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76 Guidebook for Understanding Urban Goods Movement Lessons and Conclusion Cleckley believed that once a truck route network was in place, enforcing truck size and weight laws would be a key factor in preserving the infrastructure and improving truck safety. Each year, DDOT spent roughly $20 million on pavement rehabilitation and preservation, and it was sus- pected that a significant amount of pavement and bridge wear resulted from damage caused by overweight trucks. DDOT officials understood that increasing maintenance costs while facing diminishing highway funds would require effective steps for preserving some roadways rapidly approaching critical condition. To address the enforcement issues, DDOT developed a project scope to analyze and quantify the effects of overweight trucks and their associated costs on the District roadway network, and developed an enforcement strategy to mitigate future damage resulting from illegal truck oper- ations. The District hired a consultant to assist in carrying out the analysis with the ultimate goal of developing a citywide truck safety enforcement plan. The analysis undertaken for the study estimated total infrastructure costs, both pavement and bridges, attributable to overweight trucks at approximately $16 million per year. The study also laid out a comprehensive plan for upgrading enforcement technologies, such as the addition of several weigh-in-motion (WIM) scales to detect overweight trucks, and an increased amount of enforcement personnel. After making great progress in less than 2 years, the election cycle and a new administration granted D.C transportation officials time to reflect on next steps for implementing and main- taining a quality truck route system, steps that would require resources and increased inter- agency cooperation. At a peer-to-peer exchange with NYDOT in 2010, D.C. officials witnessed how cooperation across offices and departments could, to an extent, overcome resource hurdles. So the next challenge was to improve communication and cooperation among offices and juris- dictions responsible for truck licensing, data collection, and traffic enforcement in the District. References and Sources D.C. DOT Freight and Commercial Vehicle Operations website: getting-around/freight-management.aspx District-wide Truck Safety Enforcement Study, online fact sheet available online at Portals/0/Freight_PDF/District-wide%20Truck%20Safety%20Enforcement%20Study.pdf Presentation to DVRPC Freight Committee: Innovative Approaches to Enhancing Goods Movement available online at U.S. Census Bureau, 2010 Census Bureau: Population Density, available online at 2010census/data/ Texas Transportation Institute, 2009 Annual Urban Mobility Report, Summary Table 1, available online at Nashville: Vanderbilt Medical Center-- Freight Consolidation Background Nashville, Tennessee, is a medium-sized U.S. urban area of 2.1 million residents. The metro- politan population has more than doubled in the past 2 decades; its growth has accelerated from almost a 3 percent compound annual rate in the first 10 years, to more than 5 percent in the next 10 years. Situated on the Cumberland River, Nashville is the state capital and stands at the inter- section of three Interstate highways: I-40, I-65, and I-24. This crossroads location, coupled with the pressures of growth, has brought important transportation challenges to the area.

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Case Studies 77 Vanderbilt University is Nashville's largest private employer, generating economic activity of Principal Findings $6.5 billion annually. The university's renowned medical center, which includes medical and nursing schools as well as an extensive network of hospitals, clinics, and research facilities, pro- Freight consolida- duces the greatest part of Vanderbilt-related employment and economic impact. Since health- tion centers (FCC) care is the metropolitan area's leading industry, Vanderbilt Medical Center (VMC) is at the apex can have major of the urban economy. benefits in terms of Like the region it serves, VMC has experienced tremendous growth. Spending more than $100 million each year on major construction and renovation projects, its physical footprint expanded reducing the num- over 80 percent during the past decade. This investment supports a system that handles 50,000 bers of vehicles admissions, 100,000 emergency room visits, and more than 1 million ambulatory visits each year. entering urban areas. Of key The Story importance to their VMC's supply requirements are tremendous, ranging from large quantities of everyday mate- establishment is a rials like bed linens and food, to sophisticated medical instruments and sensitive products like blood plasma, stents, and pharmaceuticals. The breadth of individual items and the number of detailed under- individual suppliers--distributing from a range of points that are local to global--could easily standing of the give rise to a barrage of separate shipments arriving daily. Add to this the urgency with which current methods of many goods are required, and the diversity of care and caregivers they supply, and two conse- quences can follow: supply by busi- 1. Hospital space and hospital budgets stuffed with