Ganga Care Hospital

ganga care hospital , nagpur .

Summer Internship Report .

Streamlining the supply chain management

By AMIT SHAW (SYMBIOSIS INSTITUTE OF HEALTH SCIENCE )

7/13/2012

THE FINAL REPORT ON THE SUMMER INTERNSHIP DONE AT THE GANGA CARE HOSPITAL NAGPUR .

THE TOPIC :- STREAMLINING THE SUPPLY CHAIN MANAGEMENT RELATED TO THE PHARMACY DEPARTMENT .

FOLLOWING ARE THE STEPS :-

1) FINDING THE PROBLEMS AND MAKING OBSERVATIONS .2) DETERMINING THE PROBABALE SOLUTIONS FOR THE PROBLEMS .3) EMPLOYEE ANALYSIS .4) VENDOR ANALYSIS 5) APPLICATION OF REAL TIME LOCATING SYSTEM IN THE HOSPITAL .

THE OBSERVATIONS IN THE PHARMACIES:-

THE DEVIATIONS FROM THE SOP’S

IRREGULARITIES RELATES TO PROBLEMS

• NO DEPARTMENT IS PERFECT 100 % EFFICIENT AND SAME APPLIES TO HUMAN BEINGS , THIS CAN BE EASILY SAID IN ANY OTHER INDUSTRY BUT IN SERVICE SECTOR , ITS ALL TOGETHER A DIFFERENT BALL GAME , “ NO COUNTRY IS PERFECT ITS CITIZENS HAVE TO MAKE IT A PERFECT COUNTRY TO LIVE “ .

• THE MAJOR PROBLE THAT IS RELATED TO THE WORKING IS THE ATTITUDE OF THE EMPLOYEES RATHER THAN THE SYSTEMS AND STANDRDS , THE PROCEDURES ARE PROVIDED AND ARE UP TO THE MARK BUT THE IMPLIMENTATION PART MAKES IT DIFFICULT FOR THE DEPARTMENT TO WORK IN AN EFFICIENT MANNER .

THE FOLLOWING ARE THE PROBLEMS AT OUT PATIENT DEPARTMENT:-

1. ONE OF THE MAJOR PROBLEMS IS THE NON AVAILIBILITIES OF THE MEDICINES AND THE WAY THE STAFF BEHAVE , ( STRAIGHT NEGATIVE STATEMENT IS GIVEN ON THE FACE OF THE PATIENTS WHICH IS NOT GOOD ) .

2. THE STAFF DOESN’T DO ANY EFFORT TO CONVINIENCE THE PATIENT .

3. NO CONFIRMATION IS DONE WITH THE CONSULTANT .

4. THE PROVISION WITH THE OTHER PHARMACIES IE THE OUT SIDE PHARMACIES IS NOT DONE .

5. THERE IS NO COMPASSION WHILE TALKING TO THE PATIENTS .

6. NO TRAINING IS GIVEN TO THE STAFF REGARDING THE WAY THEY SHOULD BE BEHAVING WHILE INTERACTING WITH THE PATIENTS .

7. IF A CONSULTANT PRESCRIBES A NEW DRUG THEN THAT DRUG IS NOT AVAILABLE AT THE OUT PATIENT PHARMACY .

8. THE STAFF AT THE OUT PATIENT DEPARTMENT IS NOT AWARE OF THE ADVERSE DRUG REACTION PROCEDURES (EXCEPT THE ADR FORM , NOT AWARE OF THE PROTOCOLS THAT NEEDS TO FOLLOWED . )

9. THIS IS A MAJOR VIOLATION OF THE STANDARD OPERATING PROCEDURES AS IT SUGGEST THAT THE PHARMACIST SHOULD BE KNOWING ALL THE PROCEDURES REGARDING THE ADVERSE DRUG REACTION .

10. MANY TIMES THERE IS NO SIGN , NO WRITTEN NOTE OR A COMPUTER GENERATED COPY ATTACHED .

11. THE MAJOR PROBLEM LIES WITH THE SIGNING AT THE AREAS WHERE THEY SHOULD BE DOING , FOR THE PURPOSE OF ACCOUNTABILITY .

12. THE STAFF IS NOT FOLLOWING THE RIGHT PROCEDURE AT THE TIME OF TAKING THE MEDICINES BACK .

13. THEY ARE NOT SIGNING AT THE RECIEVER’S AREA WHICH IS MAKING IT DIFFICULT FOR THE DEPARTMENT TO TRACK WHETHER THEY HAVE RECEIVED THE MEDICINES BACK OR NOT

14. THIS IS THE MAJOR AREA OF CONCERN REGARDING THE ACCOUNTABILITY REGISTER , WHICH MAKES IT DIFFICULT TO TRACK THE STOCK AND IS THE MAIN REASON BEHIND THE FREQUENT STOCK OUTS AT THE OUT PATIENT DEPARTMENT .

15. ON A SURPRISE CHECK MADE ON THE 19/5/12 THE DEPARTMENT SHOWED THAT THEY HAVE DONE A CHECK ON THE 8/5/12 WHICH WAS THE LAST DATE OF UPDATING THE ACCOUNTABILITY REGISTER, THE HOSPITAL ADMINISTRATION SHOULD LOOK IN TO THIS PROCESS AS THE STANDARD PROCEDURES ARE BEING VIOLATED.

16. THE FREQUENT STOCK OUT IS A BAD IMPRESSION GENERATOR IN FRONT OF THE PATIENTS AS AT TIMES THE PATIENTS HAVE TO WAIT AND CANNOT DETERMINE WHETHER THEY CAN GET THE MEDICINES FROM THE IN HOUSE PHARMACY OR GET IT FROM OUT SIDE .

17. ANOTHER MAJOR PROBLEM IS THE STOCKOUTS ITS REASONS AND THE LACK OF COORDINATION BETWEEN THE CONSULTANTS AND THE PHARMACIST .

18. THE PRESCRIBING OF MEDICINES AND THOSE MEDICINES THAT THE CONSULTANTS ARE PRESCRIBING TO THE PATIENTS NEEDS TO BE DISCUSSED WITH THE PHARMACIST AND A PLAN TO TACKLE THE ISSUE OF PRESCRIPTION OF NEW MEDICINES NEEDS TO BE DONE .

19. THERE ARE CERTAIN DOCUMENTS ON WHICH THE CASHIER SIGNS , BUT THE PHARMACIST AFTER COMPARING IT WITH THE SYSTEM HAS NOT SIGNED ON THE AMOUNT OF SUBMISSION .

20. THE TEMPERATURE REGISTER WAS MAINTAINED THOUGH WERE NOT AWARE OF THE CONDITIONS THAT NEEDS TO BE THERE IN THE PHARMACY .

IN PATIENT DEPARTMENT:-

• THE IN PATIENT DEPARTMENT IS THE MAJOR AREA OF HOSPITAL PHARMACY AS THE MEDICINES DISPENSED ARE DIRECTLY USED BY THE PATIENTS AND THE ACCOUNTABILITY FOR THESE MATERIALS SHOULD BE THERE .

NOW LET US LOOK AT THE IRREGULARITIES AT THE PROCEDURES FOLLOWED AT THE IN PATIENT PHARMACY.

• THE PHYSICAL AND SYSTEM VERIFICATION OF THE STOCKS IS NOT BEING DONE , THE LAST TIME ACCOUNTABILITY REGISTER WAS FILLED WAS ON :- 12/ 5/ 12 , WHICH WAS A WEEK BEFORE WHEN IT WAS CHECKED ON 19/5/12 .

• EARLIER IT WAS DONE ON 7/5/12 , WHICH SHOWS THAT THE REGISTER FOR THE ACCOUTABILITY WAS NOT BEING UPDATED DAILY .

THE STOCKS WHICH WAS THERE IN THE SYSTEM AND THAT PHYSICALLY PRESENT WAS NOT TALLYING AT TIMES , WHICH SHOULD NOT BE THERE , FOR EXAMPLE : - IF THE SYSTEM SHOWS THAT THERE ARE 104 . (QTY ) OF A PARTICULAR DRUG AT THE PHARMACY THEN THE SAME QUANTITY SHOULD BE THERE PHYSICALLLY PRESENT WHICH IS NOT THE CASE AT TIMES , THESE IRREGULARITIES SHOULD BE LOOKED INTO.

• MANY A TIMES THERE ARE ENTRIES WHICH SHOWS THAT A CERTAIN STOCK IS PRESENT ON THE SYSTEM , WHICH IS LEFT BLANK IN THE COLOUMN WHEN PHYSICALLY CHECKED , THUS THERE IS NO PROPER ACCONTABILITIES OF SUCH STOCKS .

• MANY A TIMES THERE ARE NO TRANFER NOTES FOR THE INDENTS THAT ARE THERE , THESE ARE SENT TO THE CDS WHICH NEEDS TO BE COLLECTED FROM THE CDS , BUT IS NOT BEING DONE , THUS THESE SHOWS THAT THERE IS LACK OF WILL AND ATTITUDE ON THE PART OF THE STAFF WORKING IN THE DEPARTMENT .

• MANY A TIMES THE RETURN NOTE IS NOT COLLECTED WHICH IS AN IRREGULARITY AT THE DEPARTMENT , THE IN PATIENT PHARMACY SHOULD COLLECT THE RETURN NOTE FROM THE DEPARTMENTS , AND SHOULD TALLY THE AMOUNT OF ISSUES , BUT WHEN CHECKED ON 19/05/12 THE ISSUES WHERE AROUND 60 IN NUMBER BUT

THE RETURN SLIPS WERE ONLY 18 , WHICH SHOWS A HUGE IRREGULARITY IN THE WORKING AND FOLLOWING OF THE SOPS .

• THE REASON FOR CONTINUOUS STOCK OUTS ,IS BECAUSE OF THE NON TALLYING OF THE PHYSICAL AND SYSTEM STOCKS , WHICH ARE PRESENT , THUS THIS IS NOT DETERMINED REGULARLY IF WOULD HAVE BEEN DONE THEN THEY CAN EASILY DETERMINE THE REORDER LEVEL , AT TIMES IT BECOMES DIFFICULT TO DETERMINE EVEN WITH SUCH SYSTEMS AND TECHNOLOGICAL INPUTS WHY SUCH IRREGULARITIES ARE BEING FOUND .

• THE IN PATIENT DEPARTMENT IS RESPONSIBLE TO DETERMINE WHETHER THE MEDICINES WHICH ARE BEING DISPENSED FROM THE IN PATIENT DEPARTMENT WHETHER THOSE ARE BEING USED CORRECTLY OR NOT , THUS THIS IS TO BE DETERMINED BY THE IN-CHARGE AT THE IN PATIENT PHARMACY .

• THE REQUIREMENTS ARE NOT FULLY SUPPLIED THROUGH THE CENTRAL DRUG STORE TO THE IN PATIENT PHARMACY WHICH BECOMES A SERIOUS PROBLEM FOR THE IN PATIENT DEPARTMENT , WHICH ACTS AS A MAJOR PROBLEM IN THE IN PATIENT PHARMACY .

• ANOTHER REASON IS THE IRREGULAR CONSUMPTION AT THE WARDS AND OTHER DEPARTMENT .

• THE TEMPRATURE REGISTER WAS NOT MAINTAINED AFTER 10/5/12 .

• THE RACK WISE STOCK REGISTER LAST TALLYING DONE 12/5/12 ONE WEEK EARLIER WHEN CHECKED ON 19/5/12 .

• NO REGULAR TALLYING OF STOCKS AT THE END OF THE DAY .

• MANY A TIMES THE ACTUAL QTY PRESENT IN THE SYSTEM DONOT TALLY TO THE PHYSICAL STOCK PRESENT OF WHICH THERE IS NO ACCOUNTABILITY NOTICED .

