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Process Framework of Materials Management in a Hospital (the notation used is explained in section 3)
Source publication
Materials management is an important issue for healthcare systems because it influences clinical and financial outcomes. Before selecting, adapting and implementing leading or optimized practices, a good understanding of processes and activities has to be developed. In real applications, the information flows and business strategies involved are di...
Citations
... These activities are critical for their operations." There are two groups of stakeholders associated with medical supply inventory management: clinicians and logisticians, and the division of tasks between them is not always clearly formulated leading to an overlap of activities between these two groups of professionals (Iannone et al., 2013). "In contrast, logistics-related activities are often performed by medical staff, taking away time from taking care of patients" (Volland et al., 2017, p. 83). ...
... On the other hand, the overview of the first practice demonstrates that, despite its expertise, a logistics department cannot work in isolation and must maintain close relationships with nursing staff, as argued by Iannone et al. (2013) as a way to improve decision-making. The concept of decoupling seems well suited to how a task or activity breakdown structure is thought out; however, as pointed out by Guven-Uslu et al. (2014), organizations need to integrate technical knowledge beyond logistics expertise across their different functions. ...
Purpose
The Covid-19 pandemic generated significant changes in the operating methods of hospital logistics departments. The objective of this research is to understand how these changes took place, what collaboration mechanisms were developed with clinical authorities and, to what extent, logistics and clinical care activities should be decoupled to maximize each area's contribution?
Design/methodology/approach
The case study is selected to investigate practices implemented during the COVID-19 pandemic in hospitals in Canada. The pandemic presented an opportunity to contrast practices implemented in response to this crisis with those historically used in this environment.
Findings
The strategy of decoupling logistical tasks of an operational nature from clinical activities is well-founded and helps free clinical staff from tasks for which they are not trained. However, the decoupling of operational tasks should be combined with an integration of the clinical information flow to the logistics hub players. With this clinical information, the logistics hub can generate its full potential enabling better inventory management decisions to be made.
Originality/value
The concept of decoupling is studied to identify configurations that offer the best benefits for clinical staff.
... In support of these findings, access to resources and facilities by paramedical departments is very important for their ability to fulfill the requirements of nurses. Also, nurses with higher access to resources, equipment, and facilities feel more empowered to deliver quality patient care (28). Shohani declared that the lack of facilities in any form would lead to undesirable patient care, wasting the time of nurses, and the inability of nurses to help their coworkers in urgent conditions (21). ...
Background: Interprofessional communication between nurses and paramedics is a crucial and challenging issue for safe and effective patient care, but it has not been addressed enough. The most important action for improving these communications is to identify their obstacles and challenges. Objectives: The aim of this study was to explain the obstacles to interprofessional communications between nurses and paramedics. Methods: This study used the qualitative content analysis method. The participants of this research were 11 nurses and paramedics who were selected using purposeful sampling and took part in semi-structured in-depth interviews. The data were collected from May to September 2022. Data analysis was carried out by the conventional content analysis method proposed by Graneheim and Lundman. Guba and Lincoln’s criteria were used to assess the rigor and accuracy of the collected data. Results: The findings of this research disclosed 3 main themes; human resources challenges, lack of coordination between nursing and paramedics departments, and emergency situations. Conclusions: The challenges of interprofessional communication between nurses and paramedics are influenced by different human and managerial factors, and identifying them is a significant step toward improving this communication. With regard to the findings of this study, managers and planners of healthcare centers can mitigate challenging factors and improve the communication between nurses and paramedical staff and, therefore, prepare the context for high-quality care of patients and boost the satisfaction of health professionals with their work conditions.
... Thus, medicines and other pharmaceutical products are considered essential goods for the proper functioning of healthcare institutions [6]. Pharmaceutical stock management emerges, which encompasses the set of activities that aim to guarantee the stock of medicines and other pharmaceutical products, in order to meet the therapeutic needs of patients, but also the interests of the health institution [7], [8]. In Portugal, the primary objective of pharmaceutical activity is the effective and efficient care of the patient, regarding the timely availability of the medicine necessary for its treatment. ...
... Considering any healthcare provider, the stock management must be balanced, since the excess of material or the lack of it can cause problems to the organization, and most importantly, the patient [7], [13]. Excess stock increases ownership costs and might outdate or obsolete products, but on the other hand the lack of it can delay treatments, worsening health status or death [14], [15]. ...
... Cost management and control are central to any institution, including in hospital institutions, where costly medical treatments can make the exercise of medicine unfeasible and put health, or even the survival of patients, at risk. In this context, the management of stocks of medicines and other pharmaceutical products due to their high economic impact (which represents the second largest item of expenditure in the hospital budget), acquires extreme importance [7], [54]. ...
