The document summarizes a study on the use of Just-in-Time (JIT) supply chain practices in the public healthcare sector of Botswana. Key findings include:
1) The study examined problems with the supply of medical drugs from central medical stores to hospitals and clinics in Botswana.
2) It identified 14 purchasing/supply problems that can impact the achievement of 5 traditional purchasing objectives in healthcare organizations.
3) The findings provide insight into using JIT supply chain techniques in developing countries like Botswana, where little was previously known about such practices in public healthcare.
The future vision of Homecare medicinesHome Care Aid
This document summarizes the key findings and recommendations from a review of homecare medicines in England. It finds issues with the current homecare medicines market such as unstable cash flows, weak governance, and a lack of collaboration between organizations. It recommends strengthening governance within NHS trusts, developing national standards for homecare providers, and more open and collaborative procurement between trusts, commissioners, providers, and patients to improve services and value for money. The goal is to establish safer, more effective and efficient homecare medicine delivery that works in the best interests of both patients and taxpayers.
This document provides an abstract for a study on marketing management practices in corporate hospital services in Tamil Nadu, India. The study aims to analyze socio-economic factors, the importance and scope of marketing, and strategies adopted by corporate hospitals. It finds that corporate hospitals need to better understand patient populations, accessibility of physicians, and service offerings to compete. Marketing approaches need to focus on uniquely meeting consumer needs rather than just doing things better than competitors. Cost-effective services, feedback systems, insurance tie-ups, overseas marketing, and comprehensive health plans are suggested to increase revenues and market share. The conclusion is that corporate hospital entrepreneurs lack decision-making and technical skills to successfully manage and market healthcare services.
Appropriate Healthcare Technology in Emerging Markets, Vietnam 2014Eric Stryson
Business plan for a domestic Vietnamese company producing appropriate, low-cost, healthcare equipment in Vietnam and throughout Asia - produced during GIFT's Global Leaders Programme in March 2014
8 covid 19 finanicial trends research paper hari masterpiece HariMasterpiece
This document summarizes a study on marketing management practices of corporate hospitals in Tamil Nadu, India. It discusses how hospitals play an important role in healthcare delivery across primary, secondary, and tertiary levels. The healthcare sector depends on socioeconomic development and government priority. Private household expenditure on healthcare is higher than public expenditure. Due to increased competition, service quality is important for corporate hospitals. The study aims to analyze socioeconomic factors, understand the importance and scope of marketing, examine product mix and pricing approaches, and identify strategies used by corporate hospitals to promote their facilities. Hypotheses are presented on how marketing positioning, orientation, and competitiveness relate to factors like investment, service variety, and assertiveness.
Strategic Management Paper: Hospital Industry ----
Definition of the industry and its dominant economic features, Industry’s Dominant Economic Features (Market Size and Growth Rate, Number of Rivals, Scope of Competitive Rivalry, Degree of Product Differentiation, Service Innovation, Pace of Technological Change), Major Players, Industry analysis using five forces model, Driving forces, Strategic group map, Competitor analysis, Possible strategic moves of competitors, Key Success factors, Conclusion of industry analysis.
The document provides an overview of the Vietnam healthcare market. It discusses opportunities in the growing hospital sector, including potential partnerships between local and foreign companies. It also outlines opportunities in pharmaceuticals and medical devices, noting Vietnam's goal of becoming a regional production hub by 2020. The private hospital sector is expanding due to government policies promoting privatization and foreign investment in healthcare infrastructure.
Research on the implementation of the essential drug system in China rural he...Jeff Knezovich
Wang YunPing of the China National Health Development Research Center gives a presentation on behalf of her boss, Director Zhang Zhenzhong about reforming China's essential drug system.
The healthcare industry in India covers hospitals, health insurances, medical software, equipment and pharmacies. It has grown substantially over time due to improvements in medical science and technology. Major components include hospitals, medical insurance, software, and equipment. Healthcare services combine tangible aspects like beds and decor with intangible services like medical consultations. The industry is large and growing, but remains underdeveloped compared to international standards. Government plans aim to improve access and quality of healthcare across India.
The future vision of Homecare medicinesHome Care Aid
This document summarizes the key findings and recommendations from a review of homecare medicines in England. It finds issues with the current homecare medicines market such as unstable cash flows, weak governance, and a lack of collaboration between organizations. It recommends strengthening governance within NHS trusts, developing national standards for homecare providers, and more open and collaborative procurement between trusts, commissioners, providers, and patients to improve services and value for money. The goal is to establish safer, more effective and efficient homecare medicine delivery that works in the best interests of both patients and taxpayers.
This document provides an abstract for a study on marketing management practices in corporate hospital services in Tamil Nadu, India. The study aims to analyze socio-economic factors, the importance and scope of marketing, and strategies adopted by corporate hospitals. It finds that corporate hospitals need to better understand patient populations, accessibility of physicians, and service offerings to compete. Marketing approaches need to focus on uniquely meeting consumer needs rather than just doing things better than competitors. Cost-effective services, feedback systems, insurance tie-ups, overseas marketing, and comprehensive health plans are suggested to increase revenues and market share. The conclusion is that corporate hospital entrepreneurs lack decision-making and technical skills to successfully manage and market healthcare services.
Appropriate Healthcare Technology in Emerging Markets, Vietnam 2014Eric Stryson
Business plan for a domestic Vietnamese company producing appropriate, low-cost, healthcare equipment in Vietnam and throughout Asia - produced during GIFT's Global Leaders Programme in March 2014
8 covid 19 finanicial trends research paper hari masterpiece HariMasterpiece
This document summarizes a study on marketing management practices of corporate hospitals in Tamil Nadu, India. It discusses how hospitals play an important role in healthcare delivery across primary, secondary, and tertiary levels. The healthcare sector depends on socioeconomic development and government priority. Private household expenditure on healthcare is higher than public expenditure. Due to increased competition, service quality is important for corporate hospitals. The study aims to analyze socioeconomic factors, understand the importance and scope of marketing, examine product mix and pricing approaches, and identify strategies used by corporate hospitals to promote their facilities. Hypotheses are presented on how marketing positioning, orientation, and competitiveness relate to factors like investment, service variety, and assertiveness.
Strategic Management Paper: Hospital Industry ----
Definition of the industry and its dominant economic features, Industry’s Dominant Economic Features (Market Size and Growth Rate, Number of Rivals, Scope of Competitive Rivalry, Degree of Product Differentiation, Service Innovation, Pace of Technological Change), Major Players, Industry analysis using five forces model, Driving forces, Strategic group map, Competitor analysis, Possible strategic moves of competitors, Key Success factors, Conclusion of industry analysis.
The document provides an overview of the Vietnam healthcare market. It discusses opportunities in the growing hospital sector, including potential partnerships between local and foreign companies. It also outlines opportunities in pharmaceuticals and medical devices, noting Vietnam's goal of becoming a regional production hub by 2020. The private hospital sector is expanding due to government policies promoting privatization and foreign investment in healthcare infrastructure.
Research on the implementation of the essential drug system in China rural he...Jeff Knezovich
Wang YunPing of the China National Health Development Research Center gives a presentation on behalf of her boss, Director Zhang Zhenzhong about reforming China's essential drug system.
The healthcare industry in India covers hospitals, health insurances, medical software, equipment and pharmacies. It has grown substantially over time due to improvements in medical science and technology. Major components include hospitals, medical insurance, software, and equipment. Healthcare services combine tangible aspects like beds and decor with intangible services like medical consultations. The industry is large and growing, but remains underdeveloped compared to international standards. Government plans aim to improve access and quality of healthcare across India.
Vietnam has a growing healthcare system and medical device market. The country has over 94 million people, with 70% of the population in the working age category. The healthcare sector is expected to see continued growth due to increasing life expectancy, modernizing public healthcare facilities, and international initiatives. The medical device market was worth $668.7 million in 2014 and is projected to reach $977.8 million by 2019, with consumables and diagnostic imaging making up around half of the market. Government-funded hospitals are the largest purchasers of medical equipment.
Vietnam Medical Device Industry 2009 - www.solidiance.comSolidiance
Solidiance shares its view on the fast growing Medical devices industry in Vietnam. Solidiance estimates the market to be worth USD 280 millions in 2009 and to double in size by 2017. Despite strong foreseeable sustained growth, the Vietnam healthcare market is no easy play and tailored marketing strategies are required.