• THE FILE RELATED TO THE TRANSFER NOTE AND INDENTS ARE NOT MAINTAINED PROPERLY .

• THE PROBLEMS ARE ASSOCIATED WITH THE LOOK ALIKE SOUND ALIKE MATERIALS WHICH ARE RELATED TO THE WRONG INDENTS IN WHICH THE WRONG MEDICINES ARE AT TIMES IN SOME CASES DISPENSED BECAUSE OF THE CONFUSION RELATED TO THE ALIKE NAMES .

• BECAUSE OF THE LACK OF COORDINATION IN THE DEPARTMENT , THE NURSING STAFF ARE NOT WELL AWARE OF THE SOPS THAT ARE BEING FOLLOWED AT THE HOSPITAL BY THE OTHER DEPARTMENT , THUS THE NURSING STAFF AT TIMES HAVE BEING SEEN KEEPING WITH THEM , DRUGS WHICH BELONG TO THE NDPS CATEGORY AND WHICH IS NOT ALLOWED AND NOT PERMITTED .

• THE NURSING STAFF AT THE GEN OT , CT OT , NEURO OT , AND SOME OF THE OTHER DEPARTMENT ARE IN POSSESSION OF THE NARCOTICS DRUGS WHICH SHOULD NOT BE DONE , WHICH IS SERIOUS VIOLATION OF THE SOPS AND IS AN OFFENCE UNDER THE NARCOTICS DRUGS ACT .

CENTRAL DRUG STORE:-

• THE REGISTER RELATED TO THE TOP 100 ITEMS , IS NOT BEING MAINTAINED FOR THE DAILY ACCOUNTABILITY OF THE STOCKS .

• THE NARCOTICS DRUGS REGISTER WAS NOT MAINTAINED DAILY .

• THE LAST TIME NARCOTICS DRUG REGISTER WAS MAINTAINED WAS ON 17/5/12

• THE DAILY RECORD AND BALANCE OF THE DRUGS AT THE CENTRAL DRUG STORE ALONG WITH THE PHYSICAL QUANTITY OF THE DRUG SHOULD BE DONE BEFORE TAKING CHARGE AND AFTER GIVING THE CHARGE .

• MANY TIMES IT HAPPENS THAT THE STOCKS ARE NOT AVAILABLE AT THE CDS , THIS IS BECAUSE OF THE NON TALLYING OF THE TWO IE THE PHYSICAL AND THE SYSTEM STOCKS FOR THE HIGH VALUE TOP HUNDRED ITEMS .

• CONSIGNMENT STOCK THAT IS RELATED TO THE CATH LAB , ITS ORDERING , ITS RECEIVING , AND THE STANDARD PROCEDURES THAT ARE THERE , WHICH AT TIMES ARE NOT FOLLOWED BY BOTH THE DEPARMENTS.

• THE INDENTING SYSTEM IS NOT FOLLOWED BY THE OTHER DEPARTMENTS WHICH THE MAKES IT PROBLEMATIC FOR THE CENTRAL DRUG STORE TO WORK IN A SMOOTH MANNER .

• THE LACK OF KNOWLEDGE RELATED TO THE LASA AND SOPS RELATED TO , GENERICS AND BRAND NAMES .

• THE CONTINUES CHANGE IN THE MRP’S AND COST PRICES OF THE DRUG MAKES IT DIFFICULT AT TIMES FOR THE STAFF AT THE CENTRAL DRUG STORES .

• THERE SHOULD BE A CONTRACT WITH THE VENDOR , WHICH WILL COVER ALL THE COST AND DETERMINE A FIX PRICE AND COST WHICH WILL BE SAME THROUGH OUT THE YEAR .

• THE CENTRAL DRUG STORE , THOUGH IS ONE OF THE MOST EFFICIENT DEPARTMENTS OF THE HOSPITAL ITS WORKING SHOWS THAT THERE IS A GREAT SCOPE FOR IMPROVEMENT IN ALMOST EVERY SPHERE OF ITS WORK .

• THE DEPARTMENT ALONG WITH THE CENTRAL DRUG STORE CAN WORK IN A BETTER AND ENHANCED MANNER IN WHICH IT HAS TO SHOW A GREATER DEGREE OF COORDINATION , THE STAFF AT THE CENTRAL DRUG STORE , THOUGH THEY ARE EXPERIENCED BUT THEY CAN HELP EACH OTHER ALONG WITH THE DEPARTMENT AS A WHOLE IN REACHING THE PRIME EFFICIENCY . LACK OF COMMUNICATION AND COORDINATION.

• THERE WAS A PECULIAR CASE IN WHICH , SOME OF THE DRUGS WERE RETURNED AND SOME WHERE ACCEPTED , OUT OF THESE THE ENTRY THAT NEEDS TO BE THERE WAS NOT DONE IN A CORRECT MANNER , AS THE CENTRAL DRUG STORE IT SAYS THAT THEY SHOULD BE REGISTERING THE INCIDENCE OF RETURN OF THE DRUGS IF IT IS DONE AT THE TIME OF , SUPPLY OF THE DRUG BY THE SUPPLIER , ON THE COUNTER . THE INCIDENCE WHICHH TOOK PLACE WAS ON 15/2/2012 .

• THE NURSING STAFF AS SEEN IN SOME CASES HAVE FORGOTTEN TO ADD THE PARTICULAR ITEM OR MATERIAL IN THE BILL , THUS THIS BECOMES A PROBLEM FOR THE INVENTORY DEPARTMENT .

• FOR EXAMPLE :- AT THE OT , IT WAS OBSERVED THAT THE , NURSING STAFF FORGOT TO ADD TWO QTY OF BONE CEMENT WHICH COSTED NEAR ABOUT RS 5000/- , THUS THIS SUGGEST THAT , BECAUSE OF NEGLIGENCE AND IRRESPONSIBILITY THE BILLING WAS DONE INCORRECTLY .

THE PROCEDURE:-

• THE PROCEDURE SHOULD BE FOLLOWED IN A MANNER IN WHICH THE INDENT , MATERIAL AND TRANSFER SHOULD BE DONE AT THE SAME TIME IRRESPECTIVELY OF THE TIME AND EMERGENCY , CAUSE THIS IF NOT DONE IN A PROPER MANNER THEN THERE IS NO USE OF MAINTAINING SUCH REGISTERS AND FILES , WHICH WILL NEVER SHOW THE TALLYING OF THE TWO , THAT IS SYSTEM AND PHYSICAL VERIFICATION .

OTHER PROBLEMS:-

• THERE ARE MANY AREAS WHERE THE SUPPLIES ARE GIVEN TO THE SUB DEPARTMENT AS PER THERE SAFETY STOCK AND VITALS (SPECIALLY THIS IS SPECIALLY HAPPENING AT THE OT PHARMACY ) .

• THE OT PHARMACY SUPPLIES THE REQUIRED AMOUNT OF DRUGS AND VITAL STOCK TO THE INDIVIDUAL OT’S AND CATH LAB , THESE MAINTAIN THERE STOCKS RELATED TO THE VITALS AND THE SAFETY STOCK .

• NOW THE OT’S DEPT HAS TO MAINTAIN THE REQUIRED AMOUNT OF STOCKS AND MATERIALS ALONG WITH THE VITALS INFORMATION , WHICH IS NOT BEING DONE ,

THUS IN SUCH CASES IF ANY DISCREPENCIES ARE TAKING PLACE THEN WHAT SHOULD BE DONE , WHO WILL BE HELD ACCOUNTABLE ???

• THUS THE STICKS WHICH ARE GIVEN TO THE OT’S FOR THEIR BULK CONSUMPTION AND USAGE ARE GENERALLY THE STOCKS RELATED TO THE VITALS AND THE SAFETY STOCKS THUS THE NURSING STAFF SHOULD MAINTAIN AN ACCOUNT REGARDING THE CONSUMPTION AND USAGE OF THE MATERIALS GIVEN TO THEM BY THE OT PHARMACY .

• THERE IS NO SYSTEM DIVISION FOR THE STOCKS INTERMS OF SAFETY AND VITALS WHICH ARE GIVEN TO THE OT DEPT , FOR THEIR CONSUMPTION , THUS EVEN AFTER THESE STOCKS HAVE BEEN TRANSFERRED TO THE DEPT PHYSICALLY THESE CAN STILL BE SEEN IN THE SYSTEM OF THE OT DEPT , NOW THESE STOCKS WHICH ARE THERE WITH THE INDIVIDUAL DEPT OF THE OT THUS THESE ARE SHOWN IN EXCESS FOR THE OT PHARMACY AND THUS , BASED ON THE ROQ LEVEL THE SYSTEM SHOWS THAT THESE STOCKS ARE PRESENT WITH THE OT PHARMACY , WHICH IS NOT THE CASE IF CHECKED PHYSICALLY , THUS INDENTING AT THE END OF THE MONTH BECOMES A PROBLEM FOR THE OT PHARAMCY BECAUSE OF THE SYSTEM .

• ANOTHER CASE IS IN MOST OF THE PHARMACIES THE DRUGS WHICH ARE SHOWN IN THE LIST IE THE SYSTEM DOESN’T TALLY IN CERTAIN AREAS WITH THE PHYSICAL STOCKS , AND THE EXPLANATION WHICH IS GIVEN IS THAT THE COMPLETE STOCK WAS NOT PROVIDED BY THE CENTRAL DRUG STORE , THIS STATES THAT , THE INDENTING IS DONE IN ADVANCE , BEFORE THE ACTUAL PHYSICAL STOCKS ARE PROVIDED THUS THIS IS A MAJOR PROBLEM RELATING TO THE CENTRAL DRUG STORE , THE INDENTING , TRANSFER NOTE AND THE PHYSICAL MATERIAL ALL SHOULD BE DONE TOGETHER TO HAVE A BETTER NOTE OF THE MATERIALS THAT ARE PRESENT .

PURCHASE DEPARTMENT;-

• LEAD TIME IS A MAJOR PROBLEM RELATED TO THE PURCHASE DEPARTMENT , THEY ARE NOT ABLE TO PROVIDE THE MATERIALS WITHIN THE GIVEN LEAD TIME .

• PROPER INDENTING WHICH IS NOT DONE BY THE OTHER DEPARTMENT WHICH MAKES IT DIFFICULT FOR THE PURCHASE DEPARTMENT TO MAKE THAT PARTICULAR MATERIAL AVAILABLE FOR THE INDIVIDUAL DEPARTMENT .

• THE IRREGULAR PAYMENT THAT ARE BEING DONE BY THE ACCOUNTS DEPARTMENT , MAKES IT DIFFICULT TO INTERACT WITH THE SUPPLIER AS THE

SUPPLIER DOESN’T SUPPLY THE ORDER ON TIME AND , LEADS TO LACK OF COORDINATION BETWEEN THE PURCHASE DEPARTMENT AND THE SUPPLIER .

• THE PURCHASE DEPARTMENT IS TOTALLY LOST IN DETERMINING THE ACTUAL , CONSUMPTION AND THE DERIVED CONSUMPTION FOR THE DEPARTMENTS WHICH MAKES IT DIFFICULT TO STREAM LINE THE PROCESS .

• THERE IS NO PROPER FORCASTING TECHNIQUE BY LOOKING AT THE STOCKS AND THE SYSTEM .

• THERE IS A 30 TO 40 % VARIATION IN THE MATERIAL PROCURRED EVERY MONTH .

CDS

THE CHECKING OF MATERIAL IS NOT BEING DONE IN A PROPER MANNER .

SPECIALLY RELATED TO THE A TYPE OF ITEMS .

