MANAGEMENT OF HOSPITAL SUPPLIES & EQUIPMENTS
• Supplies are items that are used up or consumed – Eg: drugs, surgical goods (disposables, glass wares), chemicals, antiseptics, food materials, stationeries, the linen supply etc.
• Equipment is used for more permanent type of article – Fixed equipment is items attached to the walls or floors (eg; sterilizer,) – Movable equipment includes furniture,
Purchase of supplies & equipments
Done through – General store – Dietary department and – Pharmacy department
Material management is a scientific technique, concerned with planning, organizing and controlling the flow of materials from their initial purchase through internal operations to the service point through distribution.
• About 40 percent of the funds in the health care system are used up for providing materials.
AIM :
· Right material,
· In right quantities
· At right time,
· At right price,
· From right sources
· At a least cost.
Elements
· Planning for materials
· Demand estimation
· Purchasing
· Inventory management
· Inbound traffic
· Warehousing and stores
· Incoming quality control
Factors for Budgeting a purchase –
· Transport charges (local delivery reduces the transport charge)
· Incidental costs
· Cost of chemicals and other consumable to be used with the equipment (eg; ECG paper for an ECG machines)
· Operating cost (hiring a technician)
· Cost of maintenance service; 10-20% of hospital equipment may remain idle if serving is not done periodically.
· Cost of technology obsolesces: when a better quality appears in market there is tendency to discard the old model.
· Replacement cost of equipment
When purchasing an article;
· It should be durable, non-corroding, non toxic and safe for use.
· Should have standard shapes and dimensions to fit into various situations
· Reparability and spare part availability of the articles
· Inter-changeability of the article (Exchange facility)
· All surgical instruments used in a hospital should be sterilizable and they should stand the tests for leakage, hydraulic pressure tests for bursting etc
· Should have accuracy in measurements
· Should have ease of operation
The Central Supply Service
The central supply varies hospitals to hospital
• Some hospital the central soppy room deals with only the sterile supplies and ward trays.
• Some hospitals all types of equipment such as oxygen, suction, ward trays, catheters, syringes etc supplied centrally
Factors in Material Purchase
1. Type of service provided by the hospital
2. Age of patients: children need different type and amount of equipments than adults.
3. Sex- men and women sometime require different type of equipment.
4. Degree and type of illness- neurologic patients sometimes require more bedsides, rubber mattress and linen than patients with other type of illness.
5. Cost of items- cost of items will limit the purchase of number of equipment.
General Utility Services in the Hospital
Ø Electric supply and installations
Ø Water supply
Ø Disposal of waste
Ø Ventilation and environment control
Ø Transport
Ø Supply of medical gases , compressed air,hot water, vacuum suction and gas plants
Ø Laundry
Ø Fire hazard
Ø Communication
• Essential clinical services- medicine, surgery, paediatrics., OBG, and acute psychiatry(when necessary)
• Optional clinical services – oral surgery, orthopedic surgery, otolaryngology, neurology and psychiatry.
• Essential clinical support- anaesthesia, radiology and clinical laboratory
• Optional clinical support services- pathology and rehabilitation including physiotherapy. Essential medical equipment
• Diagnostic imaging equipment –it include x-ray and ultrasound equipment. X-ray equipment can be stationary in one room or mobile
• Laboratory equipments
• Refrigerator – an ordinary household refrigerator with a freezer unit, for storing preparations, vaccines, blood etc.
• Instillation and purification apparatus - it should be made of metal that resists acid, and alkali and should be free standing.
Electrical medical equipment
• Portable electrocardiograph
• Defibrillator( external)
• Portable anaesthetic unit
• Respirator
• Suction pump
• Operating theatre
• Delivery table
• Diathermy unit
Other equipments
• Autoclave
• Small sterilizers
• Cold chain
• Ambulance
Small, inexpensive equipment and instruments
• BP apparatus, oxygen manifolds, stethoscope, diagnostic sets and spotlights.
Introduction
Material planning is the scientific way of determining the requirements that goes into meeting production needs within the economic investment policies.
It is done at all stages and all levels of management. Material planning is based on certain feedback information and reviews.
. Aim
• To gain economy in purchasing
• To satisfy the demand during period of replenishment
• To carry reserve stock to avoid stock out
• To stabilize fluctuations in consumption
• To provide reasonable level of client services
Basic Principles
Sound purchasing methods Skillful and hard poised negotiations
Effective purchase system
Should be simple
Must not increase other costs
Simple inventory control programme
Elements of material planning
. Procurement
. Objectives of Procurement System
• Acquire needed supplies as inexpensively as possible
• Obtain high quality supplies
• Assure prompt and dependable delivery
• Distribute the procurement workload to avoid period of idleness and overwork
• Optimize inventory management through scientific procurement procedures
Methods of Procurement
1. Open tender
2. Restricted or limited tender
3. Negotiate d procurement
4. Direct procurement
5. Rate contract
6. Spot purchase
. Points to Remember Proper specification Invite quotations from reputed firms Comparison of offers based on basic price, freight and insurance, taxes and levies Quantity and payment discounts Payment terms Delivery period, guarantee.
Procurement of Equipments
• Latest technology
• Availability of maintenance and repair facility, with minimum down time
• Post warranty repair at reasonable cost
• Upgradeability
• Reputed manufacturer
• Availability of consumables
• Low operating costs
• Installation
• Proper installation as per guidelines
• Store must be of adequate space
• Appropriate method of store
• Group wise and alphabetical arrangement helps in identification and retrieval
• First-in, first-out principle to be followed
• Monitor expiry date
• Follow two bin or double shelf system, to avoid stock outs
• Reserve bin should contain stock that will cover lead time and a small safety stock
Inventory control is a scientific system which indicates as to what to order, when to order, and how much to order, and how much to stock so that purchasing costs and storing costs are kept as low as possible.
• To keep the investment on inventories to stock outs and shortages.
• To avoid carrying cost.
• To improve quality of care with lesser inventory
. • To avoid obsolescence of inventor
Techniques
ABC Analysis (Always Better Control)
VED Analysis (Vital, Essential, Desirable)
HML Analysis (High, Medium, Low)
FSN Analysis (Fast, Slow moving and Non- moving)
SDE Analysis (Scarce, Difficult, Easy)
ABC Analysis
This is based on cost criteria
It divides inventory into 3 categories A, B & C based on their annual consumption value. Also known as Selective Inventory Control Method (SIM)
ABC analysis has universal application for fields requiring selective control.
VED Analysis
This is based on critical value and shortage cost of an item.
Vital items – Its shortage may cause havoc & stop the work in organization. – Are stored adequately to ensure smooth operation.
Essential items – Here, reasonable risk can be taken. – They should be sufficiently stocked to ensure regular flow of work.
Desirable items – Its non availability does not stop the work because they can be easily purchased from the market as & when needed. – They may be stocked very low or not stocked
HML Analysis
This is based on cost per unit.
Highest- high price items
Medium- medium price items
Low- low price items
This is used to keep control over consumption at departmental level for deciding the frequency of physical verification.
. FSN Analysis
This is based on utilization.
Fast moving, Slow moving & Non moving
Classification is based on the pattern of issues from stores & is useful in controlling obsolescence. Date of receipt or last date of issue, whichever is later, is taken to determine the no. of months which have lapsed since the last transaction.
The items are usually grouped in periods of 12 months. It helps to avoid investments in non moving or slow items. It is also useful in facilitating.
SDE Analysis
This is based on availability of items.
Scarce- managed by top level management. Maintain big safety stocks.
Difficult – maintain sufficient safety stocks.
Easily availability- maintains minimum safety stocks.
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