Health sector is considered as one of the most important sectors in any economy because the
wellness of a country depends on the wellness of its citizens. This can be only achieved when there is an efficient
and effective health system in the country. Despite many government interventions to ensure that services are
not interrupted in public hospitals in Kenya, there are still many challenges as pertains to efficient stock
management leading to frequent stock outs
China is reforming its healthcare system to address issues like an aging population, rising incomes and healthcare demands, and physician shortages. Reforms include removing financial incentives from some medical areas, increasing spending to 8% of GDP, expanding education to train more nurses and doctors, easing restrictions on private investment, and increasing public-private partnerships between hospitals. Shanghai is also reforming to develop high-end medical services through international medical parks and encouraging collaboration between public and private hospitals.
Over the past 3 years, medical device companies in Thailand performed well from both revenue and net profit perspective. Thailand is expecting to be the leader of Healthcare and medical device market in ASEAN.
Find out more about Medical device market in ASEAN, check out our paper at http://bit.ly/1hmvwFq
The insights driving superior healthcare outcomes in Asia Pacific.
Asia-Pacific Insight Magazine brings together IMS Health experts from across the region, delivering fresh perspectives on how to navigate through the challenges and opportunities in Asia-Pacific pharmaceutical market.
This document discusses health technology assessment (HTA) and commissioning in the English NHS, with a focus on general practitioners (GPs). It provides background on HTA, which evaluates the clinical effectiveness and cost-effectiveness of health interventions. It also discusses key elements of the 2010 NHS reform plan and the history of GP commissioning in England since the 1990s, including GP fundholding schemes that gave GPs budgets to purchase some services. Evaluation found GPs were able to improve primary care and develop alternatives to hospital care, but faced challenges shifting resources from hospitals.
mHealth - how to make Wireless Healthcare workNick Hunn
mHealth Business models for consumer healthcare. Health Demographics explaining the problem and an analysis of why wireless is needed as part of the solution. Why Bluetooth Health Device Profile and Low Energy provide the best choice for mobile health devices.
The document discusses operations management concepts related to just-in-time (JIT) and lean operations. It describes how Toyota Motor Corporation pioneered JIT and the Toyota Production System (TPS) to eliminate waste, reduce variability, and improve throughput. Key aspects of JIT/lean covered include minimizing inventory, reducing setup times and lot sizes, using level scheduling and kanban signals, and emphasizing continuous improvement.
This presentation analyzes the different strategies adopted by multinational enterprises (MNEs) to coordinate their international operations. It describes international, multi-domestic, global, and transnational strategies, highlighting their strengths and weaknesses. As a case study, it examines Procter & Gamble's strategy over time, from initially using an international approach in the 1930s, to adopting multi-domestic and eventually transnational strategies as it expanded globally. The transnational strategy allows P&G to balance global efficiency with local responsiveness but also poses management challenges to coordinate decision-making across subsidiaries.
In this presentation we will discuss about the concept of just in time (JIT) production philosophy, types and concepts of JIT, objectives of JIT manufacturing, comparison between ideal production system and JIT production, characteristics of JIT system, JIT manufacturing vs. JIT purchasing. We will also discuss about major tools and techniques of JIT manufacturing, JIT implementation approach, problems regarding implementation of JIT, planning of a successful JIT system, obstacles faced for JIT conversion, operational benefits of JIT systems.
To know more about Welingkar School’s Distance Learning Program and courses offered, visit: http://www.welingkaronline.org/distance-learning/online-mba.html
This document provides an overview of just-in-time (JIT) manufacturing. It describes JIT as a philosophy involving minimal inventories and goods that move through the system as needed. The document outlines the history and evolution of JIT in Japan after World War II. It also discusses the seven types of waste in manufacturing that JIT aims to eliminate and lists some key principles of JIT including total quality management, pull-based production, and inventory management with the goal of zero inventory. The document concludes by discussing advantages like reduced waste and disadvantages like risk from supply disruptions of implementing JIT manufacturing.
1) The document examines how customer demographics (age, gender, religion) influence consumer preferences for private health services in Nakuru County, Kenya.
2) It reviews Kenya's public and private healthcare systems and shifts toward increasing patient satisfaction, autonomy, and demand for quality care.
3) The study uses a descriptive survey design and questionnaires to collect data from 136 patients at private hospitals on how demographics relate to their preference, finding a weak but statistically significant relationship between the variables.
The document summarizes challenges to accessing essential medicines in Kenya's public health system. It discusses how Kenya's health system is divided into public, private, and faith-based sectors. The public sector faces challenges like stockouts of commonly prescribed medicines, issues in the supply chain, and poor storage conditions. Decentralization of healthcare management to county governments has contributed to financing issues challenging public health facilities. The document analyzes these challenges and provides recommendations to improve access, such as better training for ordering, storing, and prescribing medicines.
This document summarizes a draft review of literature on paying for health services. The preliminary results suggest that increasing user fees reduces demand for preventive and curative care, especially outpatient care. While fees were intended to generate revenue, studies show they raise little money and disproportionately exclude the poor. The recommendations are that user fees are an inappropriate financing mechanism and should be replaced with pre-paid options to facilitate cross-subsidization for the poor.
Implementing A Certified Electronic Health Record SystemCrystal Torres
The document discusses implementing a certified electronic health record system in a healthcare organization to improve patient safety, ensure privacy and security of patient data, and improve patient outcomes. It addresses the progress many health systems have made in meeting meaningful use regulations through using electronic health records and systems like Epic. Barriers to successful implementation are also discussed.
The Kingdom of Bhutan has made great achievement in establishing and sustaining public financed and managed health system in the past five and a half decades. As enshrined in the Constitution, health services are free in the integrated traditional and allopathic medicines. The report also notes the epidemiological and health system challenges and the way forward to overcome in line with achieving SDGs.
This document is a report for a project to open a comprehensive satellite clinic in Pocahontas County, West Virginia. It provides background on the need for additional health services in the rural county, which only has one 25-bed hospital. An assessment finds that internal and external stakeholders support the project. A market analysis shows high rates of diseases and health issues among the county's aging population. A SWOT analysis identifies strengths like improving access to care, and weaknesses like the large upfront costs. The report recommends proceeding with the project to address unmet health needs in the community.
Situation AnalysisThe Industry – Healthcare servicesThe healthcar.docxjennifer822
Situation AnalysisThe Industry – Healthcare services
The healthcare industry is an aggregation and integration of sectors within the economic system that provides goods and services to treat patients with curative, preventive, rehabilitative and palliative care.
The healthcare industry is one of biggest and fast-growing industries in the world. With the development of technology, the healthcare industry need follow up with the technology to provide more ways such as mobile devices or other online service to provide easier and convivence methods for both patients and doctors. There full of opportunity for the online healthcare industry to build a better environment in the industry, according to survey made by the committee of US online healthcare, in 2016, here have more than 15 million patients get help from the online healthcare service by using different ways.Industry Trend
In China, because of the uneven distribution of medical resources, the lack of grass-roots doctors‘professional level, patients with disorders, which is not conducive to the development of telemedicine industry, online healthcare service stat later than other developed countries.
First, the scale of online healthcare service has expanded further. On the one hand, China's aging population continues to increase, the number of chronic patients is growing rapidly, and the time of treatment is long, service demand is large, stimulating the market demand for telemedicine increased. On the other hand, the popularization of mobile medical terminals, the development of medical Internet of Things and the increasing participation of medical institutions will also promote the continuous expansion of the scale of telemedicine. The Prospective Industry Research Institute predicts that the market size of the domestic telemedicine industry will exceed 23 billion yuan in 2023.
Second, the rate of medical reimbursement is expected to increase steadily. Although insufficient medical reimbursement has always been considered a major obstacle to the implementation of telemedicine, the current changes are driving the expansion of telemedicine. In the future, we will see more health insurance institutions and health insurance advantages planned to cover telemedicine services.
Third, telemedicine services are increasing. Mature telemedicine services can range from counseling, supplementary prescription drugs, management of chronic diseases such as diabetes, COPD and congestive heart failure to data transmission and storage of imaging data, access to second counseling advice, and remote bi-directional vision for emergency, trauma, stroke, and intensive care. Frequency guidance treatment.
Fourth, the level of telemedicine services has been greatly improved. The next generation telemedicine system will integrate all kinds of information systems, network technology, medical imaging equipment, traditional medical system and so on, and develop into a new generation of integrated telemedicine syste.
