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Inventory Management
Smriti Sharma
Highlights of the Session
 Introduction of management, material
management and inventory management
 Aims of inventory management
 Functions of inventory management
 Types of inventory
 Functional areas of inventory management
3
Highlights of the Session
 Demand estimation
 Key terms in demand estimation
 Procurement
 Receipt and Inspection
 Inventory Identification
 Methods of Inventory management
 Methods of ordering
4
Highlights of the Session
 Storage of materials
 New trends in inventory management
 Roles of nurses in inventory management
 Issues in inventory management in nursing
 Global efforts in inventory management
 National efforts in inventory management
5
Introduction
 Health care institutions are complex
organization providing large number of
services to the patients, physician and
staffs.
 Health care technologies are essential for
the functioning health system
6
Introduction contd…
 The global health care and supplies sector is
valued $184 billion (Healthcare equipments
and supplies, Global report 2011)
 According to Gartner (2012), supply chain
and management constitutes of 40 – 45
percentage of the total expenses of the
health care system
7
Introduction contd..
 Quality management of health care
technology helps ensure that these services
are provided in a safe and effective way
 The first step in managing health care
technology is to determine what items are to
be managed and to create the health care
technology inventory.
8
Introduction contd..
According to Gartner (2012), healthcare
organizations have potential to reduce the
expenses on supply chain and management
by 5-15% through proper planning, better
analysis, control and use of goods and
supplies which could translate into profit
increase of 2 to 4%.
9
Introduction contd…
It was estimated that a hospital could reduce
its total expenses by at least 2% through
better inventory management and
distribution of finished medical materials
(Schneller, 2006)
10
Management
 Mobilizing , protecting and utilizing men,
money, materials, machines and other
resources
 Healthcare delivery system thus includes the
 Personnel Management
 Material Management
 Financial Management
11
Material Management
Material management is;
 integrated function
 dealing with supply of materials and allied
activities
 to achieve the maximum co-ordination and
optimum expenditure on materials
12
Contd..
 The importance of effective material
management was first felt by profit making
business organizations
 Gradually service organizations like
educational organizations, hospitals realized
the value of managing their materials and
supplies in scientific lines
13
Elements of Material Management
 Demand estimation
 Procurement
 Receipt and inspection
 Storage
 Inventory management
14
Contd…
 Issue and use
 Maintenance and repair
 Value analysis and standardization
 Condemnation
 Disposal
 Accounting and information system
15
Inventory
 Materials or goods on hand
 Is an idle resource of any kind having an
economic value
16
Inventory Management
 Is a tool of management
 Used to maintain an economic minimum
investment in materials and products
 To obtain the maximum financial return
17
Inventory Management contd..
 Inventory management is a supervision of
the supply and storage and accessibility of
items in order to insure an adequate supply
without excessive oversupply
 Maintaining of stock at a level at which
purchasing and stocking costs are at the
lowest possible without interference with the
supply.
18
Inventory Control
High inventory level – high cost of inventories
by:
1. Locking the finance
2. Large storage space
3. Large handling and administration charges
4. Obsolescence
5. Spoilage
19
Inventory Control contd..
On the contrary, low inventory may lead to;
1. Frequent stock outs
2. Higher shortage costs
20
Inventory Management contd..
 Thus balancing the cost of carrying high
inventories and the cost of shortages is
done by system of scientific inventory
control.
21
Aims of Inventory Management
To attain,
 The right quality of supplies
 Right quantity of supplies
 At the right time
 At the right place
 For the right cost
22
Functions of Inventory Management
Primary Function:
 To provide maximum supply service,
consistent with maximum efficiency and
optimum investment
 To provide cushion between forecasted and
actual demand for a material
23
Other Functions
 Avoid uncertainties in supplies
 Permit to meet new demands
 Allow continuous and smooth production
system
 Makes a rational production system
possible. In hospital context this means
patient care system
24
Types of inventory
 Consumable materials (also called
expendable )
 Non-consumable materials (also called non-
expendable)
25
Consumable Materials
 Drugs
 Surgical goods
 Chemicals
 Antiseptics
 Stationeries
 Linen
 Food materials 26
Non-consumable materials
A. Fixed
o Sterilizers
o Monitor
o Fixed diagnostic machines like MRI, CT
Scan
27
Non-consumable Materials contd..
B. Movables
o Furniture
o Instruments
28
Functional Areas of Inventory Management
 Central Institutional Stores
 Departmental level/ Unit level
29
Functional Areas of Inventory Management
contd…
a. Surgical stores
b. Medical and Drug store
c. General store
d. Linen stores
e. Dietary stores
f. Stationary stores
g. Engineering and Maintenance stores30
Demand Estimation
 Consumption method
o data about actual use or past consumption
31
Demand Estimation contd..
 Morbidity data method
o data about prevalence and incidence of
disease and health problems and
o the standard treatments for these
32
Demand Estimation contd..
 Objectives of the organization
 Changing trend in healthcare
 Stock on hand
 Losses expected
33
Unique Feature of Healthcare Demand
 No assumptions/forecast can be done
 No stable pattern of demand
 Change in trends and practices due to new
inventions, scientific advancement
34
Key Terms
 Lead time
o Internal lead time
o External lead time
 Buffer Stock
 Maximum stock level
 Minimum stock level
35
Key Terms contd..
 Re-order level
 Inventory turnover
 Average consumption
36
Lead Time
 Average duration of time in days between
the placing of order and the receipt of
materials.
 Order should be placed at a time when the
existing stocks are sufficient for the needs of
the hospital during the lead time
37
Lead Time contd..
Internal Lead Time
 Is the time required for organizational formalities
to be completed
External Lead Time:
 Is the time taken in placement of order and
receipt of goods.
Total Lead Time: Internal Lead Time + External
Lead Time
38
Buffer Stock (BS)
 Quantity of stock set apart as a safeguard
against the variations in demand and
procurement period.
 Safety stock/ Reserve stock
 Is used only at the time of emergency for
unforeseen demands
BS= (Maximum consumption-Average
consumption) × Lead time
39
Maximum Stock Level
 It is the maximum amount of any item in
stock at any time.
Maximum Stock level = Reserve stock level
+
Order quantity for one supply period
40
Minimum Stock Level
 Is the stock level that indicates the need to place
an order to avoid running short of supplies.
 The minimum stock level can change over time,
so check it regularly and make any necessary
adjustments to the stock card and orders.
Minimum stock level = Reserve stock + Stock
used during lead time
41
Re-order Level
 Stock level at which fresh order has to be
placed
Re-order level = Average Consumption/ day
× Lead time + Buffer stock
42
Average monthly consumption (AMC)
 It is the average quantity of an item that is
issued each month over a period of months.
AMC = Quantities issued in the time period
Number of months in the time period
43
Economic Order of Quantity (EOQ)
 Quantity of materials for which an order is to
be placed each time.
