SAN ANTONIO – Aging populations and an employee exodus from health care have created what’s being called the industry’s “great staffing shortage.”
The Texas Hospital Association reports health care staffing shortages in every sector of hospitals.
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In a mad dash for solutions, the key is efficiency. Hospitals keep staff doing the most important tasks in the least amount of time.
For University Hospital in San Antonio, one of the answers is robots.
HEAVY HOSPITAL HAULS
On the basement floor of the hospital, a machine sat at the elevator labeled “robots.”
A voice sounded out saying, “Calling elevator.” As a person approached, the voice said, “Waiting for doors to open.”
The shoulder-height machine has a connected flatbed that links up to a series of metal carts loaded with trash, linens and recycling collected throughout the hospital.
The robots go back and forth, day and night, mostly without much help from humans.
“This is the busiest intersection they have,” University Health Automated Guided Vehicle Logistics Manager James Stranahan said.
In the hospital’s sprawling basement, 23 robots roamed in lines picking up and dropping off carts as well as getting on and off elevators.
Stranahan oversees the fleet of 23 robots and said University Hospital is the only hospital in San Antonio using them.
“They have multiple sensors: infrared, sonar and navigation lidar, safety lidar, and it also has time of flight sensors on the side,” Stranahan said. “That allows it to navigate safely around people and, if there’s an obstacle in its path, it will navigate around it.”
The first version of the bots came in 2014, but they weren’t as efficient in their movement. In 2022, the current models rolled in.
“You still need people to clean the ORs and all that, but they don’t need to waste time to take the trash down to the trash room and also bring empty stuff up. And also with linen, soiled linen, the carts can weigh up to 1,000 pounds,” Stranahan said. “They just have the people be able to do their jobs better,.”
All the humans operate are touch screen consoles on every floor.
“We hit ‘Go,’ and now we have an empty trash cart scheduled to come up here,” Stranahan said. “This is a map. You can click on the robot and find out where it is. See them on the still cameras if something is wrong or in the way.”
Back at Stranahan’s office is a control room with a huge monitor full of camera shots of the hallways, monitoring the bots.
Also in his office is a trophy.
“We won an award the first year we used these, the Robo Hero Award, from the company that makes these for the most deliveries in one year for a shared fleet,” Stranahan said. “And then one for the most deliveries for a single robot for a shared fleet.”
Stranahan called it a team effort. He hopes the robots can be used for patients’ nutrition and pharmacy services.
“The goal would be to do soiled trays from the floors in a timely manner and hopefully next would be maybe pharmacy to bring up saline solution,” Stranahan said. “Which can weigh thousands of pounds.”
SURGICAL ASSISTANT
Another type of robot at University Hospital is helping save more lives.
“Robotic surgery has revolutionized the way we do surgery for some of the most medically complex and surgically complex patients,” said Dr. Georgia McCann, Gynecological Oncology Chief with University Health and UT Health San Antonio.
McCann uses a multi-armed robot for surgical cases like endometrial cancer, which used to require large laparotomy surgeries.
“Complications from doing a laparotomy like that were very high. So 50% wound infection rate, 30% rate of wound dehiscence, prolonged hospital stay, complicated recoveries,” McCann said.
Using the surgical robot makes it an outpatient surgery instead of a two to 4-day hospital stay.
“With robotic surgery, we are able to do the same and probably larger, arguably better surgery through five small incisions with the same oncologic outcomes,” McCann said.
McCann first looks into a console to use the surgical robot.
“It almost looks like virtual reality, the glasses that I put on, so you kind of put your head into the console, and you’re looking through lenses,” McCann said. “And then there are two finger manipulators. You control the movement with your hands. You can open and close the instruments.”
McCann made one thing clear: “We control the surgical arms at all times, so it’s never a situation where we just let the robot do the surgery.”
The result: more precise surgeries.
“It’s amazingly more precise,” McCann said. “So the magnification that you can see, the anatomic detail that you can see is incredible.”
Every day, McCann said she remains amazed at the surgical results.
“The most rewarding part is when they come back at their post-operative visit and they say, ‘Dr. McCann, I didn’t even need a single pain pill,’” McCann said smiling.
Almost every medical specialty is using these robots. They’re not new — they were first approved in 2006 — but they are constantly developing.
“It’s life-changing, I think, from both a patient perspective and a surgeon perspective,” McCann said. “I think if you talk to a lot of surgeons, you’ll find that it’s added longevity to their career from an ergonomic standpoint, as well.”
STERILIZING HOSPITAL ROOMS
Now zoom in to after those surgeries when patients are released from the hospital.
Their rooms need to be perfectly sterilized and ready for the next patient.
That’s where a different robot comes in.
“It’s a UV light that kills all pathogens,” University Health Environmental Services Manager Mohammed Al-Tameemi said.
Al-Tameemi oversees that robot, seeing how much it expedites crucial cleaning efforts.
“It clears out 99.9 percent of CDEF and MRSA, everything else,” Al-Tameemi said. “But it doesn’t help with COVID.”
Al-Tameemi tapped several commands into a touch screen on the robot. The purple dome on top of the robot began to rise up, revealing the light.
The light is so bright that people can’t stand in a small room with it. Thanks to a big empty hallway, KSAT got a demonstration.
NOT YOUR AVERAGE ROBO VACUUM
That isn’t the only cleaning machine that roams the hospitals.
Visitors in any main University Hospital lobby can catch a glimpse of WALL-E, the sweeper robot.
“It sweeps all of our lobbies from Women and Children’s, to Sky Tower, to Rio, to some of our back lobbies,” University Health Environmental Services Assistant Director David Harris said. “It pretty much works all day. We pretty much have it doing four schedules a day.”
Harris oversees the robot. Once it’s programmed, Harris said he doesn’t need to do much.
“It won’t hit anybody. It had the lidar system on it, so it sees everyone,” Harris said. “So this is the whole map of what it will clean throughout the day several times a day.”
Inside is a trash bag and filter, and it doesn’t just pick up dust.
“Masks,” Harris said. “People drop masks all the time on the floor. Cheetos, French fries, collected earbuds one time.”
Other than attempting to steal earbuds, WALL-E is a popular staff member.
“We love it, kids love it, visitors love it,” Harris said.
The human cleaning employees love it, too, because it’s a solution for their workflow efficiency.
“So that employee can now do the higher task, the harder task, the more detailed task while this guy can run 24 hours a day,” Harris said.
Each team said there are more developments and higher-level robots still in the works.