Vietnam has a growing healthcare system and medical device market. The country has over 94 million people, with 70% of the population in the working age category. The healthcare sector is expected to see continued growth due to increasing life expectancy, modernizing public healthcare facilities, and international initiatives. The medical device market was worth $668.7 million in 2014 and is projected to reach $977.8 million by 2019, with consumables and diagnostic imaging making up around half of the market. Government-funded hospitals are the largest purchasers of medical equipment.
Vietnam Medical Device Industry 2009 - www.solidiance.comSolidiance
Solidiance shares its view on the fast growing Medical devices industry in Vietnam. Solidiance estimates the market to be worth USD 280 millions in 2009 and to double in size by 2017. Despite strong foreseeable sustained growth, the Vietnam healthcare market is no easy play and tailored marketing strategies are required.
Health sector is considered as one of the most important sectors in any economy because the
wellness of a country depends on the wellness of its citizens. This can be only achieved when there is an efficient
and effective health system in the country. Despite many government interventions to ensure that services are
not interrupted in public hospitals in Kenya, there are still many challenges as pertains to efficient stock
management leading to frequent stock outs
China is reforming its healthcare system to address issues like an aging population, rising incomes and healthcare demands, and physician shortages. Reforms include removing financial incentives from some medical areas, increasing spending to 8% of GDP, expanding education to train more nurses and doctors, easing restrictions on private investment, and increasing public-private partnerships between hospitals. Shanghai is also reforming to develop high-end medical services through international medical parks and encouraging collaboration between public and private hospitals.
Over the past 3 years, medical device companies in Thailand performed well from both revenue and net profit perspective. Thailand is expecting to be the leader of Healthcare and medical device market in ASEAN.
Find out more about Medical device market in ASEAN, check out our paper at http://bit.ly/1hmvwFq
The insights driving superior healthcare outcomes in Asia Pacific.
Asia-Pacific Insight Magazine brings together IMS Health experts from across the region, delivering fresh perspectives on how to navigate through the challenges and opportunities in Asia-Pacific pharmaceutical market.
This document discusses health technology assessment (HTA) and commissioning in the English NHS, with a focus on general practitioners (GPs). It provides background on HTA, which evaluates the clinical effectiveness and cost-effectiveness of health interventions. It also discusses key elements of the 2010 NHS reform plan and the history of GP commissioning in England since the 1990s, including GP fundholding schemes that gave GPs budgets to purchase some services. Evaluation found GPs were able to improve primary care and develop alternatives to hospital care, but faced challenges shifting resources from hospitals.
mHealth - how to make Wireless Healthcare workNick Hunn
mHealth Business models for consumer healthcare. Health Demographics explaining the problem and an analysis of why wireless is needed as part of the solution. Why Bluetooth Health Device Profile and Low Energy provide the best choice for mobile health devices.
The document discusses operations management concepts related to just-in-time (JIT) and lean operations. It describes how Toyota Motor Corporation pioneered JIT and the Toyota Production System (TPS) to eliminate waste, reduce variability, and improve throughput. Key aspects of JIT/lean covered include minimizing inventory, reducing setup times and lot sizes, using level scheduling and kanban signals, and emphasizing continuous improvement.
This presentation analyzes the different strategies adopted by multinational enterprises (MNEs) to coordinate their international operations. It describes international, multi-domestic, global, and transnational strategies, highlighting their strengths and weaknesses. As a case study, it examines Procter & Gamble's strategy over time, from initially using an international approach in the 1930s, to adopting multi-domestic and eventually transnational strategies as it expanded globally. The transnational strategy allows P&G to balance global efficiency with local responsiveness but also poses management challenges to coordinate decision-making across subsidiaries.
In this presentation we will discuss about the concept of just in time (JIT) production philosophy, types and concepts of JIT, objectives of JIT manufacturing, comparison between ideal production system and JIT production, characteristics of JIT system, JIT manufacturing vs. JIT purchasing. We will also discuss about major tools and techniques of JIT manufacturing, JIT implementation approach, problems regarding implementation of JIT, planning of a successful JIT system, obstacles faced for JIT conversion, operational benefits of JIT systems.
To know more about Welingkar School’s Distance Learning Program and courses offered, visit: http://www.welingkaronline.org/distance-learning/online-mba.html
This document provides an overview of just-in-time (JIT) manufacturing. It describes JIT as a philosophy involving minimal inventories and goods that move through the system as needed. The document outlines the history and evolution of JIT in Japan after World War II. It also discusses the seven types of waste in manufacturing that JIT aims to eliminate and lists some key principles of JIT including total quality management, pull-based production, and inventory management with the goal of zero inventory. The document concludes by discussing advantages like reduced waste and disadvantages like risk from supply disruptions of implementing JIT manufacturing.
1) The document examines how customer demographics (age, gender, religion) influence consumer preferences for private health services in Nakuru County, Kenya.
2) It reviews Kenya's public and private healthcare systems and shifts toward increasing patient satisfaction, autonomy, and demand for quality care.
3) The study uses a descriptive survey design and questionnaires to collect data from 136 patients at private hospitals on how demographics relate to their preference, finding a weak but statistically significant relationship between the variables.
The document summarizes challenges to accessing essential medicines in Kenya's public health system. It discusses how Kenya's health system is divided into public, private, and faith-based sectors. The public sector faces challenges like stockouts of commonly prescribed medicines, issues in the supply chain, and poor storage conditions. Decentralization of healthcare management to county governments has contributed to financing issues challenging public health facilities. The document analyzes these challenges and provides recommendations to improve access, such as better training for ordering, storing, and prescribing medicines.
This document summarizes a draft review of literature on paying for health services. The preliminary results suggest that increasing user fees reduces demand for preventive and curative care, especially outpatient care. While fees were intended to generate revenue, studies show they raise little money and disproportionately exclude the poor. The recommendations are that user fees are an inappropriate financing mechanism and should be replaced with pre-paid options to facilitate cross-subsidization for the poor.
Implementing A Certified Electronic Health Record SystemCrystal Torres
The document discusses implementing a certified electronic health record system in a healthcare organization to improve patient safety, ensure privacy and security of patient data, and improve patient outcomes. It addresses the progress many health systems have made in meeting meaningful use regulations through using electronic health records and systems like Epic. Barriers to successful implementation are also discussed.
The Kingdom of Bhutan has made great achievement in establishing and sustaining public financed and managed health system in the past five and a half decades. As enshrined in the Constitution, health services are free in the integrated traditional and allopathic medicines. The report also notes the epidemiological and health system challenges and the way forward to overcome in line with achieving SDGs.
This document is a report for a project to open a comprehensive satellite clinic in Pocahontas County, West Virginia. It provides background on the need for additional health services in the rural county, which only has one 25-bed hospital. An assessment finds that internal and external stakeholders support the project. A market analysis shows high rates of diseases and health issues among the county's aging population. A SWOT analysis identifies strengths like improving access to care, and weaknesses like the large upfront costs. The report recommends proceeding with the project to address unmet health needs in the community.
Situation AnalysisThe Industry – Healthcare servicesThe healthcar.docxjennifer822
Situation AnalysisThe Industry – Healthcare services
The healthcare industry is an aggregation and integration of sectors within the economic system that provides goods and services to treat patients with curative, preventive, rehabilitative and palliative care.
The healthcare industry is one of biggest and fast-growing industries in the world. With the development of technology, the healthcare industry need follow up with the technology to provide more ways such as mobile devices or other online service to provide easier and convivence methods for both patients and doctors. There full of opportunity for the online healthcare industry to build a better environment in the industry, according to survey made by the committee of US online healthcare, in 2016, here have more than 15 million patients get help from the online healthcare service by using different ways.Industry Trend
In China, because of the uneven distribution of medical resources, the lack of grass-roots doctors‘professional level, patients with disorders, which is not conducive to the development of telemedicine industry, online healthcare service stat later than other developed countries.
First, the scale of online healthcare service has expanded further. On the one hand, China's aging population continues to increase, the number of chronic patients is growing rapidly, and the time of treatment is long, service demand is large, stimulating the market demand for telemedicine increased. On the other hand, the popularization of mobile medical terminals, the development of medical Internet of Things and the increasing participation of medical institutions will also promote the continuous expansion of the scale of telemedicine. The Prospective Industry Research Institute predicts that the market size of the domestic telemedicine industry will exceed 23 billion yuan in 2023.
