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Procedia Engineering 192 ( 2017 ) 665 670 Available online at 1877-7058 2017 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http:/creativecommons.org/licenses/by-nc-nd/4.0/). Peer-review under responsibility of the scientific committee of TRANSCOM 2017: International scientific conference on sustainable, modern and safe transport doi: 10.1016/j.proeng.2017.06.115 ScienceDirect TRANSCOM 2017: International scientific conference on sustainable, modern and safe transport Implementation of Automated Guided Vehicle system in healthcare facility Marko Pedan a *, Milan Gregor a , Dariusz Plinta b a University of Zilina, Faculty of Mechanical Engineering, Department of Industrial Engineering, Univerzitn 1, ilina 010 26, Slovak Republic b The University of Bielsko-Bia a, Faculty of Mechanical Engineering and Computer Science, Department of Production Engineering, Willowa 2, Bielsko-Bia a 43 309, Poland Abstract The article deals with the use of automated guided vehicle (AGV) system in the hospital. This paper provides the requirements and technical specifications of AGV cart designed for healthcare facility. The second part describes the application and benefits of AGV implementation in selected health care facility gained from computer simulation that is used as a verification tool. This part also contains the economic evaluation of this implementation and summary of further investments related to this technology. 2017 The Authors. Published by Elsevier Ltd. Peer-review under responsibility ofthe scientific committee of TRANSCOM 2017: International scientific conference on sustainable, modern and safe transport. Keywords: AGV; healthcare; improvement; simulation; efficiency 1. AGV for healthcare facilities Automatic Guided Vehicles (AGV) or self-guided vehicles (SGV), have been widely used in material handling for decades 1. In these days, the demand for mobile robots and their use in hospitals has increased due to changes in demographic trends and medical cost control. For healthcare facilities, these automated systems are designed specifically for handling bulk material, pharmacy medicines, laboratories samples, central supply and transportation of food, dirty dishes, bed laundry, waste (biological, recyclable), biomedical instruments etc. Operating efficiency is gained by automating these supplies, which allows the transfer of human resources to other departments or activities. * Corresponding author. Tel.: +421-41-513-2713 ; fax: +421-41-513-1501. E-mail address: marko.pedanfstroj.uniza.sk 2017 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http:/creativecommons.org/licenses/by-nc-nd/4.0/). Peer-review under responsibility of the scientific committee of TRANSCOM 2017: International scientific conference on sustainable, modern and safe transport666 Marko Pedan et al. / Procedia Engineering 192 ( 2017 ) 665 670 Automated systems are working 24 hours a day, 7 days a week. Automated solution can streamline traffic flow of material in the hospital, control costs, reduce workload. Hospital operating installation have to fulfill some important requirements, see Fig. 1. These requirements and the use of modern logistics systems significantly affects the operation of the entire facility and its economy, improves the quality of patient care and increases their safety. 2 Fig. 1. The requirements for AGV integration in healthcare facility (Source: author). 2. The 3D design of AGV model for healthcare facilities The use of automated transport system (AGV) relieves hospital staff and allows them to spend most of their time on direct patient care. This increases safety in the hospital by minimizing potential injury to the staff when pushing heavy carts. The system monitors all major movements in the hospital and may prefer the most important jobs and tasks that can be completed first (e.g. surgical instruments transported first, then food for patients, bedding, eventually garbage, etc.) 3. AGV is equipped with sensors to detect obstacles that allow safe stop before hitting obstacles that might be in the way. The system and its vehicles is reliable, safe, efficient and cost-effective 4. Applications and commands are mediated through a user-friendly touch screen. The system is fully integrated for automatic control of doors, elevators, trolley washers, garbage dump truck, etc. Fig. 2. Low profile Automated Guided Vehicle for healthcare facilities (Source: our research). This designed 3D model of vehicle, see Fig. 2., has technical specifications specified in Table 1, and we will use it in the simulation model, which verifies its potential implementation in the hospital 5. 