EOQ= Average Monthly Consumption × Lead
Time (in months) +Buffer Stock -
Stock on hand
44
Cost Estimation
 Total Price = Unit price +No. of units
 Also includes;
o Maintenance and carrying cost (5-7%)
o Transportation cost
o Insurance cost
45
Procurement
 Procedure of ordering
 According to the organization rules and
regulations
46
Receipt and Inspection
 Inspection of incoming materials and supplies
 Quality and Quantity inspection
 Chemical Inspection
 WHO GMP (Good Manufacturing Practice)
certified medicines
 Other good quality prescribed by concern stake
holders
47
Inventory Identification
 Each piece of equipment is assigned a
unique number to allow it to be identified
from among all other pieces of equipment in
the inventory.
 Identification numbers are provided by the
following methods:
o Sequential numbering
o Codification
48
Inventory Identification contd..
o Barcodes
o Radio Frequency Identification (RFID)
 The clinical engineering department
determines the identification numbering and
labeling system to be used within the
organization.
49
Inventory Records
Minimal information that should be collected
o Product name/ description
o Stock on hand/ beginning stock balance
o Receipts
o Issues
o Losses/adjustments
50
Inventory Records contd…
 Consumption data/ Average monthly
consumption (AMC)
 Lead time for ordering/ requisition
 Maximum and minimum stock levels
 Emergency order point
51
Additional Records
o Special storage conditions
o Unit prices
o Bin locations
o Item codes
o Expiry dates
52
Computerized system for inventory
management (CMMS)
 Ease inventory management
 Especially larger inventories.
 The inventory may be integrated into a
Computerized Maintenance Management
System (CMMS),
53
Some Medical Inventory Softwares
 MedasPack Software
 ArbiMed Inventory
 Visual Inventory Control
 BarCloud Online Inventory
 Clinic Essentials
 WebOps Logistics
 AIMS. Net
54
Methods of Inventory Management
 ABC Analysis
 VED Analysis
 HML Analysis
 X-Y-Z Analysis
 FSN Analysis
55
Methods of Inventory Management
contd…
 SDE Analysis
 GOLF Analysis
 SOS Analysis
56
ABC ANALYSIS
(ABC=Always Better Control)
 Based on cost criteria
 The monetary value of the annual consumption
of all items of materials are classified roughly as:
 About 10% of the materials consume 70% of
resources (A)
 About 20% of materials consume 20% of
resources (B)
57
ABC Analysis contd…
 About 70% of materials consume 10% of
resources (C)
58
‘A’ Items
 Small in number, but consume large amount of
resources
 Must have
o Tight control
o Rigid estimate of requirement
o Strict and close watch
59
o Low safety stocks
o Managed by top management
Example:
 Ventillator, Defibrillator, Incubators
 Diagnostic machines- CT-scan, MRI machines,
Ultrasound, X-ray machines
60
‘C’ Items
 Larger in number but consume lesser
amount of resources
 Must have
o Ordinary control measures
o Purchase based on usage estimates
o High safety stocks
61
Example
 Gauge, cotton
 Betadine paint
 Stationary items
 Medicines- analgesics, vitamins
62
‘B’ Items
 Intermediate
 Must have
o Moderate control
o Purchase based on rigid requirements
o Reasonably strict watch and control
63
o Moderately safety stocks
o Managed by middle level management
Example:
 Surgical instruments
 Medicines
64
20000050020
19950050019
19900050018
19850050017
19800050016
19750050015
19700050014
19650050013
196000150012
194500150011
193000175010
19125027509
18850040008
18450045007
18000050006
17500075005
16750075004
160000200003
140000500002
90000900001
CUMMULATIVECUMMULATIVE
COSTCOST [Rs.]
ANNUAL COSTANNUAL COST
[Rs.]
ITEMITEM COST %COST %ITEM %ITEM %
70 %70 %
20 %20 %
10 %10 %
10 %10 %
20 %20 %
70 %70 %
ABC
A
N
A
L
Y
S
I
S
WORK
SHEET
65
VED Analysis
 VED analysis is based on critical values and
shortage costs of the Item.
 Based on the; criticality, the items could be
classified into three categories:
1. Vital
2. Essential and
3. Desirable
66
Vital Items:
 Items in the inventory of a hospital, which
could make difference between life and
death.
 Shortage cannot be tolerated
 Top management should control this group
of items.
67
Essential Items
 The shortage of such items can be tolerated for
a short period.
 If these items are not available for a few days or
a week, functioning of the hospital can be
adversely affected (drugs like Antibiotics,
surgical instruments etc.).
 Top/middle level management should preferably
control these items.
68
Desirable Items:
 The shortage of these items will not
adversely affect the patient care or hospital
functioning even if the shortage is prolonged
(items like Vitamins).
 Middle/lower level management should
control desirable items.
69
Combination Of A-B-C and V-E-D
classification
V E D ITEM COST
A AV AE AD CATEGORY 1 10 70%
B BV BE BD CATEGORY 2 20 20%
C CV CE CD CATEGORY 3 70 10%
70
Combination of ABC and VED Analysis
Category 1: Needs close monitoring and control
Category 2: Moderate Control
Category 3: No need for control
71
Research Input
A study on ‘Drug Inventory Control at Thai
International Hospital, Mahasarakhm on May,
2010, coupling of ABC and VED analysis was
proved to be an efficient and effective tool to
classify medicinal products was found. Further it
was found that the combination of these
methods can ease the inventory management
by narrowing down number of items that need
special attention and high level management.
72
F-S-N Classification
 Based on the consumption pattern or the
movement of the items from the store.
 Items are classified as fast moving, slow
moving and nonmoving based on their
consumption pattern.
 F-S-N analysis is specially useful to control
obsolescence, spillage and deterioration in
all kinds of items.
73
A thumb rule for F-S-N Classification
 Fast moving : Items which have moved at
least once in a year
 Slow moving: Items which have moved at
least once in a period of one or two years
 Non-moving: Items which have not moved
even once during a two- year duration
74
X-Y-Z classification
 Based on value of inventory available on a
particular date in the store .
 This classification is required to be done at least
once in a year.
 X items are those items whose stock value is
high,
 Z items are those whose stock values are low .
 Y falls between the two category
75
Combination or X-Y-Z and F-S-N
Classification
 The combination of X-Y-Z and F-S-N
classification can be more successfully
applied to control the piling up of obsolete
items.
 Disposal of obsolete items becomes
important to prevent building up of the
inventory over the years. The X-Y-Z and F-
S-N classification exercise will help in timely
prevention of obsolescence.
76
SDE Analysis
 This is based on the availability of items in the
market.
 S - items are scarce,
 D - items are difficult to procure and
 E - items are easily available in the market.
 Such an analysis may be handy when there is a
lot of uncertainty or vagaries in the
availability/procurement of the items.
77
HML analysis
 Based only on cost i.e., High, Medium, Low
cost items.
