Hospital In-plants Prove Their Value During a Crisis

Even as Americans isolate themselves at home during the COVID-19 crisis, hospital workers have been busier than they’ve ever been, working to save lives from the terrible disease plaguing our world. Supporting them in this crucial mission have been their in-plants, many of which are working overtime to provide essential signage, informational flyers, and even patient charts. The number and variety of COVID-19-related printed items in demand right now is staggering.

Sanford Health Print and Mail Services has been busy printing COVID-19-related pieces during the pandemic.

“We’re printing a lot of items for check-in, for patients coming in,” says Stephen Derderian, print manager at Rhode Island Hospital, in Providence. “A lot of forms need to be filled out” — to find out if patients have a fever, if they’ve been out of the country, and other information to determine whether they may have contracted the coronavirus disease. 

In Sioux Falls, S.D., Sanford Health Print and Mail Services just got a request to print, punch, and string 12,000 toe tags, a sad but necessary item in these trying times. 

The busy staff at Monument Health Printing Services, practicing good social distancing (from left): Larry Mills, Pattie Paulsen, and Jose Huertas.

About 350 miles west in Rapid City, S.D., Monument Health Printing Services is printing and cutting 8,000 round vinyl stickers a day to be placed on the ID badges of hospital workers to indicate they have been screened that day for coronavirus symptoms. 

“That’s been running overnight, pretty much every night,” remarks Manager Larry Mills. 

But that is certainly not the only thing his in-plant’s Roland VersaCAMM VS-640 has been printing during the pandemic. Mills says 85% of his three-employee shop’s work is wide-format, and the number of vinyl banners and signs the in-plant has been producing has exploded. Signs directing patients to urgent care, signs warning people not to enter areas of isolation, signs listing COVID-19 symptoms, window clings at public entrances, door signs declaring “No Visitors” — the signage demands seem endless.

Heavy Volume

“My volume has flown out of control,” Mills says. “On average, we’ve been working … between 55 and 60 hours a week. Last weekend I went in four hours on Sunday.”

The in-plant serves a network of more than 40 health care facilities, including six hospitals and dozens of clinics. Mills says signs must often be reprinted when situations change, which happens a lot in these uncertain times. 

To give signs a longer shelf life, they are being printed on gloss cover stock and UV coated with the shop’s Tec Lighting coater. This way the signs can be wiped down and sanitized.

“You can pour alcohol on it, you can pour any of these cleaners on it that we currently use in health care … and it does not affect the UV coating,” he says. “The UV coating has helped a lot.”

Jose Huertas and Pattie Paulsen at Monument Health Printing Services.

Other projects that have consumed the shop are business cards for the public to direct them to triage phone lines; printed patient screening forms; tabbed patient charts to have ready if hospitals get overrun with patients; labels for hand sanitizer that is being produced locally for the hospital system; and informational flyers.

“We have been mass producing handouts … for different procedures that are happening in the clinical areas,” Mills says — instructions telling caregivers about steps they need to take or personal protective devices they will need. 

Once orders are printed, he and his staff set them on carts in the distribution center attached to his facility, and drivers transport them to where they’re needed. 

Doing Essential Work

At Rhode Island Hospital, Derderian’s in-plant serves five hospitals in the Lifespan network. His shop takes print orders from a command center that runs 24/7.

“We get the order in, we print it, we bring it directly to that department,” he says — always while wearing a mask. “Once we leave our department, we put on our N95 mask.”

The staff of Rhode Island Hospital Office Services (before the COVID-19 crisis). From left: Anibal Cunha, Ed Paiva, and Steve Derderian

Those jobs include a lot of forms, which are changing all the time as the situation develops. The in-plant also printed 120,000 labels to designate patients that arrived with a fever. 

Poster volume skyrocketed in February and March, Derderian says, with the five-employee shop printing 400 posters, compared to just 30 in January. 

“It’s definitely a value to have us here for emergencies like this,” he says. 

In Springfield, Ill., the five-employee printing department at HSHS St. John’s Hospital has also been open and busy during the crisis, printing materials for eight Illinois hospitals in the Hospital Sisters Health System. In addition to informational and directional posters, the shop has been printing such things as CDC guidelines for health care workers, flyers promoting free COVID-19 virtual assessments, contact information for the local Department of Public Health, and triage cards to alert health care workers of the status of emergency patients.

The in-plant has also printed thousands of “Hearts for Healthcare Workers” labels for colleagues to place on their vehicles.  

“This initiative was developed to assist the police and fire departments to easily identify health care workers on the roads while the state and federally mandated self-isolation is in place,” notes Jennifer Goldstein, graphic designer.

Disaster Recovery Plan

At Sanford Health Print and Mail Services, one of the country’s largest integrated health care systems, Manager Lisa Stelter notes that much of the in-plant’s normal work has dried up, such as daily mailings related to elective procedures and printing for symposiums and other events. That work has been replaced by COVID-19-related work: patient information pieces, flyers, posters, door signs denoting isolation areas, even labels for hand sanitizer. A recent job order had the in-plant printing table tents with COVID-19 information on them to be sent to 430 locations. The in-plant is also printing circle floor graphics for common areas asking people to stand six feet apart.

Hospital signage printed by Monument Health Printing Services.

In the production area, still fully staffed, work spaces are sanitized several times throughout the day, and employees must take breaks on the production floor to minimize contact with other health system staff. All shipments are contained to the dock area; drivers and other visitors are not allowed in the production area. 

The in-plant is fortunate to have a good disaster recovery plan in place, even if it wasn’t intended as such. Sanford Health’s consolidation with the Evangelical Lutheran Good Samaritan Society in January 2019 gave the organization a second in-plant, which Stelter was in the process of merging with her own. Now, however, that shop is being maintained as a backup location.

“If someone in one of our locations gets sick, we can shift all the work to the other print shop,” she says. 

The in-plant also has team members in Fargo, N.D., to handle data processing and file management, so if neither facility is able to print, jobs can be sent to external vendors. 

Print and Mail Services is preparing to play a more crucial role by shipping PPE and sanitizer from Sanford Health’s warehouses in Fargo, Sioux Falls, and Bismarck to its medical centers around the region. The in-plant will use its Pitney Bowes SendSuite shipping software to coordinate the process.

“As it becomes harder and harder to get that [material], we need to be able to ship that to our centers from our main warehouses,” Stelter says.

COVID-19-related items printed by Sanford Health Print and Mail Services.

While dealing with the crisis, she is also looking ahead to a time after the pandemic, when normal business will resume.

“Once the light switch turns back on, we’re going to get an influx of invitations, announcements, symposium booklets and such that are going to need to go out,” she predicts. “I’m a little nervous about that.”

One lasting impact of COVID-19, she says, is that the heavy volume of signage it engendered underscored the need for additional support in the wide-format area.

“We need a second person in our large-format [area],” she affirms. 

Even in this state of emergency, customers have been impressed with the in-plant’s wide-format capabilities and are ordering additional pieces. Stelter knows she will need to expand the operation to keep up.

“I do see an increase in our large-format production area,” she says.