667 Marko Pedan et al. / Procedia Engineering 192 ( 2017 ) 665 670 Table 1. Technical specifications of designed AGV. Technical parameters Values Dimensions 127 x 63 x 32 cm Speed (max.) 2 m/s Load carrying capacity (max.) 500 kg Battery capacity 100 Ah The transport principle will be carried out in such a way that the medical supplies will be transported by special transport boxes that AGV cart undercuts and then lifts up. Fig. 3. describes the principle of object transportation using designed AGV cart. Fig. 3. also shows the key dimensions of the vehicle and transported objects which are necessary to be observed when transporting boxes. Fig. 3. The minimum dimensions of the transport box and the distance between the vehicle and transport box (Source: our research). 3. AGV implementation in a ward of healthcare facility. In selected healthcare facility we designed AGV integration in the following areas 6: Food transportation to the patient rooms. This process represents the provision of food transportation from the food arrival, which provides the external company, to the food transportation provided by AGVs to the kitchen, then sorting the meals for patients by healthcare staff and distributing the meals by AGVs to the patient rooms. The rooms have designed areas for precise stopping and unloading food from AGVs. Collection and transportation of used and clean laundry. Healthcare facility has their external company, which carries away and washes the dirty laundry and delivers the clean one back. The facility can use AGVs for the internal transport service. Transportation would consist of loading the laundry box and transporting it to the desired location (central storage). Transportation through the floors will be carried by freight elevator. Waste transportation. Waste will be transported from a well-marked spaces and areas from the whole ward. The waste will be collected on these places in special boxes. The AGVs will then take and move the waste to the temporary storage of waste to the base floor. 668 Marko Pedan et al. / Procedia Engineering 192 ( 2017 ) 665 670 3.1. The visualization of AGV integration in simulation software SIMIO We used simulation software for verification of our suggested implementations of AGVs in inpatient ward. For this purpose, we used software Simio in which we have imported the real objects and the physical disposition of healthcare facility. Fig. 4. shows the transportation process of food in the ward in digital environment 5,6. AGVs in this simulation software follows the inpatient ward streams that we have mapped and analyzed (i.e. the movement of medical staff and medical material). Transport between the floors will be carried by freight elevator, see Fig. 4a. AGVs will then transport the food to a designated locations in patient rooms 7, see Fig. 4b. Fig. 4. (a) food transportation to the inpatient ward by freight elevator; food unloading in patient room (Source: our research). 3.2. Simulation as a decision-making tool Simulation in healthcare can be considered as an effective tool, technique or method 8. Healthcare personnel especially decision makers - directors and managers - need reliable operational tool that supports them in decision- making process. Such techniques and tools help them in reductions of costs, waiting time of patients, future predictions of patients arrivals and provide them with visualization that enables them to prepare staff and all resources that are necessary for provision of high-quality healthcare service to the patients at the right time 9. These tools should also facilitate the decision making evidence and informative environment. Simulation models, especially those with transparent structure to their core variables that can be easily understood and trusted by people with decision-making competence, are a useful tool to support decision-making, communication, discussion, ideas, policies, scenario analysis, from which they can gain knowledge and from which they can learn 10. That was also our case, since we needed to create a simulation model of a real healthcare facility that will help the management to decide whether to implement the AGV system or not. After many interviews with the hospital leaders we have created several model variants. Whereas the creation and process of a simulation study is very extensive, in the next chapter, we bring and summarize the most important outcomes and results that were the key ones for healthcare managers 7. 3.3. The benefits from AGV integration gained from simulation runs With the AGV integration we were able to save 345 minutes of total 1440 minutes (representing 23.96 %) for medical assistant (MA) per day, see Table 2. This can result in the transfer or movement of medical assistants to activities and tasks that our legislation allows them 5,6, so they can spend more time with patients. Furthermore, we were able to relieve the cleaning and transporting services of heavy and dangerous waste by AGV system integration. Among other things, the AGV can be also used for transportation of medicines and medical supplies with low requirements on safety or hygiene. This integration will bring benefits associated with the reduction of damage, unreasonable and incorrect shipments, and physically heavy transport. Another advantage is that the vehicle can operate 24 hours a day while meeting the requirements of charge. 