 Commonly used for management of
consumable items.
 Based on unit price
 Does not depend on consumption
78
G-O-L-F Analysis
 Based on the availability and nature of the
suppliers
 ‘G’ stands for ‘Government Suppliers’
 ‘O’ stands for ‘Ordinary Suppliers’
 ‘L’ stands for ‘Local Suppliers’
 ‘F’ stands for ‘ Foreign Suppliers’
79
SOS
 Based on seasonal availability
 S stands for seasonal
 Os stands for of seasonal
80
Methods of Ordering
 Two bin method
 Cyclical Method
81
Two-Bin Method
 Separates the stock of each item into two
bins (boxes)
 One bin consists the main stock
 The second consists of enough stock to
satisfy demand during the period necessary
for replenishment
 When the first bin is exhausted, an order for
replishment is immediately placed
82
Two-Bin Method contd…
 In the mean time stock in the second bin is
used to satisfy demand until the replishment
stock arrives
 Part of the new supply when arrives is used
to fill the second bin as reserve
 The remainder of the replenishment stock is
placed in the first bin available for issuing
and use.
83
Cyclical Method
 Stocks of various items are checked with
certain periodicity
 Find out the consumption pattern and
balance in hand
 Then, place an order to bring up the stock to
the desired level
 The period between the order remains the
same
84
Storage of The Materials
 WHO guidelines
 USAID guidelines
85
WHO Guidelines
 Follow the manufacturer or shipper’s
directions when stacking, and follow labels
for storage conditions.
 Place liquid products on the lower shelves or
on bottom of stacks.
 Store products that require cold storage in
appropriate temperature controlled zones.
86
WHO Guidelines contd…
 Store high security/high value products in
appropriate security zones.
 Separate damaged or expired products from
the usable stock without delay, and dispose
of using established disposal procedures.
 Always store all commodities in a manner
that facilitates FEFO policy for stock
management.
87
WHO Guidelines contd…
 Arrange medicines orderly either by generic
name, pharmacological category, dosage or
frequency of usage.
 Special storage condition for flammables,
corrosives and drugs like narcotics, strong
analgesics, psychotropic drugs,
Antiretrovirals.
88
Store Drugs and commodities in rack, cupboards and palettes.
Store Drugs and commodities in dry and well ventilated space
Store Drugs and commodities raised from ground and not
touching the walls
Store Drugs and commodities away from direct sunlight
Store Drugs and commodities away from office equipments,
insecticides and chemical.
Prevent Drugs and commodities from dampness and water
USAID Guidelines for Storage of Essential
Health Commodities and Vaccine
89
Store Condom and rubber items away from electric motors
and extremely bright lights.
Available of Fire extinguisher tool in the store
Assure Security (using grills, locks)
Prevent Store from rats and insects
Store Items according to FEFO system
StoreThe drugs and commodities in carton and racks with
properly visible label and expiry date
Separate Damages and expired drugs
90
PROCEDURE OF ISSUE
A) direct supply to the wards, OPD and
dispensary from the main stores of indents.
B) one more step in distribution is to include
a Floor pharmacy or a Sub store.
91
New Trends in Inventory Management
 Just In Time (JIT) System
 Radio Frequency Identification (RFID)
 Two Bin Methods (Kanban Method)
92
Just In Time System
 Originated from Toyota of Japan
 Method of industrial organization aimed at only
producing what is needed, when it is needed.
 A process capable of instant response to the
demand without the need for excess of
inventories
 Inventories should not be overstocked and
should be delivered to the right place at the right
time
93
JIT contd..
 Guaranteeing great service and right products at
the right time is very essential in healthcare
operation.
 Contractor provided reprocessing and
sterilization of surgical equipments is one of the
version of JIT.
 JIT similarly can be applied for hospitals daily
supplies of stationery items, forms and folders
which occupies space
94
Research Input
A study by Brandt (2011), on how JIT was applied
in a surgical room After applying JIT analysis, it
was realized equipments were placed in different
locations which led the nurses running all over
the place in the middle of the surgery.
Application of strict organizational structure
allowed for inventory to go down making easier
to see inventory and replenish them before stock
out and also minimize waste due to spoilage of
perishable goods.
95
Advantages
Reduces,
 Carrying cost
 Storage cost
 Insurance cost
 Space
 Risk of damage
 Risk of obsolescence
96
Controversy/ Discussion
 Healthcare provider cannot stock their
services and provide limited services
 Hard to forecast demand
 Inventories held for assisting the care of the
patient and in many cases saving the lives.
 Anticipating unknown having direct effect on
life- can’t afford to have empty shelves
97
Radio Frequency Identification (RFID)
 RFID is a technology that connects objects
to the Internet, so that they can be traced,
and companies can share data about them.
 In contrast to bar codes application, RFID
tags are robust and do not require line-of-
sight identification,
 No need for human intervention.
98
Advantages
 Improved tracking of high-value items/assets
 Reduced shrinkage and shipping errors in the
supply chain
 Inventory visibility, accuracy, and efficiency at
each stage
 Improved production planning and smart recalls
for effective scheduling, and
 Technology standards to drive down costs
99
Limitations
 Technical issues
 Cost
 Privacy concerns
100
Roles of Nurses in Inventory Management
 Nurses as a important part of the health care
delivery, essential is to understand the
system to effectively deliver quality care.
 The success of health care business
depends on nursing participation in
changing the system for delivering cost
effective care ensuring quality.
101
Roles of Nurses in Inventory Management
 Planning
 Organizing
 Leading and Delegating
 Controlling
 Supervising
102
Roles of Top Level Management
 Advising on the purchase of hospital
supplies and equipments used for nursing
services according to the need
 Supervising the maintenance of inventory
records by nursing staffs
 Facilitate in supplying adequate supplies for
carrying out nursing services
103
Role of Middle Level Management
 Responsible for keeping an adequate amount of
equipment and supplies in the ward
 Make sure that equipments and supplies are in
good conditions
 Put in a requisition for necessary equipment for
repair and maintenance when needed.
 Make sure that equipments and supplies are
conveniently located
104
Contd…
 Make sure that all the personnel in the ward
should clearly know who may use ward articles
and equipments and who assumes responsibility
for it .
 Prevent waste or misuse by educating the staff
in the economical and appropriate use of all
equipments and materials.
 Arrange a ward class to enable the staff to know
the cost of the equipment and materials when
necessary
105
Contd…
 Set a standard for the quantity of each item to be
maintained in the ward all the time.
 Have a satisfactory system for replacement of
broken or worn out equipment.
 Make regular inventories of all the items.
106
Responsibilities of the staff nurse
 Assist in taking inventories
 Checking for misuse and minimize it.
 Keep materials in good working conditions.
 Orders necessary supplies and equipments for
daily and weekly use.