Second, the rate of medical reimbursement is expected to increase steadily. Although insufficient medical reimbursement has always been considered a major obstacle to the implementation of telemedicine, the current changes are driving the expansion of telemedicine. In the future, we will see more health insurance institutions and health insurance advantages planned to cover telemedicine services.
Third, telemedicine services are increasing. Mature telemedicine services can range from counseling, supplementary prescription drugs, management of chronic diseases such as diabetes, COPD and congestive heart failure to data transmission and storage of imaging data, access to second counseling advice, and remote bi-directional vision for emergency, trauma, stroke, and intensive care. Frequency guidance treatment.
Fourth, the level of telemedicine services has been greatly improved. The next generation telemedicine system will integrate all kinds of information systems, network technology, medical imaging equipment, traditional medical system and so on, and develop into a new generation of integrated telemedicine syste.
Future Watch: Healthcare in China and opportunities for Finnish technologiesTeam Finland Future Watch
- China's healthcare system is divided into three tiers, with over 95% of the population now insured. However, medical resources remain unevenly distributed between urban and rural areas.
- Sharing health records across the system needs further development, as the government struggles with digitization and could benefit from foreign expertise.
- Expected healthcare spending is projected to double by 2020 and again by 2030 to keep up with demands from China's rapidly aging population and the increased prevalence of chronic diseases.
- Opportunities exist for foreign tech companies to partner with private hospitals and help address the huge demand for eldercare services through digital solutions that appeal to younger generations and are integrated with Chinese systems.
Capacity building of private sector workforce for publicDrChetanSharma5
The document discusses capacity building of India's private sector healthcare workforce to provide public health services. It notes that while the public sector was initially the main healthcare provider, the private sector now accounts for over 70% of healthcare services. However, private sector services are often more expensive and unregulated. The document proposes strategies like competency training, incentives, and integrating informal providers to help mobilize the private sector workforce to improve access and quality of public health services while addressing challenges of regulation and costs.
Advancing Healthcare With the BoP Seriesnextbillion
The following 14-part series, Advancing Healthcare With the BoP, presents both established and unfolding innovations, models and technology leaps that are making a real and lasting impact in market-based solutions to healthcare delivery. Anything from mobile technologies - to new patient financing schemes - to re-considered business models from major pharmaceutical companies - to overhauls in medical staffing that reach rural patients - are just a few examples presented in the following pages.
The document discusses differing strategies among New York's leading health systems regarding growth and expansion. Some systems like Northwell, Montefiore, and Mt. Sinai favor aggressive expansion through mergers and acquisitions to increase scale and bargaining power. Others like New York-Presbyterian and NYU Langone are more cautious, focusing on ambulatory care and selective partnerships over acquiring additional hospitals. The strategies differ in views on vertical integration, population health management, and whether owning an insurance plan is advantageous.
The document discusses nursing reforms in India to address the growing demand-supply gap in the nursing sector. It notes that nurses form the largest segment of the healthcare workforce but that India currently faces a significant shortage of trained nurses. The Federation of Indian Chambers of Commerce and Industry has constituted a task force to examine challenges in nursing education, regulation, and career opportunities. The task force aims to develop recommendations to strengthen the nursing sector and empower nurses to better deliver healthcare.
Ey nursing-reforms-paradigm-shift-for-a-bright-futureanshuman0309
This document discusses the growing healthcare needs in India and the demand-supply gap in nursing. It notes that India's population is growing and lifestyle diseases are increasing, placing greater demand on the healthcare system. However, India lags in healthcare spending and availability of infrastructure and qualified workforce. Specifically, there is a significant gap between the demand and supply of nurses. India needs an additional 2.4 million nurses to meet the growing demand. Strengthening nursing education and reforms are needed to close this gap and help India's healthcare sector meet the country's growing needs.
Factors Affecting Consumer Health Care Services Delivery in Private Health Fa...AI Publications
Background: In 2007, the government of the republic of Tanzania has launched the Primary Health care services development programme as one of the renewed efforts to effectively engage the healthy sector in poverty reduction strategies. The study was dealing with evaluation on the factors that affects health services delivery to private hospital facilities Method: Data was collected from 169 patients who are customers of KMH and two sampling techniques were used, namely purposive sampling and random sampling. The study use questionnaire and interviews together with documentary review together information concerning the study objective. Quantities data were analyzed through SPPS data were coded ruined to observe to which percent the variables were significant or not significant towards research objectives. Results: The study finding that there are factors that are challenges towards delivering health services to patients including absence of good communication, customer care, shortage number of health professionals and most of patients are not attended on time, however on other hand study discover that there factors pull health services delivery including presence of social media, good infrastructures that support patients from far and presence of NHIF services to KMH. Recommendations: This study recommends that Private Public Partnership should be more emphasized and applied in health sector for the aim of improving health survives delivery to patients. Conclusion: The study concludes that although much has been done over many years to restructure the health care system and to improve the quality of care being rendered to patients, the literature reveals that a lot of people in Mwanza city still suffer from getting quality health services from health facilities including hospitals which are owned by private institutions.
Behavioral Intention In Revisiting Hospital Under The Effect Of Expertise, Reputation And Service Quality. Trust comes from the belief of a party’s promise or sentence is reliable and the obligation that party need to be fulfilled in vice versa for relationship purpose (Schurr and Ozanne, 1985). Based on the trust, the interaction of a buyer’s perception future and service provider (seller) is anticipated (Doney and Cannon, 1997). It creates a long-term orientation of a relationship B2C in positive ways (Ganesan, 1994). The trust’s advantages which create strong relationship in business has been researched in the literature review of Morgan and Hunt in 1994. The individual experience is considered as the trustworthy source rather than the referral from relatives or friends which is explained as the second-hand trust referral or the popular.
Cost-Benefit Analysis of Outsourcing Cleaning Services at Mahalapye Hospital,...HFG Project
As published in the Journal of Hospital Administration 2016, Vol. 5, No. 1.
As part of its national privatization strategy to diversify the economy, Botswana has started outsourcing nonclinical services at seven public hospitals. Hospital managers are signing contracts without knowing whether outsourcing offers better value for money than “insourcing”. The objective of this study is to assist hospital administrators in making evidence-based outsourcing decisions.
HFG and the Botswana Ministry of Health conducted a cost-benefit analysis of cleaning services at Mahalapye Hospital. We take the hospital manager’s perspective when considering two alternatives: outsourcing, and “insourcing”. We used an activity-based costing approach and monetised benefits by weighting costs of the alternatives based on a service quality survey of hospital managers.
RUNNING HEAD: Progress Report1
Senior Project Progress Report
Melonie Lindsey
HCA 459
Vicki Sowle
June 2, 2014
Topic:
The topic that I selected for my senior project was “challenges of employee recruitment and retention of health care professionals”. I chose this topic because it is a growing problem among the healthcare institutions. The professionals who are capable of delivering best efforts in health care institutions are less in number and the opportunities that they have in this modern world are a lot. The human resources department of health care institutions adapt many modern ways to overcome these challenges. It is very interesting to understand such modern methods of human resources department for employee retention. At the same time, it’s interesting to visualize how the employees react to the actions performed by the human resources department of such healthcare institutions. In case the human resources department is unable to retain their employees irrespective of the hard measures taken by them, the backup plans executed by them in such cases are also worth studying.
Organization Specific Rationale:
New York Presbyterian is the health care organisation that I have selected for my senior project. This health care organisation is one of the top medical service providers in US. They have won several awards for maintaining good quality in delivering the health care services. The latest award that they have won is the “Energy Star Award” from EPA. This health care organisation offers a wide variety of medical services for their patients. The staff of this organisation is highly capable of delivering the best results. (http://nyp.org/, n.d.)
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Health care jit
1. [Abstract Code: 015-0601]
Just in Time Supply Chain Practices in Developing Countries: A case of the Public
Healthcare Sector in Botswana
Kabossa A.B. Msimangira
School of Business
Open Polytechnic of New Zealand
Auckland Learning Centre
Box 6558, Wellesley Street
Auckland 1141
New Zealand
Phone: + 64 9 918 4655
E-mail: kabossa.msimangira@openpolytechnic.ac.nz
POMS 21st Annual Conference
Vancouver, Canada
May 7 to May 10, 2010
2. Abstract
The Just in Time (JIT) philosophy and supply chain management (SCM) have been
widely practiced in developed countries than in the developing countries. Little is known
regarding the JIT practices in public healthcare sector in developing countries, especially
in Africa. This paper reports the problems associated with using JIT supply chain
technique and highlights JIT supply chain practices in public healthcare sector in
Botswana. Data were collected using a triangulation of methods: interviews, a survey,
and personal observation. The findings and recommendations to solve some of the key
problems are presented.