• NO FIRMNESS IN ACTION , ALL THE INCHARGE SHOULD BE WORKING IN A MANNER WHERE THE OLD MISTAKES SHOULD NOT BE REPEATED AND THE PEOPLE WORKING UNDER THE INCHARGE SHOULD NOT TAKE THEM FOR GRANTED .

• WHICH AT TIMES HAPPENS AT THE CENTRAL DRUG STORE .

• THE CDS AND PURCHASE SHOULD BE LIKE HAND IN GLOVE WHILE WORKING WITH EACHOTHER , AND THERE SHOULD NOT BE , EGO CLASHES AND , ITS HIS RESPONSIBILITY AND I AM NOT GOING TO DO THAT , SUCH KIND OF ATTITUDE SHOULD NOT BE THERE .

SOLUTIONS FOR THE PROBLEMS THAT WERE OBSERVED

1) THE VERY IMPORTANT POINT IS THE NEED TO GO FOR THE MOU WITH THE SUPPLIERS AND PROMPT PAYMENT TERMS , WITH THE LEGALITIES WHICH ARE INVOLVED .

2) 1) FOLLOW UPS OF THE FOLLOWING WORK :- A) PENDING INDENTS .3) B)ACCOUNTABILITY .4) C)FAST MOVING .5) D)NARCOTICS 6) 2) TREND ANALYSIS :- THE TREND ANALYSIS IS USED FOR DETERMING THE

CONSUMPTIONS LEVELS OF THE FUTURE AND LOOKING AT THE PAST TRENDS AND

THEIR AVERAGES THE OVERALL CONSUMPTIONS OF THE FUTURE CAN BE DETERMINED .

7) TREND ANALYSIS GIVES A TRAIL LINE GRAPH WHICH GIVES THE PAST HISTORICAL TREND AND THE FUTURE TRENDS OF CONSUMPTION OF THE DRUG , THIS CAN BE DONE FOR THE FAST MOVING ITEMS AND ALSO FOR THE ITEMS WHOSE CONSUMPTIONS CANNOT BE DETERMINED .

8) THE TREND ANALYSIS IS VERY MUCH USEFULL FOR DETERMINING THE CONSUPTIONS IN CASE OF THE DRUGS , WHICH ARE OF HIGH MONETARY VALUE AND THUS BASED ON THE TREND ANALYSIS , ITS APPROX NUMBER OF PURCHASE OF THE FUTURE TRENDS CAN BE DETERMINED .

9) DETERMINING THE CORRECT REORDER LEVEL :- 10) THE CORRECT REORDER LEVEL , WHICH IF ONCE DETERMINED , THEN ITS BUFFER

STOCK AND LEAD TIME OF ORDER CAN BE DETERMINED .11) THE PROPER REORDER LEVEL CAN BE DETERMINED IF THE SOFTWARES ARE USED OR

BY DOING CORRECT CALLCULATIONS .12) THE SOFTWARES WHICH ARE THERE TO DETERMINE THE REORDER LEVEL , BY

PUTTING IN THE CONSUMPTION AND THE LEAD TIME THE REORDER LEVEL CAN BE DETERMINED .

13) CURRENTLY THE HOSPITAL IS NOT ABLE TO ORDER BASED ON THE REORDER LEVEL AND IS BEING DONE WHEN THE INVENTORY COMES TO NIL OR ZERO LEVEL , THUS THIS CREATES PROBLEM AND EMERGENCIES WHICH CAN BE AVOIDED EASILY DURING THE LEAD TIME OR THE TIME TAKEN FOR THE MATERIAL TO REACH THE HOSPITAL .

14) THE REORDER LEVEL IS THE LEVEL AT WHICH THE PARTICULAR DEPARTMENT SHOULD REORDER THE PARTICULAR MATERIALS , TO THE PURCHASE DEPRATMENT AND PURCHASE SHOULD FORWARD THE REQUEST TO THE SUPPLIER .

15) THE BUFFER STOCK :- THIS IS THE STOCK WHICH CAN BE STATED AS THE COMSUMPITON DURING THE LEAD TIME , AND THUS THE STOCK OUT WON’T BE THERE IF THE ORDERING IS DONE ACCORDING TO THE REORDER LEVEL .

16) 4)FOR THE DRUG , THE CONSULTANTS SHOULD BE ASKED ONLY FOR THE PARTICULAR BRANDS FOR EXAMPLE THREE BRANDS AND THREE SUPPLIER , AT THE REQUIRED PRICES , THUS THIS WILL PREVENT A) STOCK OUTS

17) B) NON AVAILABILITY OF THE SUBSTITUTE .18) C) TO FORCEFULLY PURCHASE FROM OUT SIDE THE HOSPITAL .19) 5) THE LOGISTICS AND PURCHASE SHOULD COLLABORATE AND COORDINATE .20) THE SHOULD COORDINATE IN THE FOLLOWING AREAS :- A) CONSUMPTION ,B)

OCCUPANCY , C) DRUG AVAILABILITY .21) D) TO PREVENT THE CENTINAL EVENT OR ADVERSE EVENT WITHIN THE HOSPITAL . 22) 5) THE HOSPITAL SHOULD MAKE EFFORTS BY COLABORATING WITH THE

CONSULTANTS , BY MAKING THE HOSPITAL FORMULARY WHICH WILL TELL ABOUT

THE DRUG , STARTING FROM PURCHASING , STORAGE , PRESCRIPTION , AND ITS SUPPLIER AND AVAILABILITY .

23) SOP VIOLATION WHICH IS THERE UNDER CERTAIN CASES WHERE DUE TO EMERGENCIES THE PROTOCOLS CANNOT BE FOLLOWED OR WHERE THE PROTOCOLS WHERE FOLLOWED BUT SOME POINTS WHERE NOT FOLLOWED , NOT IN A PROPER MANNER .

24) THUS IN THAT CASES , THE PROTOCOLS SHOULD BE CHANGED , WITH LITTLE FLEXIBILITY , AFTER TAKING SUGGESTIONS FROM THE STAFF , HEAD OF PURCHASE , AND CENTRAL DRUG STORE , CERTAIN CHANGES WHERE EVER IS POSSIBLE SHOULD BE DONE , TAKING INTO CONFIDENCE THE REAL SITUATIONS AND HUMAN ERROR .

25) 7) DISTRIBUTION ------------------à 100 % PROCUREMENT SHOULD BE THERE . 26) CHANNELISATION OF THE PURCHASE IN TIME AND WITHIN THE LEAD TIME THE

MATERIAL SHOULD BE MADE AVAILABLE .27) THERE SHOULD BE AN ANALYSIS OF THE DRUG ON THE BASIS OF THE A TYPE ITEMS

AND THE VITAL ITEMS , AS CURRENTLY THERE IS ONLY THE CATEGORISATION ON THE BASIS OF THE ABC ANALYSIS , VED ANALYSIS AND INTER GRADING ANALYSIS LIKE ( A-V) ITEMS SHOULD BE DONE .

28) THE SUPPLIER SHOULD BE IDENTIFIED AND WE SHOULD ENTER INTO A LEGAL CONTRACT WITH THEM ALONG WITH A GURANTEED ORDER AND TENDER CONTRACT FOR THE A AND V CLASS ITEMS THIS SHOULD BE DONE TO MAKE IT AVAILABLE FROM THE SUPPLIER AT THE RIGHT TIME , THUS THE MOST EFFICIENT WILL BE AN MEMORANDUM OF UNDERSTANDING (MOU)

29) MANAGEMENT AND RECRUITMENT SERVICES RELATED TO THE PHARMACY SHOULD BE HAVING KNOWLEDGE AND TOOLS WHILE RECRUITING THE EMPLOYEES .

30) TRAINING AND EDUCATION SHOULD BE GIVEN TO THE EMPLOYEES . ‘31) FOR VITALS DRUGS AND EMERGENCY DRUGS , SOME STANDARD PROTOCOLS AND

PROTOCOLS FOR THE INVENTORY CONTROL AS THERE IS NO CURRENT PROTOCOLS FOR THE VITALS RELATED TO THE INVENTORY CONTROL.

32) ONLY PROTOCOLS RELATED TO THE ISSUEING AND DISPENSING OF THE VITALS AND EMERGENCY DRUGS IS GIVEN CURRENTLY . THE EMERGENCY DRUG AT LOW COST AND LESS QUANTITY SHOULD BE MADE AVAILABLE .

33) THE CONSULTANT WILL GIVE PRICE INFO AND THE PURCHASE WILL MAKE IT AVAILABLE RELATED TO THE MOU .

34) THERE SHOULD BE THE FOLLOWING PROCEDURE FOR THE TRAINING :- 35) CLINICAL KNOWLEDGE 36) ORIENTATIONS AND ASSESMENT 37) REPORTING OF PERFORMANCE 38) 10) PHARMACEUTICAL RELATED NURSING EDUCATION , BOTH THE NURSING

STAFF AND PHARMACIST .

39) THEY SHOULD HAVE A COLLABORATION , THE NUMBER OF BRANDS SHOULD BE LESSENED WITH THE INTROCUCTONS OF THE HOSPITAL FORMULARY . ,THUS THE MEDICATION ERRORS CAN BE LESSENED .

40) THERE SOULD BE A DRUG INFORMATION SERVICE WHICH SHOULD BE ORGANISED ANDTHIS SHOULD BE DONE ONLINE , OR BY DAILY NEWS BULLETIN , WHICH WILL UPDATE THE INFORMATION RELATED TO THE DRUG INFORMATION AND ITS AVAILABILITY .

41) 11) AT EVERYEND OF THE RECEIVING , PURCHASE AND CENTRAL DRUG STORE IT SHOULD BE CROSSED TALLYED .

42) 12) THE INDIVIDUAL DEPARTMENT SHOULD BE WELL VERSED WITH HOW THE OTHER DEPARTMENT WORK AND WHAT ARE THEIR LIMITATIONS AND WHAT ARE THE PROBLEMS IN THE DEPARTMENT .

43) 13) FOLLOW UPS SHOULD BE TAKEN BY THE CENTRAL DRUG STORE INCHARGE , PURCHASE INCHARGE , AND HEAD OF THE DEPARMENT.

44) THEY SHOULD WORK ON A DAY WISE BASIS IN WHICH THEY SHOULD CHECK EVERYDAY TAKING INTO ACCOUNT THE LEAD TIME WHEN THE DRUG WAS ORDERED , AND WHEN IS THE ISSUE DATE AND WHAT IS THE LEAD TIME .

45) 14) MATERIAL FRM THE MARKET WHEN THE WORKLOAD IS MORE , WE SHOULD THINK OF KEEPING NIGHT DUTIES FOR THE FOLLOWING WORK :-

46) 1)CHECKING OF PHYSICAL STOCK .47) 2) PROBLEM HANDLING .48) 3) EMERGENCIES 49) 4) ACCOUNTABILITY 50) 5) REST OF THE PENDING GRN’S , TRANSFERS , AND PURCHASE ORDER .51) 6) FILLING OF DOCUMENTS .52) 7)MATERIAL WHICH IS RECEIVED LAST NIGHT . 53) ) AS SOON AS THE MATERIAL COMES SHOULD BE TRANSFERRED TO THE RESPECTIVE

DEPARTMENT BASED ON THE 54) 1) PRIORITY 55) 2)DATE OF INDENT 56) 16) THIS LINKS TO THE BOUNCES , STOCKOUTS , AND ACCOUNTABILITY .57) 17) IN THE OPERATION THEATER THE , ALL THE PROCEDURES SHOULD BE DONE

THROUGH THE SYSTEM BEACAUSE RIGHT NOW ALL THE MATERIAL IN THE OT’S ARE DONE MAUALLY .

