Mapping and Analyzing Internal Hospital Material Flows: A Case Study of the Best Service System at Kalmar Hospital

Sammanfattning

This study examines the operational stage of an internal hospital logistics system, BestService, implemented at Kalmar Hospital in Region Kalmar. The purpose is to develop apractice-level understanding of how traceability limitations, routine variation, andcoordination practices shape the reliability and efficiency of the material flow between thecentral warehouse and the emergency department. The study also aims to identify areas forimprovement in flow reliability, efficiency, and workload in hospital logistics operations.A qualitative case study design was adopted, based on seven semi-structuredinterviews and 24 hours of direct observations across the warehouse, transport unit, andemergency department. The empirical material was analyzed abductively using fourcomplementary theoretical perspectives: Lean principles, process flow analysis,organizational routines, and a sociotechnical perspective.The findings show that the material flow is characterized by interrelated proceduralchallenges, particularly limited traceability across process stages, variation in routines andflow timing, reliance on manual coordination, delayed detection of disruptions, and limitedvisibility into prioritization. These conditions give rise to searching, checking, follow-up, andinformal communication. From a Lean perspective, such activities can be interpreted asnon-value-adding. At the same time, the analysis shows that such activities function ascompensatory practices that help sustain continuity under conditions of limited systemvisibility and coordination uncertainty across process interfaces.The study contributes conceptually by showing that reliability in internal hospitallogistics does not emerge solely from formal process structures, but through compensatorycoordination practices that stabilize incomplete sociotechnical systems in everyday work.These practices include searching, follow-up, informal communication, and manualcoordination across process interfaces. Practically, the study identifies areas for improvementrelated to enhanced traceability, stronger feedback mechanisms, and improved prioritizationvisibility. It also highlights the need for better alignment between planned process structuresand actual execution to support a more reliable and resilient material flow.