inventory, or nesses in the dis- 2. Hospital delivery docks constantly under siege from an endless line of delivery trucks. trict and the mech- The VMC in this sense is a microcosm of the city; it has a large, insistent population wanting anisms by which many things as soon as possible, all uncoordinated as to needs and timing. Freight carriers serv- the FCC could ing VMC will, as a matter of efficiency, combine shipments into single deliveries when possible, but since each carrier has only limited control over their link of the supply chain, several carri- operate (100 per- ers often serve any given receiver of goods. cent privately In the early 1990s, VMC recognized the situation for the well-intentioned chaos it promised, and funded, a mixture anticipating coming growth, inaugurated a consolidated supply system with the aid of third-party of private/public logistics providers (3PLs). Prior to consolidation, VMC was devoting an ever-expanding portion of facility space to a centralized stock room and keeping inventory on care wards as well. Inventory partnership, com- stocking practices piled building and inventory carrying expenses on top of healthcare costs, and pulsory buy-in for this situation was made worse by the high costs of transporting small, expedited shipments. access to specific After seeking input from 3PLs, two basic changes followed. First, wards would be resupplied areas, and/or vol- daily and directly with whatever they needed, but inventory would be kept off-site in distribution centers (DCs) that received goods from many suppliers and served many hospitals. Supplies untary buy-in). would be guaranteed and emergency requirements accommodated, but mainly this would be done from a warehouse about an hour away. Second, the 3PLs would consolidate and deliver all of the supplies from all of the vendors. This meant that a single delivery truck would handle a full set of shipments, and although several might arrive in the course of a day, the number of trucks arriving (and the miles they traveled) would be drastically reduced. By serving multiple hospitals, the 3PLs were able to consolidate truck arrivals inbound to the distribution centers as well. Today, the VMC logistics system has evolved into five supply chains, treating five distinct sets of needs, as follows: Medical-pharmaceutical is for the supply of drugs. Drugs have a host of regulatory and secu- rity requirements preventing them from being mixed with other products. Hence, pharma- ceutical products are handled as an independent logistics chain.

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78 Guidebook for Understanding Urban Goods Movement Medical-surgical provides most other patient supplies, excluding drugs. Management of this supply chain has been contracted to a 3PL that operates from a local warehouse served by a hub DC in the region. Multiple scheduled deliveries occur daily, emergencies are added, and stocks are managed at the ward level by the 3PL interacting with caregivers. Laboratory supplies for research and diagnostics come directly from manufacturers to a central DC in the city and arrive twice daily at VMC. Office supplies supporting administrative needs are handled through a single catalogue ven- dor offering daily service. Office supplies are managed cooperatively with Vanderbilt Univer- sity, so that both parties are supplied at once. Miscellaneous supplies, principally linens and food service, are handled directly by local vendors and managed cooperatively with the university. In addition, small package carriers bring vendor- direct materials for patient-specific needs, oxygen and blood come from nearby sources, and waste haulers carry away refuse. The evolving consolidated supply system allows the full range of medical center needs to be accommodated with just three loading docks. The docks have bays and handling areas (see Exhibit 7-6), but the stock room is now gone and has been converted to medical space. Inven- tory investment is kept low, yet the wards have better command of their materials and better access to more supplies than previously. VMC staff estimate that in the first dozen years of imple- mentation, volumes climbed by a factor of 10 or more, while truck activity remained constant. The net effects of this system are more productive utilization of capital by VMC, improved ser- vice to patients, lower healthcare costs to the public, and a more competitive healthcare indus- try in a region that depends on it--plus effective management of truck VMT. Lessons and Conclusion Cities commonly suffer through circumstances like those that VMC faced: disparate users sit- uated in constrained facilities cause excessive delivery activity for goods. One solution tried in Europe and elsewhere under various management approaches has been the urban consolidation center. Its central concept is the requirement that all deliveries and pickups in an urban district be funneled through a staging center that consolidates shipments to reduce truck traffic (and often to ensure the use of low-emission vehicles and off-peak hours). These typically have been government-initiated programs, although the more successful ones have deferred heavily to pri- vate stakeholders in operational management. Exhibit 7-6. Inside VMC's main dock. Source: Halcrow.