58) 18)ACCORDING TO THE NEED FOR STOCK ROOM , HOLDING AREA , AND A WARE HOUSE WHERE THE EXCESS STOCK CAN BE KEPT . MANY TIMES STOCKS WHICH COME DURING THE EARLY PART OF THE MONTH IS BEING KEPT IN THE LOBBIES AND WHICH ENCROACHES THE PATIENT MOVING AREA .

59) 19) AT THE TIME OF RECRUITMENT KNOWLEDGE OF PERSON WHO IS BEING RECRUITED SHOULD BE TRAINED WITH THE EXPERIENCES STAFF IN A STEP WISE MANNER .

60) BENCH STRENGTH SHOULD BE DEVELOPED IN THE HOSPITAL RELATED TO THE TRAINEE WHO ARE COMING IN THE DEPARTMENT .

Employee analysis :-

BASED ON THE QUESTIONAIRRE • FOLLOWING IS THE PART OF THE QUESTIONAIRRE WHICH RELATES TO THE JOB

SATISFACTION :-• 1) HOW LONG THE EMPLOYEE HAVE BEEN WORKING ( TO CHECK THE ADAPTATION

LEVELS AND EXPERIENCE ) • 2) FEEL ABOU T THE WORKING ENVIORMENT .• 3) HOW SECURE THEY FEEL ABOUT THEIR JOB .• 4) HOW SMOOTH IS THE RELATIONSHIP WITH THE OTHER EMPLOYEES .• 5)OPINION ABOUT THEIR JOB .• 6) SATISFACTION LEVEL ABOU T THE INCENTIVE AND BONUSES . • 7) SATISFACTION ABOUT THE OVERALL PACKAGE THEY ARE GETTING • 8)WELFARE SCHEMES ABOUT THE HOSPITAL .• 9) DESCRIMINATION IN THE HOSPITAL OF ANY KIND .• 10) SATISFIED ABOUT THE FEEDBACK THEY ARE GETTING . •

• SHANKAPAL MANKAR :-• MORE THAN FIVE YEARS OF EXPERIENCE IN THE FIELD .• FEELS (GOOD ) IN THE WORKING ENVIORMENT .• FEELS SECURED IN THE JOB .• VERY HIGH SMOOTH RELATIONSHIP WITH THE SENIORS AND THE STAFF .• HIGHLY SATISFIED BY HIS JOB .• SATISFIED BY THE REWARD OR INCENTIVE SYSTEM OF THE HOSPITAL .• FEELS THAT THE BONUS SYSTEM SHOULD BE IMPROVED BUT SATISFIED BY THE

OVERALL PACKAGE OF THE EMPLOYER .• THINKS THAT THE WELFARE SCHEME SHOULD BE IMPROVED .• DID NOT EXPERIENCED ANY DISCRIMINATION IN THE ORGANISATION .• STRONGLY AGREES WITH THE FEEDBACK GIVEN TO HIM BY THE UPPER LEVEL

MANAGERS .•

• NANDKISHOR SHARMA :- MORE THANFIVE YEARS OF EXPERIENCE • FEELS (GOOD ) IN THE WORKING ENVIORMENT .• FEELS SECURED IN THE JOB • MEDIUM SMOOTH RELATIONSHIP WITH THE SENIORS AND THE STAFF ..• NOT SATISFIED BY HIS JOB

• FEELS THAT THE BONUS SYSTEM SHOULD BE IMPROVED , AND THE OVERALL PACKAGE SHOULD ALSO BE IMPROVED .

• WELFARE SCHEME SHOULD ALSO BE IMPROVED •

• PRAVIN MAIND :- • MORE THAN FIVE YEARS OF EXPERIENCE IN THE FIELD .• FEELS (EXCELLENT ) IN THE WORKING ENVIORMENT .• FEELS HIGHLY SMOOTH RELATIONSHIP WITH HIS SENIORS AND STAFF .• SATISFIED ABOUT HIS JOB .• SATISFIED BY THE INCENTIVE AND BONUS SYSTEM OF THE HOSPITAL .• THE OVERALL PACKAGE SHOULD BE IMPROVED .• THE WELFARE SCHEME SHOULD BE IMPROVED .• OBSERVED NO DISCRIMINATION IN THE ORGANISATION .• SATISFIED WITH THE FEED BACK UPPER LEVEL MANAGERS GIVE HIM TO IMPROVE .•

•

• SUGAT WANKHEDE :- • MORE THAN FIVE YEARS OF EXPERIENCE • FEELS EXCELLENT IN THE WORKING ENVIORMENT .• FEELS SECURE ABOUT HIS JOB .• HIGHLY SMOOTH RELATIONSHIP WITH HIS WORKERS AND THE STAFF .• SATISFIED WITH HIS JOB .• FEELS THE INCENTIVE AND BONUS SYSTEM SHOULD BE IMPROVED .• BUT IS SATISFIED WITH THE OVERALL COMPENSATION PACKAGE .• FEELS THAT THE WELFARE SCHEME SHOULD BE IMPROVED .• NO DISCRIMINATION WAS OBSERVED .• SATISFIED WITH THE FEEDBACK THAT WAS PROVIDED BY THE UPPER LEVEL

MANAGERS .

• FOLLOWING IS ANALYSIS OF THE QUESTIONAIRRE RELATED TO THE PHARMACHOLOGY .

• SHANKPAL MANKAR :-

• SCORED (7/10) IN THE PHARMACOLOGY TEST.

• THUS SHOWS THAT IS GOOD IN THE KNOWLEDGE AREA RELATED TO THE PHARMACOLOGY .

• BUT NEEDS MORE INFORMATION RELATED TO THE ADR , GUIDANCE SHOULD BE GIVEN TO THE EMPLOYEE ABOUT THIS AS HE IS NOT AWARE AND NOT WELL VERSED WIT H THE PROTOCOLS RELATED TO THE ADVERSE DRUG REACTION .

• NANDKISHOR SHARMA :-

• SCORED (6/10) IN THE PHARMACOLOGY TEST

• THERE IS SCOPE OF IMPROVEMENT IN THE FIELD OF THE KNOWLEDGE RELATED TO PHARMACOLOGY .

• REQUIRES GUIDANCE IN THE FIELD OF THE ADVERSE DRUG REACTION .

• HE SCORED (4/10) IN THE QUESTIONAIRRE RELATED TO THE STANDARD OPERATING PROCEDURE .

• PRAVIN MAIND :- SCORED VERY POORLY IN THE QUESTIONAIRRE RELATED TO THE PHARMACOLOGY .

• POOR KNOWLEDGE IN THE AREA OF ADVERSE DRUG REACTION .

• NEEDS SERIOUS SESSIONS RELATED TO THE PHARMACOLOGY AND ADR BOTH .

• SOCRED (5/10) IN THE QUESTIONAIRRE RELATED TO THE STANDARD OPERATING PROCEDURE .

• SUGAT WANKHEDE :-

• SCORED (7/10) IN THE PHARMACOLOGY TEST .

• IS ONE OF THE MOST KNOWLEDGABLE EMPLOYEE PRESENT IN THE CENTAL DRUG STORE .

• HAS GREAT SKILLS IN THE FIELD OF THE PHARMACEUTICS AND PHARMACOLOGY .

• SUGAT WANKHEDE IS THE ONLY EMPLOYEE PRESENT IN THE CENTRAL DRUG STORE WHO IS WELL VERSED WITH THE ADVERSE DRUG REACTION AND THE PROTOCOLS THAT ARE ASSOCIATED WITH THE ADVERSE DRUG REACTION .

• SCORED (5/10 ) IN THE QUESTIONAIRRE RELATED TO THE STANDARD OPERATING

• RAMESH MESHRAM :-

• CLEAR ABOUT HIS SHORT TERM AND LONG TERM GOAL .

• STRENGTHS :- THE MOST POSITIVE EMPLOYEE PRESENT IN THE PHARMACY DEPARTMENT , WORK S WITH A POSITIVE ATTITUDE AND ALWAYS READY TO TAKE NEW CHALLENGES AND TASK WHICH ARE DIFFICULT TO HANDLE .

• TAKES REGULAR FOLLOW UPS AND IS VERY PUNCTUAL .

• WEAKNESSES :- AT TIMES SHOWS LACK OF CONFIDENCE .

• SILLY MISTAKES ARE THERE WHEN WORK LOAD INCREASES AND THIS IS ONE AREA WHERE HE NEEDS GUIDANCE , AND CAN IMPROVE .

• SHOULD IMPROVE HIS COMMUNICATION SKILLS WHICH SHOULD BE A GUIDED EFFORT FROM THE ADMINISTRATION DEPARTMENT .

• HE FEELS THAT HIS COORDINATION WITH THE CENTRAL DRUG STORE NEEDS IMPROVEMENT AND THUS CAN BE IMPROVED TO A GREATER DEGREE .

• RELATED TO THE STANDARD OPERATING PROCEDURE QUESTIONAIRRE HE SCORED (6.5 /10) WHICH IS THE HIGHEST SCORE AMON ALL THE EMPLOYEES .

• NISHA NANDANWAR :-

• CLEAR ABOUT HER SHORT TERM AND LONG TERM GOAL .

• STRENGTHS :- IS A QUICK LEARNER .AND GRAB THE NEW ASSIGNMENTS FASTER EFFICIENT MANNER .

• CONCENTRATES ON HER WORK AND IS HARD WORKING .

• SHE HAS A COMPATIBILITY WITH THE OTHER STAFF AND WORKERS IN THE DEPARTMENT .

• WEAKNESS :-

• AT TIMES LACKS THE ATTITUDE OF MAN MANAGEMENT .

• GETS EMOTIONAL WHILE WORKING .

• SHE LACKS POSITIVE ATTITUDE AND DONOT TAKE CRITICISM IN A POSITIVE WAY .

• SHE AT TIMES HAVE PROBLEMS IN QUESTIONING THE OTHER MEMBERS OF THE STAFF AND DEPARTMENT .

• SHOULD IMPROVE HER COMMUNICATION WITH THE OTHER MEMBERS OF THE DEPARTMENT .

• IN THE QUESTIONAIRRE RELATED TO THE STANDARD OPERATING PROCEDURE SHE SCORED (5/10) THUS SHOULD BE FOCUSSING MORE ON THE SOP’ GIVEN IN THE HOSPITAL PROTOCOLS .

The employee efficiency rate DEPARTMENTAL EFFICIENCY .:-

The above efficiency is based on the keen observation of the working of the departments

• Central drug store :-

• Arjun maurya

• Sugat wankhede

• Nandkishore sharma

• Nisha nandanwar

The above employees are the part of the central drug stores .

• The central drug store in mainly the link up between various sub stores and the suppliers .

• The central drug store is related to the ordering of the material and receiving the same along with the maintenance of the stocks and doing the documentation work along with the completion of the system transfers and goods receipt notes ( called the GRN’S )

• The purchase orders are also prepared at the central drug stores and which is mandatory for the ordering of the material .

Allotment of work

• the allotment of work is done as follows .

• Sugat wankhede ( incharge central drug stores)

• Nandkishor sharma ( purchase head )

• Nisha nandanwar and Arjun maurya ( GRN’S and transfers )

• The receiving of materials is done by everyone .

•

• Positives :-

• 1) timely catering of items .

• 2) Keeps the emergency stocks.

• 3) Holds the narcotics and dispense them , in the right manner in most of the cases .

• 4) In frequent talks with the consultants about the new drugs and information for their requirements .

• 5) Helps in coordination with other sub stores to fulfill their requirement .

NEGATIVES :-

• 1) materials not transferred in the system .

• 2) wrong documentation .

• 3) demand not determined .

• 4) orders are not given at the right time .

• 5) the lead time is exceeded in most of the cases .

• 6) getting the materials is not a problem but within the right time frame is a major lacking .

