Hospital Casters: Four Critical Challenges

Here’s a riddle many hospitals are attempting to answer. What has one wheel, is heard before it is seen, and also lowers your HCAHPS scores, causes injuries to your staff, increases your maintenance costs and makes your floors unsightly?

Your hospital casters.

Look on the bottom of your laundry carts, IV poles, mobile workstations, dietary carts and food service carts in your hospital and you’ll see cheap, commodity casters that are lowering your patient satisfaction scores and increasing your costs. Commodity casters cause many problems for hospitals. Here are the top four pains—and how to best address them.

PAIN 1: INCREASED NOISE

At the top of the list is noise, because excessive noise is the number-one complaint among patients, staff and visitors according to Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) annual surveys year after year.

Hospital casters are noisy for three primary reasons.

1. Wrong tread material: Caster wheels made from hard materials are noisy. Hard rubber, for example, is not designed to absorb and distribute impact. This material is fine for carts that are used in noisy manufacturing environments. But it’s unsuitable for hospitals and healthcare facilities because it makes too much noise when rolling.
2. Loose raceways: The raceway is the part of the caster that allows the caster to swivel. It typically contains ball bearings or rollers that rotate. On the majority of carts, workstations and poles used in today’s hospitals, the caster raceways are too loose, making that chattering noise so commonly associated with casters.
3. No wheel bearings: Check your hospital equipment and you’ll likely discover that most of your caster wheels don’t have bearings at all. Instead, they feature a metal axle that grinds on the plastic core of the wheel as the wheel rotates, producing noise.

PAIN 2: WORKER INJURIES

The leading cause of workplace injuries is physical overexertion. Overexertion causes 35% of all work-related injuries and is the largest contributor to workers’ compensation costs. Back injuries alone account for nearly 20% of injuries and illnesses in the workplace. A typical back injury costs between $62,000 and $81,000 per incident.

Plenty of these workplace injuries are caused by carts that are difficult to push, pull, steer and stop. The root cause of the problem? Cheap, commodity casters that have high rolling resistance. Many casters on hospital carts do not have bearings, making them harder to move, especially when overloaded. They also commonly have standard swivel leads, which makes them harder to maneuver.

PAIN 3: COSTLY MAINTENANCE

Commodity casters, the kind found on most hospital carts, are not designed to be maintenance free. They require time-consuming, regular greasing through a zerk fitting to prevent seizing. Others have design flaws that allow debris to gather in the upper bearing and upper raceways, damaging the caster and requiring regular servicing.

PAIN 4: DAMAGED FLOORS

The final key pain that hospitals suffer from commodity casters is marked and damaged floors. Caster wheels with rubber treads can mark floors, particularly when they are left stationary in one place for extended periods and mopped around by cleaning staff.

Another problem for hospital floors is caster wheels that are too hard. Wheels made of nylon, for example, don’t mark floors, but they collect debris off the floor. This debris eventually hardens into the wheel’s tread, denting and dimpling hospital floors with every rotation.