The current situation of healthcare units is characterized by the increasing cost of providing the respective care, the consequent deterioration of the financial situation and the complicated and time-consuming processes. Allied to the growing demand, they could become factors that make the service demand deficient. Due to this situation, more efficient and effective logistics and supply chain management is transversally recognized as one of the main areas for improvement. In order to provide insight on which areas to improve, several objectives where looked after in this work, as the analysis of the methods and criteria for the selection of medicines in hospital pharmacies, the definition of obstacles to the rational management of stocks and analysis of historical data to forecast future demand of a Portuguese public hospital. The study revealed that some of the 1346 products present on the pharmacy’s ERP do not have sufficient historical data to create an accurate forecast. With this context, and considering a service level of 99%, 41% of products have a stock higher than what should be the maximum stock, approximately € 147.908,87 of fixed assets and 11% of the products were, at the time, at risk of going out of stock. The importance of the evolution of core information system of Hospitals was at stake, ensuring the technological sustainability of the ongoing digital
transformation, alignment with ICT rationalization measures, improvement of customer service and improvement of the quality of information available to the user. On a side note, considering the current event of pandemics, it was analyzed its impact on hospital supply chain. The change in the behavior of hospital patients led to two clear breaks in two relevant indicators, the number of hospital visits and spending on medication. These indicators show that there is less demand for scheduled hospital services, 1,9M less consultations carried out in Portuguese Public Hospitals. In these times, the capacity for hospital care and intensive care is exceeded, creating a significant challenge. In Portugal, as the impact of the pandemic on medication consumption nationwide, it was predicted an additional cost of € 103M by the end of the year, higher than in previous years.
... Hospitals need a certain stock to avoid interruptions in the examination and treatment phases of their structures or to meet any immediate needs. Therefore, the establishment of an efficient and effective stock structure is of great importance not only for the continuous provision of services but also controlling the entrances and exits, invoicing drugs without leakage, and ensuring supervision (Iannone et al., 2013). ...
... In sub-Saharan Africa, causes that have been identified include inadequate procurement financing and procedures, poor planning and distribution resources as well as limited skilled personnel and supply capacity [6][7][8]. Amid resource-constraint and with limited management time, efficient utilization of organizational resources is essential, and effective inventory management is needed for substantial efficiency gains in total annual hospital budgets [9,10]. In health care systems, it is beneficial to introduce effective logistics practices and supply chain systems to control cost as well as procurement and distribution which would also impact positively on the cost of healthcare to patients. ...
Background: A well-functioning pharmaceutical supply system is an important aspect of ensuring efficient and proper clinical services in any health care system. This analysis was conducted on 31-member health facilities of the Christian Health Association Ghana (CHAG) to determine current consumption patterns and related expenditure for medicines on the Ghana Essential Medicines List. The overall aim was to inform the setting up of a digital pharmaceutical supply chain management system for CHAG providers.
... However, in the case of a stock out, not only will the professional's performance be interrupted, but this may also compromise the patient's health, causing incalculable losses. Thus, efficient stock management in a hospital environment becomes fundamental, since it financially impacts its operations and clinical outcomes (Iannone et al., 2013). ...
... Thus, managers must pay close attention to efficiency improvement and cost reduction in their health-care systems. [1][2][3][4][5] Additionally, the delivery of health care while enhancing the levels of quality service, patient gratification, and staff fulfillment is increasingly becoming a vital concern of administrators in health-care systems. Because operating rooms (ORs) and nursing unit are closely allied departments, both are considered simultaneously by administrators in their search for quality improvement and cost reduction. ...
... w is 1, 2, 3, 4, 5, 6, and 7, which are Monday to Sunday for the first week, and is 8,9,10,11,12,13, and 14, which are Monday to Sunday for the second week. k is Monday to Friday (1)(2)(3)(4)(5) for the first week, and Monday to Friday (6-10) for the second week. The example (6,9) in column m 1 shows that patients underwent surgeries on a Monday and have stayed in the hospital for 9 days. ...