107
Issues in Inventory Management in
Nursing
 Less accountability
 Less authority and control power
 Poor inventory visibility due to lack of data
systems
 Manually driven processes
 Lack of tools and standard work processes
108
Issues contd..
 Conflicting goals
 Lack of proper delegation
 Constantly evolving technologies
 Lack of skills and knowledge on inventory
control
 Physicians preferences
109
According to John Freund, (2015) between 20
and 30 percent of the clinicians including
nurse’s time is spent managing supply chain
related activities and nearly one third of their
day is spent away from patients, managing
supplies and equipments.
110
Research Input
A descriptive study by Enferm B. (1998) conducted
on the nurses of four Intensive care unit of Bahia,
Brazil revealed that only three out of four, there
was presence of nurses in the commission of
material purchase and selection. Study also
revealed that nursing performance was restricted
only for reposition of consumed materials without
effective and efficient prevision, selection,
purchasing and controlling.
111
Research Input
A study conducted on 2014 in Vanderbilt
Hospital, USA to observe the factors that could
lead to wastage of time of nurses in the
departments. 320 specific observations of
wastage were found, among them 32 percent of
all the waste related to supplies, equipments
and medication were found.
112
Global Efforts on Inventory Management
 Recognizing the important role of health
technologies, the World Health Assembly
adopted resolution WHA60.29 in May 2007.
 The resolution covers issues:
o arising from the inappropriate deployment and
use of health technologies and
o the need to establish priorities in the selection
and management of health technologies,
specifically medical devices.113
Global Efforts contd…
 Together with the World Health Assembly
resolution, the Global Initiative on Health
Technologies (GIHT), with funding from the Bill
& Melinda Gates Foundation was formed with 2
objectives:
o to challenge the international community to
establish a framework for the development of
national essential health technology
programmes
114
Global efforts contd..
o To challenge the business and scientific
communities to identify and adapt innovative
technologies that can have a significant
impact on public health.
 Three documents in this technical series
have been developed specifically to aid a
health facility or a national ministry of health
to establish or improve a medical equipment
maintenance programme.
115
Global Efforts contd..
 The documents address
1. Medical equipment inventory management
2. Maintenance and
3. Computerized maintenance management
systems.
116
National Efforts in Inventory Management
 Logistic Management Division
 Healthcare Technology Policy 2006
117
Logistic Management Division (LMD)
 Established under the Department of Health
Services in 2050/51 (1993, with a network of
central and five regional medical stores as
well as district level stores.
 The major function of LMD is to procure,
store and distribute health commodities for
the health facilities of government of Nepal.
118
Activities to Strengthen Health Care
Services
 Procurement
o District procurement plan
o Setting up of procurement committee in the
district
o Forecasting and quantification
o Cost Estimation
o Timely procurement
119
Activities to Strengthen Health Care
Services
 Annual Consensus Forecast Meeting
 Quarterly national pipeline review meetings
o Started since 1997/98
o Review the supplies and commodities of
family planning, EPI vaccines, syringes,
essential drugs, maternal and child health,
and HIV/AIDS
120
Activities to Strengthen Health Care
Services
 Strengthen storage capacity
o 54 district warehouse constructed
o 1 cold chain warehouse built in Pathalaya
transit
o Increased total storage space from 21,223 sq.
ft from 1999 to 86,400 sq. ft in 2011
o Safe storage of valuable health commodities
maintaining storage standards121
Capacity Building
 Web based LMIS and inventory
management system was started since 2008
 Training and orientation program are
conducted at different levels
 175 person were provided training on web
based LMIS and inventory management in
the year 2070/71
122
Capacity Building(1994-2012)
123
Types of training Person
Basic health logistic training for newly
transferred staffs
31
Basic health logistics training for MCHW/FCHV 2,459
Sub district level logistic review and orientation
program
2,996
District level public procurement training 434
Training on web based LMIS and Inventory
management
508
National Health Care Technology Policy
 With the aim of providing access to quality health
service to all in the country, the Ministry of Health
and Population has given priority to preparing
and reviewing relevant health policies and
guidelines as when they are necessary.
 Realizing the need for a Health Care Technology
Policy as utmost importance to implement the
health services in an effective way, the Ministry
of Health and Population submitted a policy
document to the cabinet for its approval.
124
National Healthcare Technology Policy
contd..
 The policy was approved on 2060/11/11 and
brought into action. The policy was
developed in line with the basic principles of
the WHO and adopted in accordance to our
national need.
 To address the problem Ministry Of Health
has formulated 11 policies.
125
Conclusion
 Inventory management is the important
element of material management and
management which ensures the regular flow
of supplies and equipments in an healthcare
system in a optimum investment possible.
 For the effective management of materials
the approach of various bodies are essential
like administrators, physicians and nurses
126
Conclusion contd…
 Because of the change in the trends in
healthcare system managerial
responsibilities of the nurses have been
challenged to ensure effective and quality
patient care with due consideration in the
optimum expenditure.
127
Reference
Ali, M.,et al. (2012). Inventory Management and Its Effects on Customer
Satisfaction.
Basavanthappa, BT.,(2009). Nursing Administration, Jaypee Brothers
Medical Publishers, 2nd edition
Clark, C.C., (2010). Creative Nursing Leadership and Management,
Jones and Bartlett Publishers, 1st edition
Hani, U., Basri, M. H., & Winarso, D. (2013). Inventory Management of
Medical Consumables in Public Hospital
Kaini, K.B., (2005). Principles of Hospital Management, Triyuga Printing
Press, 1st edition
128
Reference contd…
Kamani, P.,(2004). Hospital Supply Chain Saving, ASCEF, volume 6.
Lenel A et al.,(2005). How to organize a system of healthcare technology
management,guides no. 1., St Albans, Ziken International
Mahyadin, F.A.,(2015). The Influence of Inventory Management
Practices Towards Inventory Management Performance in Malaysian
Public Hospitals.
Mehta, R., Pokharel, T., (2007). Leadership and Management, Heidal
Press Ltd.,1st edition
Miller, R. (2010). Inventors Control: Theory and Practice. New Jersey
129
Reference contd…
Ogbo, A. I & Onekanma I.V. (2014). “The Impact of Effective Inventory
Control Management on Organizational Performance”, Mediterranean
Journal of Social Sciences, MCSER Publishing, Vol. 5
Rana, M., Bista, A., (2011). Leadership and Management in Nursing,
Medhavi Publication
Rossetti, D.M., (2008). Inventory Management Issues in Health Care
Supply Chain
Roark, D.C. (2005). Managing the healthcare supply chain. Nursing
Management.
Sah, A.P., Essentials of Health Management, Vidyarthi Pustak Bhandar
130
Reference contd…
USAID, (2006). Guidelines for Implementing Computerized System for
Logistic Management
Wang B et al.(2006). Medical equipment management strategies.
Biomedical Instrumentation and Technology
Waters, C. J., (2003). Inventory Control and Management, 2nd edition,
John Wiley & Sons.
