Supply Chain Management in Hospital

Pantai infirmary Ipoh (PHI), registered chthonian Paloh health check rivet Sdn. Bhd, was inst tout ensembleed in year 1996 own by Pantai conclave, luck of IHH Health mission Berhad one of the to the highschoolest degree signifi tooshiet healthc be operators in the world that exit premium health bid penny-pinchings in Asia, primeval and Eastern Europe, the Middle East and North Africa. The infirmary is strategic wholey located in Ipoh and easily friendly within a 5 minutes stab from the North-S come to the foreh Highway Interchange and the Ipoh urban center Centre.Pantai hospital Ipoh was started to do by the local anesthetic comm social unit of measurementies of Ipoh, and has since grown to become one of the occult premier healthc ar plyrs in Perak, and the northern division of Malaysia. Pantai infirmary Ipoh started with in effect(p) only 76 levels, and at once has 180 beds and 82 consultant specialists, providing timber cargon and treatment aided by qual ified nurses and some early(a) wholeied healthc atomic number 18 professionals.In partnership with unhomogeneous health insurers and corporate compositions, PHI has established itself as a prefer deliverr, on the wholeowing greater and easier admission fee to its health boot serve up, which extends beyond just a single hospital by means of the co disadvantageal network of much than 10 Pantai and Gleneagles infirmarys, all part of IHH healthcare Berhad. Through the character of appropriate engineering science and skills, Pantai hospital Ipoh is firm in its vision to be the trusted professionals of healthcare auction pitch, from balkion, detection to treatment and care, when it matters most.Apart from providing a total range of wayrn facilities and the expertise of m some(prenominal) another(prenominal) consultant specialists, the hospital is mental facultyed with warm and friendly military force who are dedicated to give our customers the individualalized heed and smell care they deserve. Central to its commitment to harbors quality healthcare, PHI strives to provide excellence in service and its coming(prenominal) allow for be built on accept change innovation, today and tomorrow. In year 2005, Pantai hospital Ipoh has successfully grasped ISO 90012008.The hospital continuously seeks to break the organizations per varianceance and the issuecome of cares. With this, PHI has started the adoption the ruff and safe practices for all the clinical and non-clinical areas which guided by Malaysia Society in Healthcare feature. Since the inception of Pantai Hospital Ipoh in 1996, the hospital has increased tremendously the disciplinary medical and surgical specialties. Listings below are the specialties provided by Pantai Hospital currently Anaesthesiology Cardiology Colorectal surgery Cardiothoracic Anaethesiology Cardiothoracic functioning Dental / Oral Surgery Dermatology Ear, Nose & pharynx Surgery (ENT) Gastroente rology General Surgery Haematology Immunology sterileness Internal Medicine Nephrology Neurology Neurosurgery Orthopaedic Surgery Obstetrics and Gynaecology Ophthalmology Paediatrics Pain worry Plastic and Reconstructive Surgery Psychiatry urogenital medicine Rheumatology Respiratory Radiology To serve the work mentioned above, Pantai Hospital Ipoh has established the following facilities and go a. 24hrs Accident & EmergencyTo provide 24-hour services for emergency as utilityously as less(prenominal) urgent cases that subprograms a triage transcription to baffle the severity of each case, to hold in that priority is ef moveery to patients with the most urgent medical need. b. Ambulance proceedss Our ambulance service provides transportation of patients throughout Malaysia with let ins 24-hour Prompt Emergency Response-Time narrow mint transport services Inter-hospital / inter-clinic transfers Doctor / nurse realise to provide immediate in-ambul ance care Ambulance pick-up for calls within Ipoh City c. Physiotherapy & Rehabilitation CentreThe caseful matter offers a wide-cut range of rehabilitation programmes to dish patients to achieve functionality and mobility. Amongst the massive spectrum of services include preventive care, and the treatment as well as rulement of movement disorders arising form medical conditions and lifelong disabilities. d. Imaging Service Pantai Hospital Ipoh has a complete range of imaging services including Multi-slice CT S canisterner, Magnetic Resonance Imaging (MRI), X-rays, ultrasonography & doppler scans and mammography. The division operates 24 hours, serving in-patients, outpatients as well as patients referred from external healthcare providers. e.Dietetic focal point PHIs dietitian provide individualized programs and counseling for patients, found on the loads recommendations and patients condition. The dietitian overly ensure that all nutrition served to patients are low in fat, salt and scar and ultimately meet the specific nutritional requisite of individual patients medical conditions and the posits diagnosis. f. drug convergenceion line certificate Service The hospitals apothecarys shop is open 24 hours, dispensing medications for both inpatients and outpatients. Pharmacy provide also offer Patient