Keywords: Just in time, supply chain, Healthcare, Developing countries, Botswana.
1.0 Introduction
The operations of healthcare in the 21st century will continue to improve using modern
techniques, such as Just in Time supply chain management. The JIT philosophy and its
benefits, and supply chain management have been widely covered in the literature. The
author defines the JIT supply chain in healthcare as effective and efficient management,
planning, control, and co-ordination of all activities in the supply chain to move sufficient
medical supplies from the source (e.g., overseas or local central medical store) to the final
consumer (e.g., hospital, clinic or a patient). The activities must be performed when
needed at the right time, not earlier or later in the supply chain. In short, we define JIT
supply chain in healthcare as value added in performing activities of moving medical
supplies from the right source to the point of consumption or use, at the right time, and at
reduced cost in order to enhance the quality of the service in the hospitals and clinics.
2
3. This paper examines the critical issues facing supply chain management in the healthcare
sector, especially in developing countries like Botswana. The problems regarding the
supply of medical drugs to the hospitals and clinics were reported by Jwaneng Town
Council (JTC) to source drugs from private companies instead of the central medical
stores (CMS), which proved unreliable in providing the JTC with required drugs (Daily
News, 2005). The JTC revealed that the move was proving successful and “the drugs
situation in clinics has now stabilised. The move is coming at a cost to the council as
they were now spending more than they did when supplied by the Central Medical
Stores.” (Daily News Online, 2005).
Botswana hospitals and clinics, like those in developed countries, can start using JIT
supply chain in healthcare sector in order to reduce operational costs and improve quality
of services to patients. That is, drugs and other medical services should be provided to
the patients when they are needed. In this case Botswana is required to have an efficient
supply chain to achieve strategic supply chain benefits. Although just-in-time supply
chain can improve healthcare services in Botswana, there is no evidence to show that
public hospitals and clinics have adopted the practice or philosophy, like those in
developed countries. In addition, the impact of the purchasing and supply problems on
meeting purchasing objectives; and the impact of the problems of using JIT in the
healthcare organisations in Botswana are not known. This research aimed to fill this gap.
3
4. Furthermore, this study examines supply chain personnel performance in supplying
requirements to hospitals and clinics, and provides recommendations to alleviate some of
the problems.
2.0 Background information
Botswana is one of the African developing countries, which have enjoyed democratic
political and economic system since independence in 1966. It is a country with an
impressive economic growth rate, which depends mainly on diamond mining.
“Botswana has maintained one of the world’s highest growth rates since independence in
1966. Through fiscal discipline and sound management, Botswana has transformed itself
from one of the poorest countries in the world to a middle-income country with a per
capita GDP of $ 9,500 in 2002” (NationMaster, 2004). The economy has maintained an
average real annual growth rate of 6 percent and per capita income has increased over
Botswana Pula 40,000 (approximately US$ 6,232) (Budget speech, 2008).
The Republic of Botswana is situated in Southern Africa, nestled between South Africa,
Namibia, Zimbabwe, and Zambia. The country is democratically ruled, boasts a growing
economy and a stable political environment. Botswana has some of Africa's last great
wildernesses including the famous Okavango Swamps and the Kalahari desert. Botswana
is the largest exporter of gemstone diamonds in the world as well as a large beef exporter
to the European Economic Community (Republic of Botswana, 2007).
The healthcare infrastructure system is one of the best in Africa and the government is
committed to continue improving the services of clinics and hospitals so that they can
4
5. provide high quality services to patients in towns and rural areas. Most countries in
developing countries like Botswana do not produce their own medical drugs and supplies.
Botswana imports drugs and other medical supplies through the government owned
central medical store. Then hospitals and clinics order their requirements from the
central medical store, which is located in the capital city Gaborone with no branches in
other towns (see Figure I).
Figure 1: Medical drugs supply chain network in public healthcare sector in
Botswana
Medical drugs flow
Various Group Purchases Customers:
Suppliers Hospitals Clinics Doctors,
Central Medical Nurses,
Store Patients
Information flow
2.1 Just in time supply chain experiences in public healthcare in Botswana
This paper establishes whether just in time supply chain management can be
implemented and identifies current practices and problems facing the public healthcare
sector in Botswana. The objective of the study was to identify problems associated with
using the just-in-time supply chain technique in Botswana. Problems and practices in
supply chain in the clinics and hospitals were revealed. The following sections of the
article examine data relating to the rating of purchasing and supplies problems, rating of
5
6. problems of using just-in-time in healthcare organisations, rating of purchasing
objectives, and rating of purchasing and stores personnel performance. Thus, the results
lead to a clear understanding of problems and practices in using just-in-time supply chain
in healthcare in developing countries, with particular reference to the hospitals and clinics
in Botswana.
The current supply chain of medical drugs in public healthcare sector in Botswana is
depicted in Figure 1. Medical drugs move from various suppliers to the Botswana central
medical stores, hospitals, clinics, and the final customers: doctors, nurses and patients.
There is physical movement of goods and services from the suppliers to the final
consumers, and the flow of information from the final customers to the suppliers. In
order for the supply chain to work effectively and efficiently, and adding value, there is a
need for management to alleviate the purchasing and supply chain problems identified by
the respondents. Proactive and vision managers who can build supply chain relationships
are needed to make JIT supply chain work.
This paper highlights the responses from sixty nurses who work in the public hospitals
and clinics, and the central medical stores I visited or consulted in Botswana. In addition,
other views were expressed by my students - nurses from the hospitals and clinics who
were pursuing a Diploma in Nursing Administration at the Institute of Development
Management (IDM) in Botswana. The nurses studied just-in-time philosophy in the
module on “managing medical supplies” in healthcare sector and were asked whether it is
possible to implement the JIT philosophy in their clinics and hospitals after graduation,
6
7. and whether the JIT supply chain can be used in Botswana to reduce operational costs
and improve productivity, quality of healthcare services, and customer focus.
3.0 Literature review
3.1 Just in time
The just-in-time (JIT) concept is widely covered in the literature. There are many
variations concerning the meaning of JIT, depending on the application of the concept.
JIT implies a continuous search for waste reduction and to make only what is needed
“just in time” (Toyoda, 1987). Most of the papers published about JIT focus on the
application of the concept in the manufacturing environment (John & Heriot, 1993).
Hall (1983) defines JIT as a philosophy where all goods are to arrive exactly when they
are needed, that is, neither too soon nor too late. The objectives of JIT are stockless
production and elimination of waste (Hall, 1983). Schonberger (1982, p. 17) defines the
JIT concept as “produce and deliver finished goods just in time to be sold, subassemblies
just in time to be assembled into finished goods, fabricated and / or produced parts just in
time to go into subassemblies, and purchased materials just in time to be transformed into
fabricated parts.” The principle is that no products should be manufactured or shipped
until there is a demand for them (Christopher, 1998).
Although JIT has been implemented successfully in most companies in developed
countries, developing countries like Botswana lag behind that of developed countries in
implementing the JIT concept. Developing countries still face many problems to adopt
7
8. JIT. For example, Msimangira (1993) points out the following problems facing Tanzania
(the developing country) in using JIT: (1) financial constraints; (2) inadequate supply of
inputs required for the company to operate near capacity; (3) international delivery
delays; (4) an inadequate transportation infrastructure, and (5) unreliable product demand
forecasts.
3.2 Supply Chain
Supply chain (SC) is a complex network of organisations covering both on the upstream
side including tiers of suppliers and on the downstream side including a network of
customer companies, retailers and financial consumers (Desouza, Chattaraj, & Kraft,
2003). Christopher (1992, p. 12) defines supply chain as “the network of organisations
that are involved, through upstream and downstream linkages, in the different processes
and activities that produce value in the form of products and services in the hands of the
ultimate consumer.” Dershin (2000) claims that the supply chain is the “mother of all
processes” because of the nature of its size, scope, and complexity, nearly all the
processes in the supply chain are not under control.
Msimangira (2003) emphasise that the purchasing and supply chain function is strategic,
and supply chain executives need training in SCM processes. Tracey and Smith-Doerflein
(2001) also stress the need for trainers to assist in the development of individuals in the
area of supply chain management. The findings from the study by Gowen III and Tallon
(2003, p. 32) propose “an interactive role of managerial and employee support to enhance
the effectiveness of employee support to training and to mitigate the adverse effect of
implementation barriers on the success of SCM practices.”