WHO, (2011). Introduction to Medical Equipment Inventory Management
WHO (2003). Guidelines for the storage of medicines and other health
commodities
131
Reference contd..
WHO (2009). Guidelines for procurement and management of supplies
and goods
Wolper, L.F., (2004). Health Care Administration, Jones and Bartlett
Publishers, 3rd edition
Woods, E.D.,(2014). Nursing and Healthcare Supply Chain: At the
Intersection of Labor and Supply Expenses
132
THANKYOU!!!!
133

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Seminar on inventory management

  • 1. 1
  • 3. Highlights of the Session  Introduction of management, material management and inventory management  Aims of inventory management  Functions of inventory management  Types of inventory  Functional areas of inventory management 3
  • 4. Highlights of the Session  Demand estimation  Key terms in demand estimation  Procurement  Receipt and Inspection  Inventory Identification  Methods of Inventory management  Methods of ordering 4
  • 5. Highlights of the Session  Storage of materials  New trends in inventory management  Roles of nurses in inventory management  Issues in inventory management in nursing  Global efforts in inventory management  National efforts in inventory management 5
  • 6. Introduction  Health care institutions are complex organization providing large number of services to the patients, physician and staffs.  Health care technologies are essential for the functioning health system 6
  • 7. Introduction contd…  The global health care and supplies sector is valued $184 billion (Healthcare equipments and supplies, Global report 2011)  According to Gartner (2012), supply chain and management constitutes of 40 – 45 percentage of the total expenses of the health care system 7
  • 8. Introduction contd..  Quality management of health care technology helps ensure that these services are provided in a safe and effective way  The first step in managing health care technology is to determine what items are to be managed and to create the health care technology inventory. 8
  • 9. Introduction contd.. According to Gartner (2012), healthcare organizations have potential to reduce the expenses on supply chain and management by 5-15% through proper planning, better analysis, control and use of goods and supplies which could translate into profit increase of 2 to 4%. 9
  • 10. Introduction contd… It was estimated that a hospital could reduce its total expenses by at least 2% through better inventory management and distribution of finished medical materials (Schneller, 2006) 10
  • 11. Management  Mobilizing , protecting and utilizing men, money, materials, machines and other resources  Healthcare delivery system thus includes the  Personnel Management  Material Management  Financial Management 11
  • 12. Material Management Material management is;  integrated function  dealing with supply of materials and allied activities  to achieve the maximum co-ordination and optimum expenditure on materials 12
  • 13. Contd..  The importance of effective material management was first felt by profit making business organizations  Gradually service organizations like educational organizations, hospitals realized the value of managing their materials and supplies in scientific lines 13
  • 14. Elements of Material Management  Demand estimation  Procurement  Receipt and inspection  Storage  Inventory management 14
  • 15. Contd…  Issue and use  Maintenance and repair  Value analysis and standardization  Condemnation  Disposal  Accounting and information system 15
  • 16. Inventory  Materials or goods on hand  Is an idle resource of any kind having an economic value 16
  • 17. Inventory Management  Is a tool of management  Used to maintain an economic minimum investment in materials and products  To obtain the maximum financial return 17
  • 18. Inventory Management contd..  Inventory management is a supervision of the supply and storage and accessibility of items in order to insure an adequate supply without excessive oversupply  Maintaining of stock at a level at which purchasing and stocking costs are at the lowest possible without interference with the supply. 18
  • 19. Inventory Control High inventory level – high cost of inventories by: 1. Locking the finance 2. Large storage space 3. Large handling and administration charges 4. Obsolescence 5. Spoilage 19
  • 20. Inventory Control contd.. On the contrary, low inventory may lead to; 1. Frequent stock outs 2. Higher shortage costs 20
  • 21. Inventory Management contd..  Thus balancing the cost of carrying high inventories and the cost of shortages is done by system of scientific inventory control. 21
  • 22. Aims of Inventory Management To attain,  The right quality of supplies  Right quantity of supplies  At the right time  At the right place  For the right cost 22
  • 23. Functions of Inventory Management Primary Function:  To provide maximum supply service, consistent with maximum efficiency and optimum investment  To provide cushion between forecasted and actual demand for a material 23
  • 24. Other Functions  Avoid uncertainties in supplies  Permit to meet new demands  Allow continuous and smooth production system  Makes a rational production system possible. In hospital context this means patient care system 24
  • 25. Types of inventory  Consumable materials (also called expendable )  Non-consumable materials (also called non- expendable) 25
  • 26. Consumable Materials  Drugs  Surgical goods  Chemicals  Antiseptics  Stationeries  Linen  Food materials 26
  • 27. Non-consumable materials A. Fixed o Sterilizers o Monitor o Fixed diagnostic machines like MRI, CT Scan 27
  • 28. Non-consumable Materials contd.. B. Movables o Furniture o Instruments 28
  • 29. Functional Areas of Inventory Management  Central Institutional Stores  Departmental level/ Unit level 29
  • 30. Functional Areas of Inventory Management contd… a. Surgical stores b. Medical and Drug store c. General store d. Linen stores e. Dietary stores f. Stationary stores g. Engineering and Maintenance stores30
  • 31. Demand Estimation  Consumption method o data about actual use or past consumption 31
  • 32. Demand Estimation contd..  Morbidity data method o data about prevalence and incidence of disease and health problems and o the standard treatments for these 32
  • 33. Demand Estimation contd..  Objectives of the organization  Changing trend in healthcare  Stock on hand  Losses expected 33
  • 34. Unique Feature of Healthcare Demand  No assumptions/forecast can be done  No stable pattern of demand  Change in trends and practices due to new inventions, scientific advancement 34
  • 35. Key Terms  Lead time o Internal lead time o External lead time  Buffer Stock  Maximum stock level  Minimum stock level 35
  • 36. Key Terms contd..  Re-order level  Inventory turnover  Average consumption 36
  • 37. Lead Time  Average duration of time in days between the placing of order and the receipt of materials.  Order should be placed at a time when the existing stocks are sufficient for the needs of the hospital during the lead time 37
  • 38. Lead Time contd.. Internal Lead Time  Is the time required for organizational formalities to be completed External Lead Time:  Is the time taken in placement of order and receipt of goods. Total Lead Time: Internal Lead Time + External Lead Time 38
  • 39. Buffer Stock (BS)  Quantity of stock set apart as a safeguard against the variations in demand and procurement period.  Safety stock/ Reserve stock  Is used only at the time of emergency for unforeseen demands BS= (Maximum consumption-Average consumption) × Lead time 39
  • 40. Maximum Stock Level  It is the maximum amount of any item in stock at any time. Maximum Stock level = Reserve stock level + Order quantity for one supply period 40