• 7) in case of instrumentation no proper coordination with the consultants and the suppliers . .

• 8) the central drug store do not ask the purchase departments about the follow ups on the purchasing of materials and the pending items .

Central drug stores needs to work on a five point program:-

• 1) regular follow ups with the departments , consultants and the supplier about the :-

• A) materials

• B) pending indents

• C) lead time

• D) accountability

• E) narcotics

• 2) regular transfer of materials both on the system and physically

• 3) periodic checks on the inventories

• 4) determining the no of GRN’S and purchase order done in a day , and preparing a list of those items which requires the priority and transfer that material in the beginning ( purchase order , GRN, and transfer all the three things should be done on a priority manner . )

• 5) to have a start up meeting with the various department on a day wise basis and with the staff of the sub stores to take their priorities and work according to it in a coordinated manner .

Individual efficiency:-

• Arjun maurya :- goods receiving and the goods receipt note .

• Areas of error :- 1) SLOW RATE OF TRANSFERS. 2) DONOT PRIORITISE THE WORK .

• 3)BACK DATE GRN’S .

• 4) POOR COORDINATION WITH THE OTHER DEPARTMENTS .

• 5)POOR COORDINATION WITH THE PURCHASE DEPARTMENT .

POSITIVES :-1) GOOD SPEED OF WORKING ON THE SYSTEM .

2) WELL VERSED WITH THE PROCESS DUE TO HIS EXPERIENCE IN THE FIELD .

3)FOCUSSED ON HIS WORKING .

4) MOST OF THE TIMES TAKES FOLLOW UPS .

• ARJUN MAURYA , NISHA NANDANWAR AND THEIR TEAM SHOULD DO ATLEAST GRN’S OF AROUND 2000 ITEMS REGULARLY AND A TRANSFER OF AROUND 1000 ITEMS REGULARLY , AND NOW THEY ARE WORKING AT A RATE OF HALF THIS RATE WHICH STATES A EFFICIENCY RATE OF 50 % .

• THIS SHOWS THAT THERE CAN THREE REASONS

• 1) SLOW IN THERE WORK

• 2) LACK OF COORDINATION WITH THE PURCHASE DEPARTMENT RELATED TO THE PURCHASE ORDER.

• 3) HAVE TIME WHEN THEY DONOT HAVE WORK RELATED TO THE GRN’S AND TRANSFERS .

• 4) BUT STILL THEY ARE LAGGING IN THE TRANSFERS AND GRN’S AT TIMES .

FIVE POINT PROGRAM:-

• ARJUN MAURYA :-

• REGULAR FOLLOW UPS WITH THE CENTRAL DRUG STORE AND OTHER SUB STORES .

1) REGULAR TOUCH WITH THE PURCHASE DEPARTMENT .

2) PRIORITY TRANSFER .

3) FOLLOW UPS IN THE CASE OF GOODS RECEIVING AND TRANSFERS .

4) SHOULD INVOLVE PLANNING AND STRATEGIC APPROACH IN HIS WORKING AND SHOULD TAKE ADVICE FROM HIS FELLOW WORKERS .

5) DAILY PLANNING IN WHAT SHOULD BE TRANSFERRED ON A PRIORITY LEVEL AND WHAT SHOULD BE DOCUMENTED ON A PRIORITY LEVEL , WHICH RELATES TO HIS WORK RELATED TO MAKING THE GRN’S .

6) WEEKLY SCHEDULE OF WORKING RELATED TO ITEMS OF MORE IMPORTANCE COMPARED TO THE OTHER ITEMS .

7) ASKING THE DEPARTMENTS TO PHYSICALLY TRANSFER THE MATERIAL WITHIN THE SAME DAY OR WITHIN 24 HRS AS SOON HE TRANSFERS THE MATERIAL THROUGH THE SYSTEM .

8) AND AT THE SAME TIME DONOT DELAY THE TRANSFER OF MATERIALS WHICH ARE AT TIMES IN CASE OF EMERGENCY TAKEN BEFORE THE DOCUMENTATION IS DONE MORE THAN 24 HRS .

9) GOODS ONCE RECEIVED SHOULD NOT BE DELAYED BY MORE THAN 24 HRS FOR THE GOODS RECIEPT NOTE .

• NISHA NANDANWAR :- 1) REGULAR CHECKING OF PENDING GOODS WHOSE PURCHASE ORDER IS DONE , AND ARE PENDING WITH THEIR GRN’S .

• 2) RECEIVING OF MATERIALS AND CROSS CHECKING WITH THE PURCHASE ORDER .

• 3) SHOULD MAKE SURE THAT ARE ACCOUNTABILITY IS DONE EVERYDAY AT THE DEPT .

• 4) SHOULD MAKE SURE PO ARE AVAILABLE INPRINT AT THE FILE REGISTER BEFORE THE MATERIAL IS RECEIVED .

• 5) ACCOUNTABILITY OF THE NARCOTICS .

• 6) HELP IN TRANSFER OF THE GOODS THROUGH THE SYSTEM .

• 7) ARJUN MAURYA AND NISHA NANDANWAR SHOULD WORK IN A MANNER IN WHICH ONCE THE PURCHASE ORDRE IS DONE IT SHOULD TAKE THE LEAST TIME IN REACHING THE SUB STORES THROUGH THE CHANNEL OF ------ ( GOODS RECEIVING -------- GOODS RECEIPT NOTE ----------- AND PHYSICAL TRANSFER ) PROVIDED THERE IS NO PROBLEM IN ANY OF THE OTHER PROTOCOL .

• 8) DAILY LOG OF THE NUMBER OF TRANSFERS AND NUMBER OF GRN’S SHOULD MATCH ALONG WITH THE PHYSICAL TRANSFERS IN AN APPROXIMATION .

• THIS WILL ALSO HELP THEM UNDERSTAND WHERE IS THE LACKING AND WHETHER ITS THEIR OWN LACKING OR THE LACKING OF PURCHASE DEPT IN PROVIDING THE MATERIALS .

• NANDKISHOR SHARMA :-

• 1) LACK OF FOLLOW UPS .

• 2) NO PROPER COORDINATION WITH THE STORES AND SUPPLIER .

• 3) LACKING IN ASKING THE CONSULTANTS FOR THE SUBSTITUTE IN CASE OF EXCEEDING OF THE LEAD TIME .

• 4) NEEDS TO IMPROVE THE COOMUNICATION WITH THE OTHER DEPT .

• 5) NEEDS TO PUT MORE EFFORTS IN CASE OF PENDING INDENTS .

• 6) IN MANY CASES EXCEEDS THE LEAD TIME .

• 7) SHOULD GRADE THE SUPPLIERS INCASE OF FREQUENT EXCEEDING OF THE LEAD TIME AND REPORT THIS TO THE HOD AND THE TOP ADMINISTRATION .

• 8) DOCUMENTATION IS AT TIMES NOT PRIORITISED WITH THE ITEMS WHICH ARE REQUIRED TO BE PROVIDED WITHIN A PARTICULAR TIME FRAME WHICH NOT DONE DUE TO DELAY IN DOCUMNTATION .

• 9) SHOULD PRIORITISE THE PURCHASE ORDER DOCUMENTAION BASED ON THE THREE BASIS A) TYPE OF DRUG , B) LEVEL OF EMERGENCY , C) TYPE OF SUPPLIER AND LEAD TIME .

• 10) THE FOLLOW UPS ON THE PENDING INDENTS AND TRACKING OF MATERIALS WHOSE ORDER HAVE BEEN GIVEN BUT NOT RECEIVED DAILY AND , ASSESMENT OF ITEMS WHICH HAVE BEEN OREDRED BUT HAVE EXCEEDED THE LEAD TIME OF MORE THAN ( 5) DAYS .

• 11) DAILY DEPARTMETNTAL INTERACTION AND WITH THE OTHER CONSULTANTS .

• 12) PRIORITISING THE OREDRS BASED ON THEIR URGENCY TO PURCHASE .

• 13) SHOULD MAKE SURE ONCE THE PURCHASE IS RECEIVED IT SHOULD REACH THE SUB STORES WITHIN THE TIME OF AROUND 24 HRS , AS IT ADDS TO THE LEAD TIME WHICH IS HIS RESPONSIBILITY TO DEACREASE AS LOW AND AS LESS AS POSSIBLE .

• 14) PURCHASE ORDER OF CERTAIN ITEMS WHICH ARE PREPARED IN SYSTEM BUT ITS COPY IS NOT PRESENT AT THE FILE VIOLATES , AS IT ADDS TO THE LEAD TIME AND MAKES THE DELIVERY PERSON WAIT AT THE COUNTER .

• 15) THE AVERAGE WAITING TIME AT THE COUNTER SHOULD BE NOT MORE THAN 10 MINS .

• 16) IF PURCHASE OREDER IS THERE IT CAN BE CROSSED CHECKLED AND TAY CAN BE DONE .

• 17) THE SERIOUS VIOLATION OF SOP’S WHEN THE ITEMS ARE RECEIVED WITHOUT THE PURCHASE OREDR WHICH SHOULD NOT BE DONE .

• 18) THOSE SUPLPLIER WHO HAVE A POOR RATING SHOULD BE INFORMED AND ASKED WHAT IS THE PROBLEM IN PROVING THE MATERIALS WITHIN THE LEAD TIME .

• 19) MAKE SURE THAT THE CONSULTANT IS AWARE OF THE DELAY IN THE LEAD TIME AND DAILY FOLLOW UPS ON THE MATERIAL TO THE CONSULTANT WHICH MAKES THEM UNDERSTAND THAT THE DEPT IS WORKING ON MATERIALS , RATHER THAN GIVING FOLLOW UPS ONLY WHEN THE SUB STORES OR THE CONSULTANTS ASKS FOR IT .

• TO ANALYSE THE TIME TAKEN BY TWO OR MORE THAN TWO SUPPLIERS TO PROVIDE THE SAME MATERIALS AND IF A DELAY IS THERE TO DO ROOT CAUSE ANALYSIS .

• 21 ) A DAILY REPORT ON THE PENDING INDENTS AND ORDERS SHOULD BE GIVEN TO THE RESPECTIVE SUB STORE .

• 22) TO DO MONTHLY OR HALF YEARLY VENDOR ANALYSIS AND DETERMING THE ALTERNATIVE NEW SUPPLIERS IN CASE OF EMERGENCIES .

• 23) IF HE CAN GIVE THE SAME ORDER TO THE TWO DIFFERENT SUPPLIER THEN SHOULD ANALYSE BOTH THE SUPPLIER ON A REGULAR BASIS IF THERE IS SOME PROBLEM .

• SUGAT WANKHEDE :- 1) IMPROVE THE SPEED ON WORKING WITH THE SYSTEM .

• 2) RECIEPT OF THE MATERIALS SHOULD BE SUPERVISED WITH A MORE EMPHASIS ON DOCUMENTATION .

• 3) OVERALL OBSERVATION ON THE WHOLE PROCESS .

• 4) SHOULD BEHAVE IN A MANNER WHERE HE IS PART OF EACH PROCESS AND HAVING A LOOK AT EACH PROCESS .

• 5) SHOULD BE A ON THE MOVE MANAGER WHERE HE IS HELPING THE PURCHASE AS WELL AS THE CENTRAL DRUG STORE TO DO THERE DAILY WORK AND WORK IN A MANNER WHERE THE WHOLE PROCESS GOES IN A SMOOTH WAY .

• 6) SHOULD NOT INTERFERE IN THEIR WORK UNLESS AND UNTILL THERE IS A PROBLEM OR DEPT ISSUE .