In order for an organisation/business to be successful in the competitive environment,
there is a need to integrate an organisation’s network of a commercial relationships.
Competition is no longer among separate businesses, but among groups of firms that are
linked together in a chain for delivering customer value (Chandra, 2000).
8
9. Supply chain management is a strategy which can help an organisation achieve
integration (Sadeh, Smith, & Swaminathan, 2003; Christopher & Ryals, 1999). The
Global Supply Chain Forum defines SCM as “the integration of key business processes
from end user through original suppliers that provide products, services, and infromation
that add value for customers and other stakeholders” (Lambert, 2004; Chan & Qi, 2003).
Lambert, Cooper and Pagh (1998, p.1) define the SCM concept as “integration of
business processes from end user through original suppliers that provides products,
services, and infromation that add value for customers.” Cox (2004) argues that SCM is a
proactive relationship between a buyer and supplier, and the integration is across the
entire SC. According to Handfield and Nichols, (2002, p. 8), SCM is “the integration and
management of supply chain organisations and activities through cooperative
organizational relationships, effective business processes, and high levels of information
sharing to create high-performing value systems that provide member organizations a
sustainable competitive advantage.” Basu and Wright (2008) go further and include the
transfer of funds in some supply chains.
Furthermore, Zhou and Benton (2007, p. 1) found in their study on supply chain practice
and information sharing that “both effective information sharing and effective supply
chain practice are critical in achieving good supply chain performance.”
3.3 Problems of SCM
Although there are many benefits of SCM reported in the literature, most SCM linked
problems originate from either uncertainties or an inability to co-ordinate activities and
partners (Turban, McLean, & Wetherbe, 2004). The bullwhip effect (demand variability)
is one of the most common problems in suply chains discussed in the literature (Fransoo
& Wouters, 2000; Basu and Wright, 2008). Small fluctuations in demand or inventory
levels of the final company/organisation in the chain are reflected throughout the chain.
Every company/organisation in the SC has limited or incomplete information regarding
the needs of other members in the SC, and it has to respond with a disproportional
9
10. increase in inventory levels and subsequently an even larger fluctuation in its demand
relative to others in the chain (Forrester, 1961).
Researchers (e.g., Forrester, 1961; Holweg & Bicheno, 2002) have indicated that the
production peak can be significantly decreased by the flow of information directly from
the customer to the manufacturer. The other problem in the SC is that some
companies/organisations optimise their own performance without taking into
consideration the benefits of the whole SC. The maximum efficiency of every chain does
not accordingly lead to global optimisation (Gunasekaran, Patel & McGaughey, 2004).
3.4 Group purchasing
Nollet and Beaulieu define a purchasing group “as a formal or virtual structure that
facilitates the consolidation of purchases for many organisations. Consolidation is a
procurement practice used to transfer to a central entity activities such as: bidding,
supplier evaluation, negotiation, and contract management” (2005, p.12). Furthermore,
Rozemeijer (2000) emphasise that a purchasing group normally provides extra power to
the members of the group in their negotiations with suppliers. As a result, members get
more favourable conditions than those which they would have gained individually.
Young (1989) says that a purchasing group is an additional link in the supply chain.
Nollet and Beaulieu (2005) support Young (1989).
Purchasing groups create savings of between 10 per cent and 15 per cent (Hendrick,
1997; Schneller, 2000). However, Scanlon (2000, p. 2) found that prices negotiated by
purchasing groups “were not always lower and were often higher than prices paid by
hospitals negotiating with vendors directly.” Similar finding was reported in Botswana
(Daily News Online, 2005).
The literature indicates that there are many problems of using JIT and SCM, but little is
known on the JIT supply chain in healthcare organisations in developing countries. This
10
11. study provides the insight on the JIT supply chain practices in Botswana (a developing
country).
4.0 Conceptual model
Previous researches have provided insights on purchasing and supply problems (e.g.,
Schonberger, 1982; Hall, 1983; Turban et al., 2004; Fransoo et al., 2000; Basu & Wright,
2008). However, there is less information in the literature concerning models that have
been developed for both purchasing and supply, and JIT problems and their impact on
traditional purchasing objectives, with reference to the developing countries.
The interviews identified fourteen purchasing and supply (including JIT) problems that
may influence the five traditional purchasing objectives. The conceptual model used in
this research is depicted in Figure 2. The model shows purchasing and supply and JIT
problems that can have influence on achieving purchasing objectives.
Figure 2.0: Conceptual model: the impact of purchasing and supply and JIT
problems on purchasing objectives
Purchasing and
supply problems
LS
PP
CO
Purchasing
TP objectives
TS
LD RQ
PG RD
Problems of RP
using JIT RT
MP RS
SM
LC
LL
DN 11
FC
LU
12. Note: LS = Late supplies from stores
PP = Purchasing planning is done by top management
CO =There is no proper communication between purchasing section and
stores
TP = Purchasing staff are not trained in purchasing
TS = Stores staff are not trained in store management
LD = Late deliveries from the suppliers due to distance
PG = There is no proper purchasing guidance or procedures
MP = Management problems
SM = Shortage of skilled manpower
LC = Lack of reliable means of communication in rural areas
LL = Long lead times (the time between ordering and receiving drugs)
DN = Demand is not known or predictable
FC = Financial constraints
LU = Lack of reliable means of communication in urban areas
RQ =The right quality
RD =The right quantity
RP = The right price
RT = The right time
RS = The right supplier.
5.0 Research methodology
Data were collected using a triangulation of methods: interviews, a survey, and personal
observation to identify critical purchasing and supply chain problems, problems of using
JIT, and how they affect achievement of purchasing objectives. In addition, data were
collected on whether JIT supply chain management can be implemented in Botswana to
alleviate some of the critical supply chain problems.
12
13. Initially, interviews with several nurses were carried out to determine purchasing and
supply problems and problems of using JIT in their hospitals/clinics in order to develop a
survey questionnaire. The common themes identified from the interviews were used to
develop the survey questionnaire. Some of the problems were identified during the visits
at the clinics and hospitals. In addition, academics and nurses commented on the clarity
and validity of the questionnaire. A survey was administered to a convenience sample of
70 nurses who studied purchasing and supply chain management (SCM) at the Institute
of Development Management (IDM) in Botswana. A total of 60 usable responses were
received representing 85.7% response rate.
6.0 Analysis
The analysis of data from the survey was carried out using the descriptive statistics and
the correlation matrix using SPSS version 17. Communality was used to determine the
variables suitable for analysis (Table 1.0). Hair et al. (2006, p. 102) define communality
as the “total amount of variance an original variable shares with all other variables
included in the analysis.” Although Hair et al. (2006) recommend a minimum of .50
communality for each variable to be included in the analysis, the variable LD (late
deliveries from the suppliers due to distance) with less than communality .50 was
retained due to its importance in the analysis.