  • 41. Minimum Stock Level  Is the stock level that indicates the need to place an order to avoid running short of supplies.  The minimum stock level can change over time, so check it regularly and make any necessary adjustments to the stock card and orders. Minimum stock level = Reserve stock + Stock used during lead time 41
  • 42. Re-order Level  Stock level at which fresh order has to be placed Re-order level = Average Consumption/ day × Lead time + Buffer stock 42
  • 43. Average monthly consumption (AMC)  It is the average quantity of an item that is issued each month over a period of months. AMC = Quantities issued in the time period Number of months in the time period 43
  • 44. Economic Order of Quantity (EOQ)  Quantity of materials for which an order is to be placed each time. EOQ= Average Monthly Consumption × Lead Time (in months) +Buffer Stock - Stock on hand 44
  • 45. Cost Estimation  Total Price = Unit price +No. of units  Also includes; o Maintenance and carrying cost (5-7%) o Transportation cost o Insurance cost 45
  • 46. Procurement  Procedure of ordering  According to the organization rules and regulations 46
  • 47. Receipt and Inspection  Inspection of incoming materials and supplies  Quality and Quantity inspection  Chemical Inspection  WHO GMP (Good Manufacturing Practice) certified medicines  Other good quality prescribed by concern stake holders 47
  • 48. Inventory Identification  Each piece of equipment is assigned a unique number to allow it to be identified from among all other pieces of equipment in the inventory.  Identification numbers are provided by the following methods: o Sequential numbering o Codification 48
  • 49. Inventory Identification contd.. o Barcodes o Radio Frequency Identification (RFID)  The clinical engineering department determines the identification numbering and labeling system to be used within the organization. 49
  • 50. Inventory Records Minimal information that should be collected o Product name/ description o Stock on hand/ beginning stock balance o Receipts o Issues o Losses/adjustments 50
  • 51. Inventory Records contd…  Consumption data/ Average monthly consumption (AMC)  Lead time for ordering/ requisition  Maximum and minimum stock levels  Emergency order point 51
  • 52. Additional Records o Special storage conditions o Unit prices o Bin locations o Item codes o Expiry dates 52
  • 53. Computerized system for inventory management (CMMS)  Ease inventory management  Especially larger inventories.  The inventory may be integrated into a Computerized Maintenance Management System (CMMS), 53
  • 54. Some Medical Inventory Softwares  MedasPack Software  ArbiMed Inventory  Visual Inventory Control  BarCloud Online Inventory  Clinic Essentials  WebOps Logistics  AIMS. Net 54
  • 55. Methods of Inventory Management  ABC Analysis  VED Analysis  HML Analysis  X-Y-Z Analysis  FSN Analysis 55
  • 56. Methods of Inventory Management contd…  SDE Analysis  GOLF Analysis  SOS Analysis 56
  • 57. ABC ANALYSIS (ABC=Always Better Control)  Based on cost criteria  The monetary value of the annual consumption of all items of materials are classified roughly as:  About 10% of the materials consume 70% of resources (A)  About 20% of materials consume 20% of resources (B) 57
  • 58. ABC Analysis contd…  About 70% of materials consume 10% of resources (C) 58
  • 59. ‘A’ Items  Small in number, but consume large amount of resources  Must have o Tight control o Rigid estimate of requirement o Strict and close watch 59
  • 60. o Low safety stocks o Managed by top management Example:  Ventillator, Defibrillator, Incubators  Diagnostic machines- CT-scan, MRI machines, Ultrasound, X-ray machines 60
  • 61. ‘C’ Items  Larger in number but consume lesser amount of resources  Must have o Ordinary control measures o Purchase based on usage estimates o High safety stocks 61
  • 62. Example  Gauge, cotton  Betadine paint  Stationary items  Medicines- analgesics, vitamins 62
  • 63. ‘B’ Items  Intermediate  Must have o Moderate control o Purchase based on rigid requirements o Reasonably strict watch and control 63
  • 64. o Moderately safety stocks o Managed by middle level management Example:  Surgical instruments  Medicines 64
  • 66. VED Analysis  VED analysis is based on critical values and shortage costs of the Item.  Based on the; criticality, the items could be classified into three categories: 1. Vital 2. Essential and 3. Desirable 66
  • 67. Vital Items:  Items in the inventory of a hospital, which could make difference between life and death.  Shortage cannot be tolerated  Top management should control this group of items. 67
  • 68. Essential Items  The shortage of such items can be tolerated for a short period.  If these items are not available for a few days or a week, functioning of the hospital can be adversely affected (drugs like Antibiotics, surgical instruments etc.).  Top/middle level management should preferably control these items. 68
  • 69. Desirable Items:  The shortage of these items will not adversely affect the patient care or hospital functioning even if the shortage is prolonged (items like Vitamins).  Middle/lower level management should control desirable items. 69
  • 70. Combination Of A-B-C and V-E-D classification V E D ITEM COST A AV AE AD CATEGORY 1 10 70% B BV BE BD CATEGORY 2 20 20% C CV CE CD CATEGORY 3 70 10% 70
  • 71. Combination of ABC and VED Analysis Category 1: Needs close monitoring and control Category 2: Moderate Control Category 3: No need for control 71
  • 72. Research Input A study on ‘Drug Inventory Control at Thai International Hospital, Mahasarakhm on May, 2010, coupling of ABC and VED analysis was proved to be an efficient and effective tool to classify medicinal products was found. Further it was found that the combination of these methods can ease the inventory management by narrowing down number of items that need special attention and high level management. 72
  • 73. F-S-N Classification  Based on the consumption pattern or the movement of the items from the store.  Items are classified as fast moving, slow moving and nonmoving based on their consumption pattern.  F-S-N analysis is specially useful to control obsolescence, spillage and deterioration in all kinds of items. 73
  • 74. A thumb rule for F-S-N Classification  Fast moving : Items which have moved at least once in a year  Slow moving: Items which have moved at least once in a period of one or two years  Non-moving: Items which have not moved even once during a two- year duration 74
  • 75. X-Y-Z classification  Based on value of inventory available on a particular date in the store .  This classification is required to be done at least once in a year.  X items are those items whose stock value is high,  Z items are those whose stock values are low .  Y falls between the two category 75
  • 76. Combination or X-Y-Z and F-S-N Classification  The combination of X-Y-Z and F-S-N classification can be more successfully applied to control the piling up of obsolete items.  Disposal of obsolete items becomes important to prevent building up of the inventory over the years. The X-Y-Z and F- S-N classification exercise will help in timely prevention of obsolescence. 76
  • 77. SDE Analysis  This is based on the availability of items in the market.  S - items are scarce,  D - items are difficult to procure and  E - items are easily available in the market.  Such an analysis may be handy when there is a lot of uncertainty or vagaries in the availability/procurement of the items. 77
  • 78. HML analysis  Based only on cost i.e., High, Medium, Low cost items.  Commonly used for management of consumable items.  Based on unit price  Does not depend on consumption 78
  • 79. G-O-L-F Analysis  Based on the availability and nature of the suppliers  ‘G’ stands for ‘Government Suppliers’  ‘O’ stands for ‘Ordinary Suppliers’  ‘L’ stands for ‘Local Suppliers’  ‘F’ stands for ‘ Foreign Suppliers’ 79
  • 80. SOS  Based on seasonal availability  S stands for seasonal  Os stands for of seasonal 80