• 7) SHOULD TAKE FOLLOW UPS FOR THE PURCHASE AND TRANSFERS

• 8) SHOULD MAKE SURE THAT DAILY PHYSICAL AND SYSTEM TRANSFER IS DONE

• 9) SHOULD MAKE SURE THAT MATERIAL WHOSE GRN IS DONE SHOULD BE TRANSFERRED PHYSICALLY .

• 10) CHECK THE ACCOUNTABILITY BOTH FOR THE DRUGS AND NARCOTICS .

RATE OF EFFICIENCY:-

• OUT PATIENT PHARMACY :-

• THE AVERAGE PATIENT TIME THAT IT TAKES TO DISPENSE THE DRUGS ALONG WITH THE BILLING AND PACKING :- IS NEAR ABOUT 13.8 MINUTES .

• 660 MINUTES AND NO OF PRESCRIPTIONS ARE 50 WHICH COMES TO AROUND 13.8 MINUTES , AND THE MINIMUM OF AROUND 3.2 MINUTES IN A DAY WHICH RELATES

TO AN AVERAGE OF 8.5 MINUTES . WHICH CAN BE COMPARED WITH THE GLOBAL AVERAGE OF AROUND 4 TO 5 MINUTES THUS CAN SHOW THAT SCOPE OF IMPROVEMENT IS THERE .

1) PRIORITISING OF THE WORK ( PATIENTS )

2) SHOULD INTRODUCE THE TOKEN SYSTEM IF POSSIBLE .

3) ON AN AVERAGE 5 BOUNCES IN A DAY .

4) 25,000 SALES EVERYDAY AVERAGE

5) 60 PRESCRIPTIONS ON AN AVERAGE

6) 25000/60 = 416/- RS

7) 416 * 5 PRESCRIPTIONS = 2100 /- RS

8) THUS A DAILY LOSS OF AROUND 2100 RS .

9) WHICH COMES TO AROUND 2100 * 30 = 63000/- TO - 65000/- RS

10) COMES TO YEARLY OF AROUND = 7,50,000/- RS

11) DECREASE THE AMOUNT OF NON MOVING STOCK AND NEAR EXPIRY STOCK BY COORDINATION WITH THE CONSULTANT BY ORDERING AND NOTING THE ITEMS WHICH ARE THERE IN THE NEAR EXPIRY AND NON MOVING .

12) TAKING FOLLOW UPS FROM THE CDS

13) TAKING FOLLOW UPS FROM THE PURCHASE DEPT

14) FREQUENT COORDINATION WITH THE CONSULTANTS ON THREE ISSUES :- 1) NON MOVING , 2) SUBSTITUTES , 3) BOUNCES .

15) SHOULD TAKE FOLLOW UPS RELATED TO THE PENDING INDENTS .

16) SHOULD TAKE FOLLOW UPS ON THE EMERGENCY ITEMS ON A REGULAR BASIS .

17) PROPER ACCOUNTABILITY TO PREVENT STOCK OUTS AND BOUNCES

18) BOUNCES TWO REASONS :- 1) NON PRESCRIPTION , 2) NON AVAILIBILITY OF THE STOCK

19) AT THE COUNTER SHOULD ASK THE CONSULTANTS IF A PARTICULAR DRUG IS NOT AVAILABLE , NO MATTER HOW SMALL THE PRESCRIPTION AND HOW LESS THE VALUE IS .

20) SHOULD MANAGE THE PATIENTS BY QUEING SYSTEM AND NUMBERING SYSTEM .

21) THIS WILL HELP IN PROVINDING THE PATIENT WHO COMES FIRST TO GET THE MEDICINE FIRST .

22) CAUSE MANY A TIMES IF A DELAY IS THERE FOR THE FIRST PATIENT ADDS TO THE TIME THE NEXT PATIENT IS WAITING FOR HIS OR HER MADICINE .

IN PATIENT PHARMACY:-

• THE AVERAGE TIME IT TAKE TO DISPENSE A PRESCRIPTION IS AROUND 8.5 MINUTES , WHICH IS 3.5 MINUTES AS A GLOBAL STANDARD , SO THE DELAY IS OF AROUND 5 MINUTES .

• THE RESPONSIBILITY SHOULD BE THERE WHICH IS ONLY CHECKED BY RETURN NOTE WHICH MOST OF THE TIMES NOT COLLECTED BY THE INPATIENT PHARMACY .

• THE ACCOUNTABILITY SHOULD BE DONJE REGULARLY

• THE TRACKING OF ITEMS TO THE WARDS

• NARCOTICS OBSERVATION

• DAILY CROSS CHECKING OF PENDING INDENTS

• PHYSICALLY TRANSFER OF MATERIALS

• TO MAINTAIN THE STORAGE CONDITIONS .

• IF MATERIAL NOT TRANSFERRED THEN THEY ISSUE DRUG OF DIFFERENT STRENGTH OR DIFFERENT BRAND WHICH CREATES PROBLEM IN THE ACCOUNTABILITY .

• DONOT CHECK REORDER LEVEL AND DONOT ORDER ACCORDING TO THE REQUIREMENT WHICH SHOULD BE DONE .

• THE SAFETY STOCK IS NOT KEPT MOST OF THE TIMES OR THE BUFFERING STOCK WHICH WILL ACT AS THE SUPPLY DURING THE LEAD TIME , MOST OF THE TIME THE DEPARTMENT WAIT TO ORDER TILL THE STOCK GETS TO THE NIL LEVEL .

• SOME TIMES THE FAST MOVING ITEMS ARE NOT CHECKED AND NOT ACCOUNTED WHICH CREATES THE PROBLEM AT THE IP PHARMACY .

• SOME ITEMS ARE NOT CHECKED EVEN WHEN THEY ARE THERE AT THE REORDER LEVEL AND EMERGENCY IS CREATED WHEN THEY GET TO THE ZERO LEVEL .

• MULTI BRANDING IS THERE AT THE IN PATIENT PHARMACY AND THUS DUE TO LACK OF KNOWLEDGE MANY A TIMES THE INDENT IS TRANSFERRED RELATED TO THE

MOLECULE BUT SIMILAR MOLECULE IS PRESENT AT THE IP PHARMACY WITH A DIFFERENT BRAND NAME .

• NARCOTICS ARE AT TIMES NOT ACCOUNTED AT THE DEPARTMENT .

• DUE TO LACK OF KNOWLEDGE OF DOSAGE THE IP PHARMACY PEOPLE INDENT THAT PARTICULAR DRUG TOO OFTEN THAN DOING IT A SINGLE TIME FOR THE REQUIRE DOSE .

• IN PATIENT PHARMACY SHOULD COORDINATE WITH THE DOCTORS TO ASK FOR THE NON MOVING AND EXPIRY STOCK .

• CHECKING OF THE RETURN NOTE , AND THE PROPER TRACKING OF THE DRUG , WHETHER IT HAS REACHED THE WARDS OR NOT .

• AT NIGHT THE MATERIALS WHICH ARE RECEIVED ARE NOT DOCUMENTED PROPERLY AND NOT FOLLOWED ACCORDING TO THE SOP’S .

• MANUAL INDENTING , WRONG DRUG , INSTEAD OF FEVAGO GIVEN EVA-Q THUS THIS IS A SERIOUS PROBLEM .

• MANUAL INDENT , ISSUED 3 GMS AND CHARGED 1.5 GMS , THUS THIS IS AGAIN A SERIOUS VIOLATION OF THE SOP .

• ISSUED TWO COST INTENSIVE INJECTIONS MANUALLY AND TAKEN RETURN MANUALLY ONLY ONE WHICH IS NEUTRALISED WITH THE ISSUE OF TWO AND THEN [PATIENT WAS DISCHARGED .

• THE DEPT STAFF ISSUED D- PROTEIN POWDER IN CASE OF PROTEIN POWDER WHICH WAS A MISTAKE ON THE PART OF THE STAFF .

• THE FOLLOWING ARE SOME OF THE CASES AFTER THE DUTIES WERE CHANGED IN THE INPATIENT PHARMACY .

• CASE 1) R KRISHNAMURTHY , THE INDENT FOR THE DRUG WAS POSTED AT 3:45 PM, BUT THE DRUG WAS RECEIVED AT AROUND 4.20 PM , THIS SHOWS THAT THERE IS A MAJOR LACK IN THE EFFECTIVE TRACKING OF THE DRUG ONCE IT IS DISPENSED FROM THE IP PHARMACY .

• CASE 2) KOHOOR RAM SAHU

• 3RD FLOOR

• IP :-27233

• THE INDENT POSTED AT AROUND 3.30 PM BUT THE MATERIALS WERE RECEIVED AT AROUND 4.12 PM .

• CASE 3) DELUX WARD 3RD FLOOR , SMIRITI RAI ,

• IP :- 272225

• TILL 4.12 PM THE MATERIALS WERE NOT RECEIVED BY THE WARD .

• CASE 3) BABULAL SUDAME , TIMING AT AROUND 2.00 PM THE IP NUMBER :- 27190, CTD TAB WAS NOT RECEIVED TILL 2.50 PM .

• CASE 4) 2ND FLOOR GENERAL WARD

• IP :- 27249

• TIMING OF INDENTING FROM THE WARDS :- 12:11PM

• RECEIVING OF MATERIALS AT THE WARD . :- 3.00 PM

• CASE 5) IP NO :- 27242

• THE MATERIAL WAS INDENTED FROM THE WARDS :- 3.50 PM

• THE MATERIAL WAS RECEIVED AT AROUND :- 4.00 PM .

• THUS LET US LOOK AT THE AVERAGE DELAY THAT IS THERE IN THE TIME THAT TOOKFOR THE MEDICINE TO REACH THE PATIENTS BED SIDE .

• THIS DELAY AFFECTS BOTH THE QUALITY OF SERVICE AND PATIENT SATISFACTION .

FINAL SUGGESTIONS:-

• THUS THE FINAL SUGGESTIONS IS AS FOLLOWS :-

• 1) FREQUENT REPORTING OF THE SHORTAGES AND STOCK OUTS TO THE SENIORS OF

• A) PURCHASE

• B)CENTRAL DRUG STORE

• C) HEAD OF THE DEPARTMENT

• D) DEPARTMENT INCHARGE .

• 2) REGULAR FOLLOWING OF THE STANDARD OPERATING PROCEDURES

• 3) REGULAR FOLLOW UPS FROM VARIOUS DEPARTMENTS .

• 4) DAILY MAINTAINING OF THE DEPARTMENTAL DOCUMENTATION .

• 5) TO HAVE A WEEKLY ANALYSIS OF ALL THE PROBLEMS AND NEW ACHIEVEMENTS OF TE DEPARTMENT ALONG WITH THE HEAD OF THE DEPARTMENT .

Real time locating system (RTLS):-

INNOVATION FOR LOCATION

ORIGIN OF TECHNOLOGY:-

• Although this capability had been utilized previously by military and government agencies, the technology had been too expensive for commercial purposes.

• By the early 1990s, commercialization began at two healthcare facilities in the United States (Foote Hospital in Jackson, MI and Broward Children's Hospital inPompano Beach, FL ).

APPLICATIONS:-

• RTLS serves in operational areas for logistics and other services, as for example stock grounds or storehouses, and for servicing areas in clinics and industrial plants.

• Tasks done by a RTLS include:

• to combine identity and location of any type of items or objects .

• to combine identity of items with location of lifter placing the items .

• to ensure permanent availability of proper information about temporary placement .

• to support notification of placing of items .

• to prove proper manning of operational areas .

• to prove consequent evacuation of endangered areas .

• to make marshalling staff dispensable .