13
14. Table 1.0 Communalities
Variable Purchasing and supply problems Communality
LS = Late supplies from stores 0.895
PP = Purchasing planning is done by top management 0.921
CO =There is no proper communication between purchasing section
and stores 0.921
TP = Purchasing staff are not trained in purchasing 0.580
TS = Stores staff are not trained in store management 0.881
LD = Late deliveries from suppliers due to distance 0.261
PG = There is no proper purchasing guidance or procedures 0.769
Variable JIT problems Communality
MP = Management problems 0.824
SM = Shortage of skilled manpower 0.572
LC = Lack of reliable means of communication in rural areas 0.645
LL = Long lead times (the time between ordering and receiving drugs) 0.715
DN = Demand is not known or predictable 0.801
FC = Financial constraints 0.905
LU = Lack of reliable means of communication in urban areas 0.761
Variable Purchasing objectives Communality
RQ =The right quality 0.931
RD =The right quantity 0.931
RP = The right price 0.931
RT = The right time 0.565
RS = The right supplier 0.768
14
15. Table 2.0: Correlation matrix of measures (1 = Disagree, 6 = Agree)
- Purchasing and supply problems
Pearson Correlation Coefficients and significance levels
1 2 3 4 5 6 7
Item Mean, S.D
1 LS Late supplies
from the stores (3.283, 0.454) 1
Purchasing
PP planning –done
2 by top
management (2.833, 0.376) - . 116 1
There is no
3 CO proper
communication-
purchasing and
stores (2.833, 0.376) - . 116 1.00** 1
Purchasing staff
4 TP are not trained in
purchasing (2.117, 0.324) . 117 -.534** .413** 1
Stores staff are
5 TS not trained in
stores
management (1.917, 0.279) - . 078 .027 . 027 . 110 1
Late deliveries
6 LD from suppliers
due to distance (1.750, 0.437) . 107 - . 258* - .258* . 210 - .035 1
There are no
7 PG proper
purchasing
procedures (1.667, 0.681) . 256* -.552** -.552** .564** . 298* . 228 1
** Correlation is significant at the 0.01 level (2-tailed)
* Correlation is significant at the 0.05 level (2-tailed)
Table 2.0: Correlation matrix of measures (Cont.) 1 = Not very important,
- Purchasing objectives 6 = Very important
Pearson Correlation Coefficients and significance levels
1 2 3 4 5 6 7
Item Mean, S.D
8 The right quality (5.90,
RQ 0.303) - . 160 . 000 . 000 - . 052 - .101 . 449** . 082
The right
9 RD quantity (5.9,
0.303) - . 160 . 000 . 000 - . 052 - .101 . 449** . 082
10 RP The right price (5.9,
0.303) - . 160 . 000 . 000 - . 052 - . 101 . 449** . 082
RT The right time (5.75,
11 0.437) . 021 . 052 . 052 . 090 . 104 . 111 . 228
The right (5.833,
12 RS supplier 0.376) - . 116 . 040 . 040 . 023 . 189 . 258* . 243
** Correlation is significant at the 0.01 level (2-tailed)
* Correlation is significant at the 0.05 level (2-tailed)
15
16. Table 2.0: Correlation matrix of measures (Cont.) 1 = Not very important,
- Purchasing objectives 6 = Very important
Pearson Correlation Coefficients and significance levels
8 9 10 11 12
Item Mean, S.D
8 The right quality (5.90,
RQ 0.303) 1
The right
9 RD quantity (5.9,
0.303) 1.00** 1
10 RP The right price (5.9,
0.303) 1.00** 1.00** 1
RT The right time (5.75,
11 0.437) .577** .577** .577** 1
The right (5.833,
12 RS supplier 0.376) .745** .745** .745** .775** 1
** Correlation is significant at the 0.01 level (2-tailed)
* Correlation is significant at the 0.05 level (2-tailed)
Table 2.0 indicates the results of the correlation matrix regarding the impact of
purchasing and supply problems on purchasing objectives. Late deliveries from the
suppliers due to distance (LD) have significant impact on achieving the purchasing
objectives: the right quality (RQ), right quantity (RD), right place (RP), and the right
supplier (RS). LD is not significant for the right time (RT).
Table 3.0: Correlation matrix of measures (1 = Not serious, 6 = Serious)
- Problems of using JIT
Pearson Correlation Coefficients and significance levels
1 2 3 4 5 6 7
Item Mean, S.D
1 MP Management
problems (3.917, 0.279) 1
Shortage of
2 SM skilled manpower (3.367, 0.52) . 098
1
Lack of reliable
3 LC communication
in rural areas (3.133, 0.503) . 081 -.320** 1
4 LL Long lead times (3.0, 0.611) . 199 -.160 . 055 1
Demand is not
5 DN known (2.167, 0.642) - . 110 -.339** . 402** -.173 1
Financial
6 FC constraints (1.967, 0.367) -.028 . 065 . 024 . 151 . 096 1
Lack of reliable
7 LU means of
communication
in urban areas (1.083, 0.279) . 091 . 137 -. 201 - . 100 . 110 . 028 1
** Correlation is significant at the 0.01 level (2-tailed)
* Correlation is significant at the 0.05 level (2-tailed)
16
17. Table 3.0: Correlation matrix of measures (Cont.) 1 = Not very important,
- Purchasing objectives 6 = Very important
Pearson Correlation Coefficients and significance levels
1 2 3 4 5 6 7
Item Mean, S.D
8
RQ The right quality (5.967, - . 056 -.048 -. 136 . 153 . 049 - . 017 . 056
0.181)
The right
9 RD quantity (5.933, -.330**
0.251) - . 081 . 061 .110 - .245 -. 024 . 081
10 RP The right price (5.9,
0.303) . 101 . 129 -.468** .275* -.523** -.031 . 101
RT The right time (5.75,
11 0.437) . 104 -.112 -.077 . 191 -.151 -.053 -.104
The right (5.833,
12 RS supplier 0.376) . 189 -.021 -.239 . 222 -.234 -.041 . 135
** Correlation is significant at the 0.01 level (2-tailed)
* Correlation is significant at the 0.05 level (2-tailed)
Table 3.0: Correlation matrix of measures (Cont.) 1 = Not very important,
- Purchasing objectives 6 = Very important
Pearson Correlation Coefficients and significance levels
8 9 10 11 12
Item Mean, S.D
8 The right quality (5.90,
RQ 0.303) 1
The right
9 RD quantity (5.9,
0.303) .695** 1
10 RP The right price (5.9,
0.303) .557** .802** 1
RT The right time (5.75,
11 0.437) .322* .463** .577** 1
The right (5.833,
12 RS supplier 0.376) .415** .598** .745** .745** 1
** Correlation is significant at the 0.01 level (2-tailed)
* Correlation is significant at the 0.05 level (2-tailed)
Table 3.0 indicates the results of the correlation matrix regarding the impact of JIT
problems on purchasing objectives. Lack of reliable communication in the rural areas
(LC), have significant impact on achieving the purchasing objectives: the right quantity
(RD) and the right price (RP). Long lead times (LL) and demand not known (DN) have
significant impact on achieving the purchasing objective the right price (RP).
17
18. 7.0 Discussion of results
7.1 Purchasing and supply problems
An effective and efficient just-in-time supply chain management function in the
healthcare system depends on the management’s efforts to solve purchasing and supply
problems facing healthcare sector in developing countries. These problems need to be
solved first before the healthcare sector organisations can achieve their purchasing
objectives in the supply chain.
The results show that the respondents are concerned with existing purchasing and supply
problems (See Table 4.0). The respondents rated the problems in order of severity as
follows:
(1) Late supplies from the stores (mean score 3.3).
(2) Purchasing planning is done by the top management (or the boss) only (mean
score 2.8).
(3) There is no proper communication between purchasing section and stores (mean
score 2.8).
(4) Purchasing staff are not trained in purchasing (mean score 2.1).
(5) Stores staff are not trained in store management (mean score 1.9).
(6) Late deliveries from suppliers due to distance (mean score 1.8).
(7) No proper purchasing guidance or procedures (mean score 1.7).
18
19. Table 4.0_____________________________________________________________________________
Purchasing and supply problems Mean Std. Deviation Rank
Late supplies from stores
LS 3.283 0.454 1
Purchasing planning is done by top management
PP 2.833 0.376 2
There is no proper communication between purchasing
CO section and stores 2.833 0.376 3
Purchasing staff are not trained in purchasing
TP 2.117 0.324 4
Stores staff are not trained in store management
TS 1.917 0.279 5
Late deliveries from suppliers due to distance
LD 1.750 0.437 6
PG There is no proper purchasing guidance or procedures 1.667 0.681 7
Scale: 1 = Disagree 6 = Agree.
The major problem is late supplies from the stores and the least problem is no proper
purchasing guidance or procedures (there was an effort to improve the situation). The
late medical supplies from hospital or clinic store is pointed out as the first problem by 50
percent of the respondents. Late delivery of drugs and other medical requirements affects
nurses’ performance in providing healthcare services to patients in the clinics and
hospitals. Respondents pointed out transport as a major problem affecting delivery of
medical supplies to clinics in the rural areas.
7.2 Problems for using just in time in healthcare organizations
Each respondent was asked to rate the problems of using just in time in healthcare
organisations. Respondents were asked to answer on the six-point Likert scale ranging
from 1 (not serious) to 6 (serious). The results show that respondents are concerned with
problems to adopt just in time supply chain in healthcare organisations (Table 5.0). The
respondents rated the problems in order of seriousness as follows:
19
20. (1) Management problems (mean score 3.9).
(2) Shortage of skilled manpower (mean score 3.4).
(3) Lack of reliable means of communication in rural areas (mean score 3.1).
(4) Long lead times (the time between ordering and receiving drugs) (mean score
3.0).
(5) Demand is not known or predictable (mean score 2.2).