  • 81. Methods of Ordering  Two bin method  Cyclical Method 81
  • 82. Two-Bin Method  Separates the stock of each item into two bins (boxes)  One bin consists the main stock  The second consists of enough stock to satisfy demand during the period necessary for replenishment  When the first bin is exhausted, an order for replishment is immediately placed 82
  • 83. Two-Bin Method contd…  In the mean time stock in the second bin is used to satisfy demand until the replishment stock arrives  Part of the new supply when arrives is used to fill the second bin as reserve  The remainder of the replenishment stock is placed in the first bin available for issuing and use. 83
  • 84. Cyclical Method  Stocks of various items are checked with certain periodicity  Find out the consumption pattern and balance in hand  Then, place an order to bring up the stock to the desired level  The period between the order remains the same 84
  • 85. Storage of The Materials  WHO guidelines  USAID guidelines 85
  • 86. WHO Guidelines  Follow the manufacturer or shipper’s directions when stacking, and follow labels for storage conditions.  Place liquid products on the lower shelves or on bottom of stacks.  Store products that require cold storage in appropriate temperature controlled zones. 86
  • 87. WHO Guidelines contd…  Store high security/high value products in appropriate security zones.  Separate damaged or expired products from the usable stock without delay, and dispose of using established disposal procedures.  Always store all commodities in a manner that facilitates FEFO policy for stock management. 87
  • 88. WHO Guidelines contd…  Arrange medicines orderly either by generic name, pharmacological category, dosage or frequency of usage.  Special storage condition for flammables, corrosives and drugs like narcotics, strong analgesics, psychotropic drugs, Antiretrovirals. 88
  • 89. Store Drugs and commodities in rack, cupboards and palettes. Store Drugs and commodities in dry and well ventilated space Store Drugs and commodities raised from ground and not touching the walls Store Drugs and commodities away from direct sunlight Store Drugs and commodities away from office equipments, insecticides and chemical. Prevent Drugs and commodities from dampness and water USAID Guidelines for Storage of Essential Health Commodities and Vaccine 89
  • 90. Store Condom and rubber items away from electric motors and extremely bright lights. Available of Fire extinguisher tool in the store Assure Security (using grills, locks) Prevent Store from rats and insects Store Items according to FEFO system StoreThe drugs and commodities in carton and racks with properly visible label and expiry date Separate Damages and expired drugs 90
  • 91. PROCEDURE OF ISSUE A) direct supply to the wards, OPD and dispensary from the main stores of indents. B) one more step in distribution is to include a Floor pharmacy or a Sub store. 91
  • 92. New Trends in Inventory Management  Just In Time (JIT) System  Radio Frequency Identification (RFID)  Two Bin Methods (Kanban Method) 92
  • 93. Just In Time System  Originated from Toyota of Japan  Method of industrial organization aimed at only producing what is needed, when it is needed.  A process capable of instant response to the demand without the need for excess of inventories  Inventories should not be overstocked and should be delivered to the right place at the right time 93
  • 94. JIT contd..  Guaranteeing great service and right products at the right time is very essential in healthcare operation.  Contractor provided reprocessing and sterilization of surgical equipments is one of the version of JIT.  JIT similarly can be applied for hospitals daily supplies of stationery items, forms and folders which occupies space 94
  • 95. Research Input A study by Brandt (2011), on how JIT was applied in a surgical room After applying JIT analysis, it was realized equipments were placed in different locations which led the nurses running all over the place in the middle of the surgery. Application of strict organizational structure allowed for inventory to go down making easier to see inventory and replenish them before stock out and also minimize waste due to spoilage of perishable goods. 95
  • 96. Advantages Reduces,  Carrying cost  Storage cost  Insurance cost  Space  Risk of damage  Risk of obsolescence 96
  • 97. Controversy/ Discussion  Healthcare provider cannot stock their services and provide limited services  Hard to forecast demand  Inventories held for assisting the care of the patient and in many cases saving the lives.  Anticipating unknown having direct effect on life- can’t afford to have empty shelves 97
  • 98. Radio Frequency Identification (RFID)  RFID is a technology that connects objects to the Internet, so that they can be traced, and companies can share data about them.  In contrast to bar codes application, RFID tags are robust and do not require line-of- sight identification,  No need for human intervention. 98
  • 99. Advantages  Improved tracking of high-value items/assets  Reduced shrinkage and shipping errors in the supply chain  Inventory visibility, accuracy, and efficiency at each stage  Improved production planning and smart recalls for effective scheduling, and  Technology standards to drive down costs 99
  • 100. Limitations  Technical issues  Cost  Privacy concerns 100
  • 101. Roles of Nurses in Inventory Management  Nurses as a important part of the health care delivery, essential is to understand the system to effectively deliver quality care.  The success of health care business depends on nursing participation in changing the system for delivering cost effective care ensuring quality. 101
  • 102. Roles of Nurses in Inventory Management  Planning  Organizing  Leading and Delegating  Controlling  Supervising 102
  • 103. Roles of Top Level Management  Advising on the purchase of hospital supplies and equipments used for nursing services according to the need  Supervising the maintenance of inventory records by nursing staffs  Facilitate in supplying adequate supplies for carrying out nursing services 103
  • 104. Role of Middle Level Management  Responsible for keeping an adequate amount of equipment and supplies in the ward  Make sure that equipments and supplies are in good conditions  Put in a requisition for necessary equipment for repair and maintenance when needed.  Make sure that equipments and supplies are conveniently located 104
  • 105. Contd…  Make sure that all the personnel in the ward should clearly know who may use ward articles and equipments and who assumes responsibility for it .  Prevent waste or misuse by educating the staff in the economical and appropriate use of all equipments and materials.  Arrange a ward class to enable the staff to know the cost of the equipment and materials when necessary 105
  • 106. Contd…  Set a standard for the quantity of each item to be maintained in the ward all the time.  Have a satisfactory system for replacement of broken or worn out equipment.  Make regular inventories of all the items. 106
  • 107. Responsibilities of the staff nurse  Assist in taking inventories  Checking for misuse and minimize it.  Keep materials in good working conditions.  Orders necessary supplies and equipments for daily and weekly use. 107
  • 108. Issues in Inventory Management in Nursing  Less accountability  Less authority and control power  Poor inventory visibility due to lack of data systems  Manually driven processes  Lack of tools and standard work processes 108
  • 109. Issues contd..  Conflicting goals  Lack of proper delegation  Constantly evolving technologies  Lack of skills and knowledge on inventory control  Physicians preferences 109