The managerial aspect of providing quality, cost-effective health services to hospital patients is becoming increasingly important. However, merely focusing on cost reduction and quality improvement may jeopardize personnel satisfaction. Therefore, a balanced approach based on multiple considerations is necessary. Operating rooms (ORs) account for almost 33% of a hospital’s budget, and nursing labor costs represent more than 40% of a hospital’s budget. The concerns around health-care quality, personnel motivation, staff satisfaction, patient length of stay, and patient flow rate are greatly influenced by these two units with regard to day-to-day operations management. A possible approach is to look into the related essential problems, such as the nursing staff time scheduling in nursing units, and the doctor time scheduling in ORs. After surgery in the OR, patients stay in the subsequent ward for a period of time. This causes loading interdependency between the anterior OR and the posterior ward nursing unit; as a result, an attempt to schedule these two departments simultaneously is necessary for operation efficiency enhancement, service quality improvement, hospital budget reduction, and personnel satisfaction. In order to achieve the multiple objectives describing the conflicting priorities and differing preferences within nursing units and ORs, a compromise programming is adopted in this study as a balancing tool for multi-objective optimization to realize improved OR and nursing unit scheduling.
... An explanation for this outcome might be associated with the fact that both the processes and items of these LC departments are less diversified, leading to an easier and more intuitive materials planning and control. Since most methods usually require relevant levels resources, time, training and integrated information systems, the implementation effort may be incompatible with the benefit generated in these departments, whose problems can be solved with simpler tools and techniques (Iannone et al., 2013). ...
... The first one was utilised as a way of converting surgical needs (independent demand) into demands for sterilised materials (dependent)(O'Neill et al., 2001). Complementarily,Iannone et al. (2013) applied BOM for drugs and medical supplies, whileRappold et al. (2011) modelled the demand for surgical procedures as non-stationary and incorporated a stochastic list of materials for each procedure, leading to uncertainty reduction of the BOM. Particularly for CRP, onlyVan Oostrum et al. (2008) addressed this method in a surgical centre. ...
This study aims at identifying the existing methods for materials planning and control applied in healthcare organisations. An extensive literature review was performed in the main database based upon two research axes: 1) materials planning and control, and 2) health services. Besides the content and bibliometric analysis, literature evidence was analysed from the perspective of two theoretical lenses: types of flow of value and complexity levels of hospital departments. Results from this review allowed the indication of two main research directions; they are: 1) integration among methods for materials planning and control, and 2) financial assessment of the implementation of materials planning and control methods in hospitals. The healthcare sector is highly important due to the criticality of it is quality, safety concerning patient care and the high cost involved in its operations. Furthermore, resources are usually limited, complicating its management.
... data analytics and big data mining) and BPM (e.g. business optimization, business process monitoring, process performance analysis) to gain business benefits. [63][64][65][66] Although SMEs have recognized innovation capability and performance measurement to be the essential success factors for their business, there are many barriers preventing the implementation of modern management concepts, such as BI and BPM, in their business practices. 67 The long-neglected issue of human resources, poor knowledge of competitors and customers, and the lack of process KPIs and process capability indices are becoming the critical factors for further efficient SMEs development. ...
Business intelligence (BI) and business process management (BPM) are widely implemented in various organizations. However, their impact on organizational performance strongly depends on their alignment. Previous research has focused mainly on large companies. Small and medium-sized enterprises (SMEs) also started to use BI and BPM in order to improve their performance. However, the research regarding this issue is scarce. The goal of the article is to examine the interrelationship of BI and BPM and their impact on organizational performance of SMEs. In order to attain this goal, a systematic literature review and a survey research on the sample of SMEs in Croatia and Slovenia have been conducted.
... One of the distinguishing features of inventory in hospitals with respect to industrial settings is the existence of a plurality of stakeholders [8]. In addition, business strategies may be different from hospital to hospital and a deep understanding of processes and activities involved in hospital logistics is necessary [9]. However, despite its unique features, only a few studies have addressed inventory problems in hospital logistics with a focus on stakeholders. ...
This paper experimentally investigates the relationships among three major stakeholders that are involved in drug inventory management at Intensive Care Units (ICUs), namely: i) nurses, who in person manage drug orders and carry out storage operations, ii) clinicians, who choose the therapy and shape demand, and iii) the hospital management, who is in charge of the economic sustainability of the hospital. As a case study, we consider the ICU ward of a major Italian public hospital and we focus on antibiotics. We exploit a previously developed Mixed Integer Linear Programming model which decides, for each drug, when and how much to order, and we improve it by adding different sets of constraints to represent each stakeholders’ point of view. By solving three generalized models, each of which ties the satisfaction of a single stakeholder to different thresholds, we explore the mutual effects of taking explicitly into account different perspectives within the inventory policy. We implemented an instance generator, built on the basis of empirical probability distributions extracted from a large set of observed historical data and representing the decision flow ruling drugs prescription. Extensive experiments have been carried out on a set of realistic instances provided by the generator. Results based on our test case not only provide computational evidence to intuitive relations among stakeholders, but also suggest possible levels of compromise. Improved stakeholder satisfaction would also benefit the patient, the passive stakeholder who is the ultimate subject of the caring process.