distribution, DePuy, Inc., 'placing the order for the needed medical device today.'

DePuy, Inc. is a major medical device manufacturer and distributor. Its distribution center near Bridgewater, Mass. ships medical devices on a just-in-time basis directly to hospitals. It also ships them just-in-time to its U.S. sales force of individual representatives who deliver the devices to hospitals.

DePuy does so with a very high degree of accuracy and with just-in-time speed and immediacy. Same-day turnaround is standard procedure for most orders.

DePuy is the oldest manufacturer of orthopedic implants in the United States. Back in 1895, salesman Revra DePuy introduced wire splints to replace wooden splints, founding his company.

Fast forward to 2004 and DePuy has become a family of companies under the Johnson & Johnson corporate umbrella. In Bridgewater, Mass., the DePuy distribution center serves the shipping needs of three affiliated manufacturing companies, each located nearby—DePuy Spine, DePuy Orthopedics, and DePuy Mitek—as well as the Codman company. DePuy also distributes devices from other suppliers.

From a relatively small DC—just 92,000 square feet—DePuy annually ships medical devices to support over 500,000 surgeries, says Johnson. The products shipped include spine implants, surgical instruments, and replacement kits for new knees, hips, elbows, and the like.

What drives DePuy distribution to achieve a high level of excellence? Its customers, both external and internal, do.

A surgeon demands a specific type and size of device to make a new knee for a patient. Others set high requirements as well. DePuy distribution must answer to Johnson & Johnson internal policies. The DC also must pass inspections from the U.S. Food & Drug Administration. The facility also is ISO certified.

'Compliance to quality assurance procedures is common to very much of what we do,' says Johnson.

The DC achieves these quality and accuracy objectives with a combination of semi-automated and mechanized systems for materials handling. The facility's semi-automated systems include horizontal carousels as well as vertical lift modules. A vertical carousel and a vertical lift module (VLM) fulfill a quality control role as well.

All of these storage and staging units (Remstar) work alongside other materials handling systems and equipment that includes narrow-aisle rack with wire-guided forklifts, conveyors, flow racks, bar code scanners, and radio frequency data communication terminals for real-time information control. See the layout above to read how this equipment and systems are integrated to fill orders day-to-day.

The vertical storage units and horizontal carousels together with their order selection software ensure that picking accuracy exceeds 99.9%, says Johnson. These systems also save floor space, he adds, as does the high-density storage capability of the narrow-aisle rack system.

Working three shifts daily on a six-day week, this DC selects orders from a total of 14,000 active DePuy stock keeping units (SKUs). Each order averages five or six lines.

The DC ships an average of 2,200 orders each night. About 70% to 80% of these shipments are for overnight delivery, says Johnson, making the DC the stockroom for many surgeons.

Much of this daily volume is packed in small parcels, he adds. Significantly, outbound parcels include many high-value items. In fact, some shipments are worth several thousand dollars.

With shipment values this high, it's important to maintain tight controls over DC inventory. It's also vital to ensure a high degree of accuracy in picking, packing, and shipping these medical devices.

Orders received at hospitals are on a consignment basis until used, Johnson says. With lead times of only a few days for items from nearby DePuy manufacturing units, the DC's inventory is kept lean. DePuy sales reps know their customers well, he adds, and they are good at reordering.

Order fulfillment is far from fully automated.

Johnson says that DePuy's materials handling philosophy is 'to create an efficient and effective distribution system with as close to flawless execution as possible.' In this DC, he says, 'we could go lights-out, but that wouldn't be effective or cost-efficient.'

A flow-rack picking area provides sufficient efficiency, for example, combining mechanization with manual handling and using bar code scans to limit picking errors. The area holds 7,000 SKUs. Daily, some 1,400 orders are pulled from this area.

DePuy operators pick orders manually from bins through using pick tickets in the flow rack area. To ensure high picking accuracy, and eliminate errors, Johnson says, he requires bar code scans several times during the picking of each item.

But order selection activities involving picking and order verification from horizontal carousels and a VLM are more automated. So, too, is quality assurance paper documentation involving the use of a vertical carousel for file storage in the quality control lab.

Three horizontal carousels, for example, are grouped together with 3,800 SKUs. On an evening shift a single operator—assisted by the carousels' light trees and software providing exact pick instructions—pulls outbound orders from this system.

'Picking accuracy is well over 99.9 percent,' says Johnson. 'The carousel software does all the sorting and picking for us,' he adds.

Each night, within a time span of three to four hours, the lone carousel operator picks 500 orders. Before the use of this technology, it took five operators picking batch orders to match this one person's productivity.

During the day shift, an additional 150 'emergency' orders, with 3 to 4 lines per order, are picked from the horizontal carousels.

Faster moving items are staged in the carousels' golden zone for more ergonomic picking, says Johnson.

Similarly, a VLM holds some 2,000 kits of DePuy spine implants and surgical instruments. On a daily basis, orders for 150 to 250 kits are picked, and about the same number putaway in the VLM.

'Order selection from the VLM is a lot easier than going looking for these kits on shelving,' says Johnson. With the VLM subsystem presenting the kits at a comfortable working level for picking (or for putaway) there's also little fatigue for operators.

Two vertical carousels are located in the packing and redress area. Here they perform such functions as product segregation and labeling, explains Johnson.

Finally, semi-automated vertical handling systems support DePuy distribution's quality control efforts.

These efforts are necessary to satisfy requirements of the FDA's good manufacturing practices (GMPs) as well as to meet DePuy's ISO certification. All incoming items from all the Johnson & Johnson divisions that DePuy serves must undergo quality control as do all items requiring sterilization before use. A vertical carousel stores and retrieves the paper documentation necessary for these efforts. A VLM stages materials prior to inspection and keeps them separated and organized, explains Johnson.

Before the surgeon's hands can work the wonders of hip and knee replacements, DePuy distribution manages the last link in the supply chain for these surgeries. Through DePuy's use of semi-automated, mechanized, and manual material handling systems, the surgeon is not left empty-handed or without the right devices and instruments.

Click on the icon to read how Rogan Corp. improved its manufacturing processes with the installation of 5 VLMs.  (Verical lift modules open a door for knob company - Oct. 2, 2003 - Casebook Directory)