  • 110. According to John Freund, (2015) between 20 and 30 percent of the clinicians including nurse’s time is spent managing supply chain related activities and nearly one third of their day is spent away from patients, managing supplies and equipments. 110
  • 111. Research Input A descriptive study by Enferm B. (1998) conducted on the nurses of four Intensive care unit of Bahia, Brazil revealed that only three out of four, there was presence of nurses in the commission of material purchase and selection. Study also revealed that nursing performance was restricted only for reposition of consumed materials without effective and efficient prevision, selection, purchasing and controlling. 111
  • 112. Research Input A study conducted on 2014 in Vanderbilt Hospital, USA to observe the factors that could lead to wastage of time of nurses in the departments. 320 specific observations of wastage were found, among them 32 percent of all the waste related to supplies, equipments and medication were found. 112
  • 113. Global Efforts on Inventory Management  Recognizing the important role of health technologies, the World Health Assembly adopted resolution WHA60.29 in May 2007.  The resolution covers issues: o arising from the inappropriate deployment and use of health technologies and o the need to establish priorities in the selection and management of health technologies, specifically medical devices.113
  • 114. Global Efforts contd…  Together with the World Health Assembly resolution, the Global Initiative on Health Technologies (GIHT), with funding from the Bill & Melinda Gates Foundation was formed with 2 objectives: o to challenge the international community to establish a framework for the development of national essential health technology programmes 114
  • 115. Global efforts contd.. o To challenge the business and scientific communities to identify and adapt innovative technologies that can have a significant impact on public health.  Three documents in this technical series have been developed specifically to aid a health facility or a national ministry of health to establish or improve a medical equipment maintenance programme. 115
  • 116. Global Efforts contd..  The documents address 1. Medical equipment inventory management 2. Maintenance and 3. Computerized maintenance management systems. 116
  • 117. National Efforts in Inventory Management  Logistic Management Division  Healthcare Technology Policy 2006 117
  • 118. Logistic Management Division (LMD)  Established under the Department of Health Services in 2050/51 (1993, with a network of central and five regional medical stores as well as district level stores.  The major function of LMD is to procure, store and distribute health commodities for the health facilities of government of Nepal. 118
  • 119. Activities to Strengthen Health Care Services  Procurement o District procurement plan o Setting up of procurement committee in the district o Forecasting and quantification o Cost Estimation o Timely procurement 119
  • 120. Activities to Strengthen Health Care Services  Annual Consensus Forecast Meeting  Quarterly national pipeline review meetings o Started since 1997/98 o Review the supplies and commodities of family planning, EPI vaccines, syringes, essential drugs, maternal and child health, and HIV/AIDS 120
  • 121. Activities to Strengthen Health Care Services  Strengthen storage capacity o 54 district warehouse constructed o 1 cold chain warehouse built in Pathalaya transit o Increased total storage space from 21,223 sq. ft from 1999 to 86,400 sq. ft in 2011 o Safe storage of valuable health commodities maintaining storage standards121
  • 122. Capacity Building  Web based LMIS and inventory management system was started since 2008  Training and orientation program are conducted at different levels  175 person were provided training on web based LMIS and inventory management in the year 2070/71 122
  • 123. Capacity Building(1994-2012) 123 Types of training Person Basic health logistic training for newly transferred staffs 31 Basic health logistics training for MCHW/FCHV 2,459 Sub district level logistic review and orientation program 2,996 District level public procurement training 434 Training on web based LMIS and Inventory management 508
  • 124. National Health Care Technology Policy  With the aim of providing access to quality health service to all in the country, the Ministry of Health and Population has given priority to preparing and reviewing relevant health policies and guidelines as when they are necessary.  Realizing the need for a Health Care Technology Policy as utmost importance to implement the health services in an effective way, the Ministry of Health and Population submitted a policy document to the cabinet for its approval. 124
  • 125. National Healthcare Technology Policy contd..  The policy was approved on 2060/11/11 and brought into action. The policy was developed in line with the basic principles of the WHO and adopted in accordance to our national need.  To address the problem Ministry Of Health has formulated 11 policies. 125
  • 126. Conclusion  Inventory management is the important element of material management and management which ensures the regular flow of supplies and equipments in an healthcare system in a optimum investment possible.  For the effective management of materials the approach of various bodies are essential like administrators, physicians and nurses 126
  • 127. Conclusion contd…  Because of the change in the trends in healthcare system managerial responsibilities of the nurses have been challenged to ensure effective and quality patient care with due consideration in the optimum expenditure. 127
  • 128. Reference Ali, M.,et al. (2012). Inventory Management and Its Effects on Customer Satisfaction. Basavanthappa, BT.,(2009). Nursing Administration, Jaypee Brothers Medical Publishers, 2nd edition Clark, C.C., (2010). Creative Nursing Leadership and Management, Jones and Bartlett Publishers, 1st edition Hani, U., Basri, M. H., & Winarso, D. (2013). Inventory Management of Medical Consumables in Public Hospital Kaini, K.B., (2005). Principles of Hospital Management, Triyuga Printing Press, 1st edition 128
  • 129. Reference contd… Kamani, P.,(2004). Hospital Supply Chain Saving, ASCEF, volume 6. Lenel A et al.,(2005). How to organize a system of healthcare technology management,guides no. 1., St Albans, Ziken International Mahyadin, F.A.,(2015). The Influence of Inventory Management Practices Towards Inventory Management Performance in Malaysian Public Hospitals. Mehta, R., Pokharel, T., (2007). Leadership and Management, Heidal Press Ltd.,1st edition Miller, R. (2010). Inventors Control: Theory and Practice. New Jersey 129
  • 130. Reference contd… Ogbo, A. I & Onekanma I.V. (2014). “The Impact of Effective Inventory Control Management on Organizational Performance”, Mediterranean Journal of Social Sciences, MCSER Publishing, Vol. 5 Rana, M., Bista, A., (2011). Leadership and Management in Nursing, Medhavi Publication Rossetti, D.M., (2008). Inventory Management Issues in Health Care Supply Chain Roark, D.C. (2005). Managing the healthcare supply chain. Nursing Management. Sah, A.P., Essentials of Health Management, Vidyarthi Pustak Bhandar 130
  • 131. Reference contd… USAID, (2006). Guidelines for Implementing Computerized System for Logistic Management Wang B et al.(2006). Medical equipment management strategies. Biomedical Instrumentation and Technology Waters, C. J., (2003). Inventory Control and Management, 2nd edition, John Wiley & Sons. WHO, (2011). Introduction to Medical Equipment Inventory Management WHO (2003). Guidelines for the storage of medicines and other health commodities 131
  • 132. Reference contd.. WHO (2009). Guidelines for procurement and management of supplies and goods Wolper, L.F., (2004). Health Care Administration, Jones and Bartlett Publishers, 3rd edition Woods, E.D.,(2014). Nursing and Healthcare Supply Chain: At the Intersection of Labor and Supply Expenses 132