• The basic issues of RTLS are standardized by the International Organization for Standardization and the International Electro technical Commission, under the ISO/IEC 24730 series.

http://en.wikipedia.org/wiki/International_Organization_for_Standardization

http://en.wikipedia.org/wiki/International_Organization_for_Standardization

http://en.wikipedia.org/wiki/Pompano_Beach,_FL

http://en.wikipedia.org/wiki/Pompano_Beach,_FL

http://en.wikipedia.org/wiki/Broward_Health

http://en.wikipedia.org/wiki/Broward_Health

http://en.wikipedia.org/wiki/Jackson,_MI

http://en.wikipedia.org/wiki/Foote_Hospital

RANGING:-

• Ranging, as a special term for measuring distance, is the prerequisite for locating .

• Determining the distance may be either a non cooperative scanning process, as with RADAR or LIDAR, or a cooperative direct distance measuring process, as with RTLS. A scanned beam may form an overall image as a model of the whole scene.

PRIVACY THREATS :-

• RTLS may be seen a threat to privacy, if applied to persons, either directly or parasitically. The requirement therefore is to describe the purpose and the conditions of operation to those affected and to advertise for expressed agreement. Recent adjustment of jurisdiction leads to more careful assessment of needs and options. The newly declared human right of informational self-determination .

MAPPING :-

http://en.wikipedia.org/wiki/LIDAR

http://en.wikipedia.org/wiki/RADAR

TAGS OR CHIPS :-

The tags which includes these chips:-

TAGGING OF MATERIAL :-

THE KEY USES OF RTLS IN HOSPITALS:-

• Inventory tracking and condition monitoring

• Hospitals require large volumes of medical equipment and devices. Most of it is now portable, but as it moves around it becomes hard to track, maintain, and keep accurate inventory .

• Using RTLS, every piece of equipment in the hospital can be accurately monitored and tracked easily, so that it is maintained and being used where it should be when it should be.

• Improved Work flow

• Hospitals can use location tags to advance patient flow and clinical efficiency. Some hospitals have even use RTLS solutions to track staff and patient traffic patterns to

identify more efficient hospital designs. RTLS allows clinicians to quickly locate needed resources which results in decreased wait times, enhanced asset utilization, and a decrease in asset loss.

• Being able to locate equipment quicker and easier allows clinicians to spend more time tending to patients than searching for equipment. Thus the patients are receiving higher quality care and the staff is being more productive.

• RTLS tags can be worn by patients that will alert hospital staff when the patient wanders outside a specified zone, into an unsafe area, or enters a restricted area. They can also be used as an alarm that includes their location in the event of an emergency, which is a feature some staff utilizes for their own safety as well.

THE MCKINSEY REPORT:-

An estimated 20 to 35 percent of hospitals are using a real-time location system (RTLS), according to a recent survey by MCKINSEY Research. Moreover, 95 percent of the 150 responding facilities, which ranged from very small to very large hospitals, said that their use of RTLS resulted in operational efficiency gains IN UNITED STATES OF AMERICA .

WHERE ELSE IS THE USAGE:-

• Automating the monitoring of refrigerator temperatures; tracking assets, patients, or staff members; assessing hand-hygiene compliance; and engaging in a variety of other uses .

• Earlier deployments of RTLS focused on the location of medical equipment. Facilities saved money on labour and lowered capital expenditures by increasing utilization of existing equipment .

• Today, RTLS utilization is likely to include the tracking of patients and clinicians. For example, RTLS tags can be used to measure patient wait times, ensure that staffers wash their hands between patient contacts, and reduce the amount of distance that nurses have to walk in the hospital.

TO AVOID CROSSING WITH OTHER SIGNALS:-

• RTLS systems depend on ultrasound or infrared to locate equipment and people within rooms to avoid interfering with electronic equipment.

Thus can be used in areas where the problem for crossing is there .

Major service providers:-

• AeroScout,

• Awarepoint,

• Ekahau,

• GE,

• Intelligent InSites,

• Radianse and Versus

• CenTrak,

• Cerner,

• Hill-Rom,

• Sonitor

• TeleTracking.

• The report by the McKinsey showed that 75 percent of hospitals using RTLS found that it improved equipment utilization and staff efficiency. Other benefits of RTLS cited by respondents included better documentation (19 percent), improved alerts and reporting (19 percent), and saving time by quickly finding assets (11 percent).

• OthEnterprise Wide, Non-Disruptive Install/Low Maintenance .

• Accuracy .

• Interoperability / Ease of Use.

Cost/Low Risk Financial Mode er advantages:-

• The last, and possibly most, critical success factor surrounds price and the financial model. It today’s economic times, approval for new capital budget expenditures can be complex. RTLS solutions exist that don’t require a large capital purchase or long-term contractual commitment .

Hospitals to easily engage in an enterprise-wide solution and expand assets as needed – on a per asset per month contract. By addressing the financial barriers to enter and getting the hard dollar ROI in asset tracking today, these providers offer the scalability and flexibility to expand to more complex applications hospitals will be addressing tomorrow. And, these solutions are delivered as a managed service, enabling a highly attractive value proposition .

• The technology no doubt is a very innovative and helpful system to curb the problems and increase the efficiency of the inventory , staff and equipment as a whole , but its relation to the cost and infrastructure , makes it slightly difficult to apply at this stage of Indian health care working , but will be very promising for the future setups to come .

APPLICATION OF THE TECHNOLOGY IN THE CARE HOSPITAL .:-

• COSTING OF THE TECHNOLOGY :-

• REQUIREMENTS :-1) INDEPENDENT WIFI SYSTEM WHICH WILL BE COST AS FOLLOWS :-

• 1) MODEMS AT EVERY DEPARTMENT

• A) NURSING STATIONS

• B) OPD’S

• C) INPATIENT DEPARTMENTS

• D) LOGISTICS

• E) CENTRAL DRUG STORES

• F) ADMINISTRATION

• G) AUDIT DEPARTMENT

• H) REGISTRATION DESK

• I) HR DEPARTMENT .

• THE SOFTWARE :- ON AN AVERAGE 4 TO 5 CRORES ( 4,00,00,000 TO 5,00,00,000 INR ) .

• THE WIFI SYSTEM WILL BE ANY WHERE BETWEEN :- 4 TO 5 LAKHS INCLUDING THE MODEMS AND THE INSTALLATIONS ALONG WITH THE CONNECTION WITH THE DESKTOPS AND THE CELL PHONES .

• THE BOOSTERS WILL BE COSTING NEAR ABOUT 4000 TO 5000 INR .

• THERE WILL BE REQUIREMENT OF NEAR ABOUT 30 TO 40 BOOSTERS IN THE HOSPITAL WHICH WILL COVER ALL THE FLOORS , AND THE PREMISES , THAT IS THE INVENTORY AND STAFF CAN BE TRACED ANY WHERE IN THE HOSPITAL AND NEAR THE PREMISES AS THE BOOSTER COVERS THE A DISTANCE OF AROUND 10 METERS .

• SAME IS THE CASE WITH THE MODEMS .

• THUS FOR THE BOOSTERS IT WILL REQUIRE 30 * 4000/- INR WHICH IS EQUAL TO :- 1,20,000 INR /-

• THUS THE RFID TAG GENERATING MACHINES WHICH WILL COST AROUND ANY WHERE BETWEEN 7,000 INR TO 10,000 INR FOR THE HOSPITALS . THE HOSPITAL BE REQUIRING AROUND THREE MACHINES FOR THE WORKING .

WHICH WILL CONSUME ELECTRICITY OF AROUND 20 UNITS OF ELECTRICITY IN A MONTH , WHICH WILL CONSUME ELCTRICITY OF AROUND 150 TO 200 INR PER MONTH .

• SOFTWARE :- 4,00,00,000 INR

• BOOSTERS :- 1,20,000 INR

• RFID MACHINES :- 7,000 INR

• WIFI SYSTEM :- 4,00,000 INR

• THUS THE TOTAL COSTING WILL BE AROUND

4,0527000/- INR .

THUS THE INVESTMENT WILL BE IN STEPS .

WHICH IS AS FOLLOWS :- FOR THE FIRST PHASE ONLY THE HUMAN RESOURCE WILL BE TRACKED BY THE SYSTEM AND LATER ON THE INVENTORIES WILL BE TRACKED .

• IN THE LATER PHASES ALL THE OTHER STAFFS WILL ASSOCIATED WITH THE REAL TIME LOCATING SYSTEM .

• THE SYSTEM WILL BE ON MONITORING BASIS AT THE STARTING AND LATER ON THE SYSTEM CAN BE MADE PERMANENT AFTER THE FINAL REPPORT IS SUBMITTED INCLUDING THE MONITORING REPORT .

• THE REASON FOR MAKING THE REPORT ON PILOT BASIS AT THE STARTING AND LATER ON MAKING INTO A FULL TIME PROGRAM AND SOLUTIONS FOR THE LOGISTICS AND HUMAN RESOURCE AS DURING THE PILOT BASIS , IT WILL BE GIVING TIME TO THE STAFF , DOCTORS AND HOSPITAL ON A LARGE BASIS TO ADJUST TO THE TECHNOLOGY AND ONCE THE ADMINISTRATION FEELS THAT THIS CAN BE CONVERTED INTO A FULL TIME SOLUTION IT CAN BE EXTENDED TO OTHER DEPARTMENTS .

• THUS THE FINAL SUGGESTION IS THAT THE TECHNOLOGY ONCE IMPLIED ON A FULL TIME BASIS WILL BE HELPFUL TO THE HOSPITAL IN THE LONGER TIME AND THE FUTURE WORKING AS IT WILL REPLACE HUGE AMOUNT OF WORK THAT IS CURRENTLY DONE WITH MAJOR LACUNAE WHICH ADDS TO THE COST AND QUALITY WHICH AGAIN HAS IMPACTS ON THE CUSTOMER SATISFACTION AND STAFF SATISFACTION .

VENDOR ANALYSIS :-

THE VENDOR ANALYSIS IS DONE ON THE BASIS OF THE FOLLOWING POINTS

• 1) CATEGORISATION OF THE RETAILERS ON THE BASIS OF THE MATERIAL THEY GIVE .

• 2) HOW MUCH CREDIT THEY PERMIT IE THE CREDIT LIMIT .

• 3) WHETHER THEY ARE FROM THE CITY OR OUT SIDE THE CITY .

• 4) AMONG THOSE WHO ARE THE EMERGENCY SUPPLIERS .

• 5) HOW MUCH PERCENTAGE OF THE TOTAL CONSUMPTIONS THEY PROVIDE ON AN AVERAGE .

• 6)WHAT IS THEIR LEAD TIME .

• 7) WHAT IS THE ACTUAL CONSUMPTION .

LIST OF RETAILERS:-

• SHRIRAME SURGICALS

• GRN VALUE :- 439339 INR

• TOTAL :- 5064029 INR

• PERCENTAGE VALUE :- 8.68 %

• CATEGORY :- SURGICALS

• LEAD TIME :- 1 DAY

• CREDIT LIMIT :- PROVIDE MATERIAL EVEN ABOVE THE LIMIT OF 60 DAYS .

• CATERGORY :- EMERGENCY SUPPLIER .

•

• PARMA NAND AND SONS

• GRN VALUE :- 328271

• TOTAL :- 5064029

• PERCENTAGE :- 6.48 %

• CATEGORY :- PHARMACEUTICALS .

• LEAD TIME :- NOT APPLICABLE

• CREDIT LIMIT :- TILL LOCK WHEN PAYMENT IS EXCEEDED ABOVE 60 DAYS .

• CATEGORY :- GENERAL SUPPLIER .

•

• VASANTLAL AND BROS .

• GRN VALUE :- 233824

• TOTAL :- 5064029



• LEAD TIME :- 2 DAYS

• CREDIT LIMIT :- FLEXIBLE WITH THE PAYMENTS .


•

• ITWARI MEDICAL STORE . .

