Say the word “warehouse” to many people, and you conjure up images of a dark, dusty, damp place with rows of equipment and boxes, piled to the ceiling.  A home medical equipment company’s warehouse certainly can be the source of problems, deficiencies with standards, safety hazards, and infection control issues.  But with just a little planning, some elbow grease and hard work, and a bit of ongoing monitoring, you can turn your warehouse into a clean, safe, even pleasant environment that improves operational efficiencies and helps your employees do their job well. 

Storage areas –their size and structure—vary greatly from company to company.  Certainly, an organization providing liquid oxygen and heavy DME will have a much different warehouse than a company that provides only soft goods and supplies or an organization providing only TENS units and electrodes.  Keep in mind that the standards are consistent regardless of scope of service and reflect the same simple concepts:

• Separation of clean, patient ready equipment and contaminated equipment that needs to be cleaned and disinfected.
• Safe storage and processing, compliant with all applicable OSHA regulations and fire code safety rules.
• An “flow” whereby incoming shipments from manufacturers, storage of equipment and supplies, loading of outgoing deliveries, and cleaning and equipment maintenance can be performed not only safely, but also in an efficient manner.

Warehouse and storage areas are generally out of the customer’s (or public’s) line of sight, and it’s easy to let equipment accumulate without putting it away properly.  Warehouses can also become a “dumping ground” for anything that an organization wants to put out of sight.  Because the warehouse is usually off limits to the public and customers, it becomes easy to put off keeping it neat and clean. 

The reality is that there is potential for major safety and infection control issues in the warehouse.  Safety and infection control issues translate into deficiencies for the organization, and also make it hard to keep operationally efficient.  Be sure to take a stroll through the warehouse, noting and correcting any deficiencies, inefficiencies, and areas that aren’t in compliance with your best practices.  Follow a checklist similar to the following one to make sure you are consistently compliant:

• Make sure all storage areas have adequate space (rows) between them to allow entrance and egress. Exit signage should be large and lit so that it can be seen if the power goes out.  If the area is large enough, there should be exit strategies—those “you are here” maps that direct you how to exit in an emergency.
• Be sure there are fire extinguishers available and functional.
• Make sure clean, patient ready equipment is separated from cleaning areas and areas where dirty, obsolete, or “needs repaired” equipment is stored. The equipment should be physically separated and there should be signage that designates the areas as such. 
• Make sure clean equipment is actually clean. If patient ready equipment is going to sit around in the warehouse for weeks or even months, make sure it is dust free and kept clean. 
• Follow your organization’s policies regarding equipment bagging and tagging.
• If equipment or supplies have manufacturer recommended temperature ranges that they should be stored in, make sure the area has temperature control, which is being maintained and monitored.
• Cleaning and repair areas should have appropriate personal protective equipment (PPE) including gloves, gowns, masks, eyewash, and first aid kits.
• Keep food and drink out of the cleaning area.
• Cleaners and disinfectants should be appropriate to the type of equipment you are cleaning. Additionally, if there are any specific guidelines, law, or regulation regarding cleaning and disinfecting, ensure you are following them.  For instance, some states mandate specific brands of cleaners for bedding or upholstery. 
• If you provide oxygen, follow all law and regulation regarding oxygen storage (use FDA document “FRESH AIR 2000” as a guideline).
• Check for expiration dates. Eyewash, some cleaners and disinfectants, and some items in first aid kids often carry expiration dates.  So do some medical supplies including tracheal tubes, sterile water for respiratory therapy equipment, and normal saline. 
• Warehouse personnel should know how to access Safety Data Sheets (SDS) for cleaners, disinfectants, and even oxygen (if providing it).
• Make sure any employee cleaning or doing maintenance on equipment can articulate and explain the process for their job duties.
• Is battery-operated equipment in “patient ready” areas charged and truly ready to go?

Revise the checklist to meet the needs of your storage areas and take that stroll through the warehouse on a regular basis to ensure compliance.