(6) Financial constraints (mean score 2.0).
(7) Lack of reliable means of communication in urban areas (mean score 1.1)
Table 5.0_____________________________________________________________________________
Problems of using JIT Mean Std. Deviation Rank
Management problems
MP 3.917 0.279 1
Shortage of skilled manpower
SM 3.367 0.520 2
Lack of reliable means of communication in rural areas
LC 3.133 0.503 3
LD Long lead times 3.000 0.611 4
Demand is not known or predictable
DN 2.167 0.642 5
Financial constraints
FC 1.967 0.367 6
Lack of reliable means of communication in urban areas
LU 1.083 0.279 7
Scale: 1 = Disagree 6 = Agree.
The most serious problem reported by the respondents is regarding management
problems and the lower level problem is lack of reliable means of communication in
urban areas. The management problems are pointed out as a serious problem by 50
percent of the respondents, especially problems related to communication between
purchasing section and stores, purchasing planning, and late supplies from the stores.
The respondents indicated that cross-sectional relationships and team spirit is at a
minimum level in many clinics and hospitals. From the interviews, the respondents
20
21. revealed that although there are problems in using the JIT, the concept of JIT supply
chain can be useful in the clinics and hospitals operations. In the interviews conducted
by the author, it was revealed that apart from the problems in using JIT, the respondents
believe JIT supply chain management has potential benefits to the clinics and hospitals.
7.3 Rating of purchasing objectives in clinics and hospitals
Each respondent was asked to rate the importance of the five traditional purchasing
objectives in healthcare organisations: the right quality, the right quantity, at the right
time, the right supplier, and at the right price. Respondents were asked to answer on a
six-point Likert scale, ranging from 1 (not important) to 6 (very important). The results
show how the personnel involved in the supply chain value the purchasing objectives in
their organisations in order to facilitate the implementation of just in time supply.
The results show that the respondents in hospitals and clinics consider all the purchasing
objectives are very important. The following factors, arranged in order of importance
reflect the recognition of the key traditional purchasing objectives:
(1) The right quality (mean score 5.9).
(2) The right quantity (mean score 5.9).
(3) The right price (mean score 5.9).
(4) The right time (mean score 5.8).
(5) The right supplier (mean score 5.8).
The highest mean scores are reported for the right quality, the right quantity, and at the
right price (90 percent of the respondents rated the objectives very important on a six-
21
22. point Likert scale). Only 80 percent of the respondents indicated low mean scores (5.8)
for the right time and the right supplier objectives. Therefore, the results show that most
hospitals and clinics put more value on quality, quantity and price rather than the right
time and supplier in the supply chain. The low rating of time and supplier by the
respondents supports the last three problems highlighted as major purchasing and supply
problems in clinics and hospitals. It is not easy to implement just in time supply chain if
time and supplier, which are crucial factors in using JIT are given less weight in clinics
and hospitals.
7.4 Purchasing and stores personnel performance
The surveyed purchasing and stores personnel in the healthcare organisations have
different qualities although they obtained the same mean score of 1.6. The rating by the
respondents showed the rating of good was given by 60 percent of the respondents for
both purchasing and stores personnel. Only 40 percent of the respondents rated
purchasing and stores personnel as “very good” in performing supply chain management
activities in the hospitals and clinics.
The result supports the problems three, four, and five mentioned as major purchasing and
supply problems in the clinics and hospitals. The performance rated “good” for
purchasing and stores personnel provide evidence that the respondents are concerned
with purchasing and stores issues in their healthcare organisations. The low level of
performance can hinder the implementation of just in time supply chain in healthcare
sector.
22
23. 7.5 Lessons learned
This paper highlights JIT supply chain practices in developing countries, with particular
reference to the public healthcare sector in Botswana. The supply of medical drugs from
the government owned central medical store has not been done effectively to meet the
requirements of the hospitals and clinics. This forced some of the town councils to use
private suppliers of medical drugs, who are expensive and can drain their medical
supplies budget (Daily News Online, 2005). However, group purchasing by the central
medical store provides potential benefits in reducing costs, only if the central medical
store is professionally managed.
The use of a centralised source of supply needs to be managed effectively and efficiently.
There is a need to have more supply chain professionals to provide leadership in
operating the Botswana’s modern semi automated supplies store so that they can provide
services to the hospitals and clinics at the right time, with the right quantity and quality,
at minimum cost. Quick response to the requirements of the hospitals and clinics will
increase productivity, and enhance service level to the patients.
The importance of JIT supply chain management in the public healthcare sector can be
enhanced by top management of the central medical store and well trained purchasing
and supply personnel, who can manage the supply chain. The need for trained personnel
in supply chain management supports the findings in the literature (e.g., Msimangira,
2003; Gowen III & Tallon, 2003).
23
24. 8.0 Conclusions and recommendations
This study presents findings about the just in time supply chain in healthcare
organizations in developing countries, with particular reference to Botswana. The
responses in this study propose that the JIT supply chain philosophy could be used in
developing countries like Botswana in order to improve customer focus, and meet the
medical requirements of hospitals and clinics. The major problems in purchasing and
supply (e.g., late deliveries of medical supplies from the suppliers), and problems of
using JIT (e.g., lack of reliable communication in the rural areas, long lead times, and
unknown demand) in healthcare organisations in Botswana must be solved first if the JIT
supply chain is to work effectively and efficiently. After solving the JIT supply chain
problems, the quality of service in hospitals and clinics can be improved significantly.
Supply chain management can help an organisation achieve integration (e.g., Cox, 2004,
Sadeh et al., 2003, Christopher & Ryals, 1999) in providing good customer service.
In addition, personnel involved in supply chain activities must be trained in supply chain
management and just in time in order to offer high quality services to patients in the
hospitals and clinics, and at the same time minimize the operational costs. Also, there
must be a good co-ordinated supply chain design, to facilitate the just in time provision of
services. That is, there is a need to have efficient flow of medical drugs and other
healthcare requirements from the central medical stores (the source) to the hospitals and
clinics. In order for JIT to function properly, first the resources should be available and
employees working in the area of supply chain should be well trained and motivated to
ensure higher productivity. Before adopting effective JIT supply chain in healthcare, the
24
25. buyer (central medical store) should first carry out negotiations with potential (local and
overseas) suppliers for cooperation and support so that supply delays can be avoided.
Healthcare organisations deal with emergencies, and therefore, medical drugs must be
available when needed not earlier or later, but just in time to be used by the customers
(doctors, nurses, and patients).
The continuous training of personnel in the area of just in time supply chain will help to
solve the problems. The facilities required (such as transport) should be available when
needed. Transport must be available to deliver medicines and other supplies to different
health centres in urban and rural areas at the right time. In order to improve the level of
supply chain management understanding, the Ministry of Health (Botswana) and the
central medical stores should continue training their purchasing and supply personnel at
the Institute of Development Management (IDM), Botswana, the Botswana Institute of
Administration and Commerce (BIAC), and overseas to acquire necessary skills and
knowledge in supply chain management. In addition, there is a need to use good
examples of early adopters of JIT supply chain in public healthcare sector from the
developed countries, as exemplars.
The introduction of the Chartered Institute of Purchasing and Supply (CIPS, U.K.) branch
in Botswana, and the continuous government’s support to improve the level of
purchasing and supply management skills in the public sector, show that the future is
bright for Botswana in reducing procurement costs and improve service delivery in the
healthcare sector. Since the Graduate Diploma in Purchasing and Supply was introduced
25
26. at IDM in 1994, the number of active members of CIPS increased tremendously to over
430 by 2005 (CIPS, 2005).
The responses show that the JIT supply chain philosophy could be used in developing
countries like Botswana in order to improve customer focus, and meet the medical
requirements of hospitals and clinics.
9.0 Study limitations and future research
This paper has provided an insight for further research in Botswana and other developing
countries. An in depth study of JIT supply chain in the public healthcare sector, and the
behaviour of managers in managing the medical drugs supply chain is required to
determine hard evidence of the level of JIT supply chain practices in the healthcare
sector, using a large sample. The major limitation of this paper is that the data were
collected from a small convenience sample of nurses in Botswana. A study on a wider
scale, including patients, nurses, and doctors in the public hospitals and clinics in
developing countries may provide different results.
_____________________________________
Acknowledgement
The author wishes to thank the nurses who pursued a Diploma in Nursing Administration
at the Institute of Development Management, Botswana, for their responses to the
questionnaire and interviews.
26
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