• GRN VALUE :- 228502

• TOTAL :- 5064029

• PERCENTAGE :- 4.51%


• LEAD TIME :- 1.5 DAYS

•

• CREDIT LIMIT :- FLEXIBLE WITH THE PAYMENTS .


• RAJ SURGICALS .

• GRN VALUE :- 194716

• TOTAL :- 5064029




• CREDIT LIMIT :- EVEN ABOVE 60 DAYS THE SUPPLIER IS READY TO SUPPLY .

• CATEGORY :- EMERGENCY SUPPLIER .

• MUKUND RAI AGENCIES

• GRN VALUE :- 181108

• TOTAL :- 5064029




• CREDIT LIMIT :- TILL IS LOCKED WHEN THE PAYMENT EXCEEDS 60 DAYS .

• CATEGORY :- GENERAL SUPPLIER

•

• SHREE MEDICALS AND GENERAL STORES

• GRN VALUE :- 160796

• TOTAL :- 5064029




• CREDIT LIMIT :-SUPPLIES EVEN ABOVE THE 60 DAYS MARK .

• CATEGORY :- EMERGENCY SUPPLIER

•

• JAI BABA MEDICALS

• GRN VALUE :- 150144

• TOTAL :- 5064029




• CREDIT LIMIT :- TILL IS LOCKED IS THE PAYMENT IS NOT DONE ABOVE 60 DAYS .

• CATEGORY :- EMERGENCY SUPPLIER

•

• PUNIT MEDICAL STORES

• GRN VALUE :- 145722

• TOTAL :- 5064029




• CREDIT LIMIT :- TILL IS LOCKED IF THE PAYMENT EXCEEDS ABOVE 60 DAYS .


•

• V.P SALES

• GRN VALUE :- 129402

• TOTAL :- 5064029


• CATEGORY :- SURGICAL .




•

• SM PHARMAC

• GRN VALUE :- 127580

• TOTAL :- 5064029


• CATEGORY :- PHARMACEUTICAL .


• CREDIT LIMIT :- LOCK THE TILL WHEN THE PAYMENT IS NOT DONE ABOVE THE 60 DAYS MARK .


BL LIFE SCIENCES :-

• GRN VALUE :- 116438

• TOTAL :- 5064029





• CATEGORY :- OUT STATION SUPPLIER.

•

• TECHTONICS NAGPUR

• GRN VALUE :- 110560

• TOTAL :- 5064029






•

• SK SALES

• GRN VALUE :- 107922

• TOTAL :- 5064029






•

• SWAMISHREE TRADING

• GRN VALUE :- 106619

• TOTAL :- 5064029






•

• KALPATRU SURGICAL PHARMA

• GRN VALUE :- 106486

• TOTAL :- 5064029


• CATEGORY :- NOT APPLICABLE .


• CREDIT LIMIT :-NOT APPLICABLE


• SURGICAL INDIA

• GRN VALUE :- 104995

• TOTAL :- 5064029






•

• VEDULA ENTERPRISES

• GRN VALUE :- 102409

• TOTAL :- 5064029






•

• MODERN AGENCIES

• GRN VALUE :- 99962

• TOTAL :- 5064029




• CREDIT LIMIT :- FLEXIBLE IN PAYMENTS


•

• DATTATRAYA MEDICAL AND GENERAL STORES


• TOTAL :- 5064029






•

• SNEHAL ENTERPRISES


• TOTAL :- 5064029


• CATEGORY :- PHARMACEUTICALS AND SURGICALS .

• LEAD TIME :- 1.5DAYS

• CREDIT LIMIT :-SUPPLIES EVEN ABOVE THE 60 DAYS MARK.


•

• WORLDMED EQUIPMENTS PVT LTD


• TOTAL :- 5064029





• CATEGORY :- OUT STATION SUPPLIER

•

• KOCHAR AGENCIES


• TOTAL :- 5064029






•

• RUKHMANI METAL AND GASEOUS LTD


• TOTAL :- 5064029






• SAMRAT PHARMACEUTICALS


• TOTAL :- 5064029






• BIOSYS


• TOTAL :- 5064029


• CATEGORY :- LABS .




• MUKUND AND COMPANY


• TOTAL :- 5064029

• PERCENTAAGE :- 1.40%



• CREDIT LIMIT :FLEXIBLE WITH THE PAYMENTS


•

• GLAND PHARMA LTD


• TOTAL :- 5064029




• CREDIT LIMIT :-LOCKS THE TILL IF THE PAYMENTS IS DELAYED .

• CATEGORY :- OUTSTATION SUPPLIER

• MEDEQUIP ENTERPRISES


• TOTAL :- 5064029






• BIOMERIUX INDIA PVT LTD


• TOTAL :- 5064029


• CATEGORY :- LAB .


• CREDIT LIMIT :-LOCKS THE TILL WHEN THE PAYMENT IS DELAYED

• CATEGORY :- OUT STATION SUPPLIER

• RUSHAIL PHARMADIN


• TOTAL :- 5064029






• MEDIQUIP SALES AND SERVICES


• TOTAL :- 5064029






• J MITRA AND BROTHERS


• TOTAL :- 5064029



• LEAD TIME :- NOT APLLICABLE

• CREDIT LIMIT :-NOT APPLICABLE .


• MEHETA DISTRIBUTORS


• TOTAL :- 5064029




• CREDIT LIMIT :-FLEXIBLE IN PAYMENTS


• CARDIAC AVENUES


• TOTAL :- 5064029






• SUGANCHAND MEDICALS STORES


• TOTAL :- 5064029




• CREDIT LIMIT :-LOCKS THE TILL WHEN PAYMENT IS DELAYED .


• V ROHIT LILDHAR SHAH


• TOTAL :- 5064029






• METRO MEDICALS AGENCIES


• TOTAL :- 5064029




• CREDIT LIMIT :-LOCK THE TILL .


• GAUTAM TRADE LINK


• TOTAL :- 5064029






• SAVADIA AGENCIES


• TOTAL :- 5064029






• BIOMEDICON SERVICES


• TOTAL :- 5064029






• ROXY MEDICALS


• TOTAL :- 5064029






• SHUSHRUTA SURGICALS


• TOTAL :- 5064029


• CATEGORY :- SURGICAL AND LABS .




• VS AGENCY


• TOTAL :- 5064029






• THUS ABOVE WERE THE TOP SUPPLIERS AND THEIR ANALYSIS .

ON VARIOUS BASIS AND CATEGORIES.

WHY A ORDER SHOULD GO TO A PARTICULAR SUPPLIER ?

• FOLLOWING ARE THE REASON :-

• 1) L1 ITEMS ARE ALWAYS TAKEN FROM THE AUTHORISED STOCKIST BASED ON OUR LEAST PRICE ,

• BUT OTHER FACTORS :- A) LEAD TIME

• B) SUPPLIER MARKET IMAGE

• C) PAYMENT TERMS

• D) CREDIT TERMS

• ARE OFTEN NOT KEPT IN MIND WHICH SHOULD BE DONE .

• KEEPING THE DRUG IN THE L1 CATEGORY MANY CASE ARE THERE WHERE THEY DIDN’T DETERMINE THAT WHETHER FOR THAT PARTICULAR DRUG SUPPLIERS IS PRESENT OR NOT .

• 2) NO OF BRANDS AND COMPANIES , THUS IF THE SUPPLIER HAS GREATER BRANDS THEN THE NO OF PURCHASE ORDER ARE ALSO LESS , AND THUS THE DOCUMENTATION TIME IS ALSO LESS , THUS NO OF BRANDS SHOULD BE KEPT IN MIND WITH THE SUPPLIER .

• 3) SUPPLIER BEHAVIOUR IS ANOTHER VERY IMPORTANT POINT ,

• A) BEHAVIOUR OF THE OWNER OF THE ORGANISATION

• B) WHETHER ADJUSTABLE , FLEXIBLE , AND UNDESTANDING .

• C) TRANSPORTATION :- 1) HOW DO THEY TRANSPORT THE MATERIAL

• 2) WHETHER FOCCUSING ON THE STORAGE CONDITIONS .

• 3) THE NO OF TIME THE SUPPLIER PROVIDES THE SERVICE IN A DAY .

• 4) SUPPLIER WHO ARE FLEXIBLE IN THE PAYMENT TERMS , ALLOW FLEXIBLE CREDIT PERIODS , PROVIDE MATERIAL EVEN IF THE PAYMENT IS DELAYED .

• 3) AVAILABILITY OF THE STOCKS , AT ALMOST ALL THE TIME .

• 4) SUPPLIER SHOULD NOT LOCK THE SUPPLY EVEN WHEN THE PAYMENT IS DELAYED

• 5) THE ITEMS OF THE COLD CHAIN SHOULD BE PROVIDED WITH THE PROPER STORAGE CONDITIONS .

• 6) THE WRONG MATERIAL IF PROVIDED SHOULD BE TAKEN BACK AND ADJUSTMENTS SHOULD B THERE .

• 7) THE CREDIT NOTE SHOULD BE PROVIDED IN CASES OF CREDIT SUPPLY .

• 8) THE NON MOVING AND EXPIRY ITEMS SHOULD BE TAKEN BACK .

• 9) ALL THE WORK SHOULD BE DONE ON THE BASIS OF MOU OR CONTRACT .

• 10) THE SUPPLIER SHOULD BE CHOSEN ON THE BASIS OF THERE AGREENESS TO PROVIDE MATERIAL EVEN AFTER THEIR CREDIT PERIOD IS VIOLATED BY THE HOSPITAL AND DELAY IN PAYMENT IS THERE .

THE POSITIVES AND NEGATIVES OF THE TOP SUPPLIERS:-

• 1) SHRIRAME SURGICALS

• POSITIVES

• ANYTIME EMERGENCY SERVICE

• IF MATERIAL NOT AVAILABLE THEN HE MAKES SURE IT IS AVAILABLE TO THE HOSPITAL .

• NO ISSUES WITH THE PAYMENT

• THE BEHAVIOUR WITH THE HOSPITAL BOTH VERBAL AND THE WAY HE CONDUCT DURING THE TRANSACTION IS VERY POLITE .

• NEGATIVES

• NO NEGATIVE POINTS FOR THE SHRIRAME SURGICALS .

• 2) PARMANAND AND SONS

• POSITIVES :-

• CHEMO DRUGS ARE ALWAYS IN STOCK WITH HIM .

• NEGATIVES :-

• IF PAYMENT IS DELAYED THEN STOPS THE SUPPLY .

• EVEN THE REGULAR ITEMS ARE NOT SUPPLIED .

• VASANTLAL AND BROS .

• POSITIVES :-

• A HUGE NUMBER OF BRANDS AND COMPANIES.

• AND HUGE AMOUNT OF STOCK WITH HIM

• HAS GOOD SUPPLIER BEHAVIOUR

• NO PROBLEM AND ISSUES WITH THE PAYMENT

• TAKES NON MOVING AND EXPIRY BACK .

• NEGATIVES :- DUE TO HUGE AMOUNT OF WORK LOAD SOMETIMES MISTAKES IN SUPPLY , MRP , BILLING TAKES PLACE .

• LATE SERVICE AT TIMES .

• EXCEEDS THE LEAD TIME .

• ITWARI MEDICALS

• POSITIVES

• A PURE SENSE OF LOGISTICS IS THERE .

• VERY GOOD WORK OF BATCH MATCHING OF DRUGS , NO ISSUES IN THEPAST HISTORY FOR ANY WRONG REASONS .

• SERVICE IS VERY FAST

• GOOD BEHAVIOUR .

• NEGATIVE :-

• MANY A TIMES THE SUPPLY OF MATERIALS IS DONE AFTER THE WORKING HOURS .

Ganga Care Hospital

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