669 Marko Pedan et al. / Procedia Engineering 192 ( 2017 ) 665 670 Table 2. Healthcare staff time reduction. Staff Activity Current state (min.) After AGV integration (min.) Time reduction (min.) MA Morning toilet 150 150 0 Blood test subscription 300 300 0 Clean laundry delivery 75 0 75 Breakfast delivery 60 0 60 Lunch delivery 90 0 90 Afternoon toilet 300 300 0 Dinner preparation 30 30 0 Dinner delivery 60 0 60 Evening toilet 300 300 0 Dirty laundry transport 60 0 60 Total 1440 1080 345 3.4. Economic evaluation The final chapter brings the economic evaluation of AGV integration in selected healthcare facility. In Table 3 we can see the investment intensity of the project. It must be said that the costs are calculated according to initial analysis only approximately, so for precise determination of the exact amount of the costs of such a project there will be needed additional analyzes 6. These analyzes have not been carried out, due to the short duration of the project and other requirements from healthcare facility. Table 3. Investment intensity of AGV integration. Costs Price () Comments Purchasing and setting AGV cart 50, 000 Installing and marking AGV navigation 700 Floor marking Customization of hospital environment 65,000 Door, elevator and AGV interface Total 115,700 To calculate the hourly costs for running an AGVs we used input costs, which are around 115,700. From these calculated costs we expressed our monthly operating costs of 4 % (specified by the AGV manufacturer) 6, representing a value of 4,628/month. From this value we expressed the operating costs necessary for one day provision ( 154.27/day). In the last stage of the calculation, we found out the hourly cost of running the AGV at around 6.43/hour. These values were then compared to the hourly cost of medical assistant in inpatient ward ( 3.5) from which we can see that operating costs of AGV are almost 2 times higher, see Table 4. And although this is a rough calculation of operating costs, it gives an approximate idea to the managers of healthcare facilities whether it is good to think about the implementation of this technology. Table 4. Hourly operating costs. Operator Operating costs per hour () Medical assistant 3.5 AGV 6.43 670 Marko Pedan et al. / Procedia Engineering 192 ( 2017 ) 665 670 4. Conclusion Case study, which we have tried to introduce to you in this article was carried out at the request of the director of healthcare facility in order to identify the potential implementation of AGV system in the hospital. In the case study, we designed AGV cart and transport methods for inpatient ward of healthcare facility. This way of transport we subsequently created in a 3D environment where we have simulated and verified the movement of AGV in terms of the physical layout of the building and material flows in the ward. The final economic assessment then pointed out that the AGV technology is currently not cheap and is affordable only for bigger facilities managing in profit. Proper and effective implementation for a given type of healthcare facility depends on many factors and requires a detailed assessment and analysis 11. The worlds top hospitals, have already adopted this technology and therefore they are reducing operating costs and increasing the quality of their healthcare services, which lead them to rapid cost recovery. However, from our view, Slovakia and its healthcare facilities are not ready to integrate this technology now. The healthcare system is in a position in which he could not benefit from the advantages of AGV systems in a way that the world does 12. AGV is also a technology, which potential is high but its specific application must be analyzed through several methods of industrial engineering (e.g. simulation). Since many healthcare facilities are deterred particularly by high acquisition costs of this technology 13, healthcare managers need to realize that the purpose of the new, modern technology is mainly to help healthcare professionals to work more efficiently and improve the quality of healthcare services. If our healthcare facilities want to respond to technology-driven environment of care and be prepared for the future development, the designers must not only design healthcare facilities as a buildings. They need to meet the requirements of patients and staff, and must predict the future. Acknowledgements This paper is the part of research supported by project KEGA 032U-4/2015. References 1 D. Plinta, M. Krajovi, Production system designing with the use of digital factory and augmented reality technologies, in: Advances in Intelligent Systems and Computing, vol. 350 (2016), ISSN 2194-5357, pp. 187-196. 2 B. Miieta, M. Gao, M. 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