Counselling Service to advice patients on the correct way of pickings as well as storing their medications.This service also extended to bed-side counseling for inpatients. g. Pathology and Laboratory Services PHIs pathology services are managed and provided by Pantai Premier Pathology Sdn Bhd, The research lab offers a full range of laboratory services and tests that are performed by skilled and experience force play with sophisticated garbments. Pathologists are available for clinical extension on concerns related to appropriate test utilization, care in test result interpretation or any other concerns which may occur in the course of patient management. h. Diagnostic and Endoscopic CentreThe centre provides treadmill to perform express Test to facilitate cardiac assessment nad forms for ECG and reduplicate Cardiograms as well as Carotid duplex to assess arterial blockages. The centre also carries out Do moreoveramine Stress Echo as an alternative rule for those patients whose condition makes them unsuitable to undergo a Stress Test notwithstanding urgently need cardiac assessment and 24-hour Ambulatory Blood Pressure supervise as well as Holter Monitoring which provides day-and-night ECG monitoring oddly for patients who complain of palpitations and/or sudden blackouts.The Endoscopic Centre facilitates varies pillow slip of scopes including gastroscopy, colonoscopy bronchoscopy, cystoscopy and ERCP. i. top dog and Nerve Centre The centre is equipped with machines which consort out the following procedures Electroencephalogram (EEG) Nerve conductivity bring (NCS) Electromyogram (EMG) Visual Evok ed electromotive force (VEP) Study Brain Auditory Evoked capability (BAEP) Study j. Sleep Study Sleep Studies are conducted is a sleep laboratory help doctor confirm certain sleep disorders. k. Haemodialysis CentreThe Putri Dialysis Centre is a well equipped centre that is intentional to provide patients with a comfortable environment including wait areas for ac allianceing family members, light refreshments and audio-video entertainment. l. Dental Services PHI has a well equipped alveolar clinic with a occupant dentist and aided by visiting dental surgeons, who can undertake and perform complex dental procedures. m. Health and Wellness Centre It provides a wide range of premium screening programmes that leave alone equip the customer with the knowledge and awareness to help to continue optimum health. . Parking & Valet Service Pantai Hospital Ipoh offers complimentary parking services, further enhanced by a free Valet Service, which operates during the following hours Mon day to Friday- 7. 00am 7. 00pm Saturday- 7. 00am 5. 00pm Sunday- 9. 00am 5. 00pm o. Concierge Service Complimentary concierge services are provided for patients who discharged from the hospital, to help to transport their bags and belongings from their several(prenominal) ward to the lobby, where node Care Assistant are at extend further assist the patient to alight their mode of transportation. . Financial Counselling Financial Counselling service was initiated to assist patients and their family members in managing the medical woo incurred from pursuit treatment at Pantai Hospital Ipoh by whirl be estimation prior to procedure and service in getting financial aid from Employees foresighted Fund (EPF) and germane(predicate) financial institution, should be arise. q. some other ServicesOther services that provide by Pantai Hospital Ipoh include Hospital Cafetaria certified halal providing a physique of local and international cuisine Bread myth offering wide choi ce of breads and buns Convimart a mini convenience install selling magazines, snacks, drinks, gifts and issue baskets. Natural Health Farm Offering various health products that promote intermit health and seniority of human body, skin and hair. Ipoh Medical Supplies offering a range of common medical supplies and equipment. Banking facilities An ATM machine is strategically located at the hospital lobby. net profit Access provides free WIFI access through-out the hospital for everyone Patient that require for inpatient treatment could be admitted through the Emergency Department or through Specialist Consultant or General practitioner Clinic. Pantai Hospital Ipoh offers a range of dwell types, to publish individual ask and demands however theses are hooked to handiness and if a particular room type is not available, option lead be provided and efforts testamenting be made to have the requested room type provided as soon as it is available. at a lower place a re the room rates which are subject to 6% Government Tax.Meals are complimentary to all patients. inhabit TypesRates Per Day (RM) Executive aureate Room330. 00 Deluxe Room250. 00 Single Room160. 00 Double-Bedded Room110. 00 Four-Bedded Room60. 00 ICU / CCU150. 00 Isolation Room 150. 00 Nursery25. 00 Day Case35. 00 Incubator 105. 00 Supply range is the lifeblood of a healthcare organization. The release chemical chain surgery is the infixed link for all programs and services offered by a hospital, and hence any receipts in managing the tote up chain can positively impact bottom line profitability of any hospitals operations.As most departments in Pantai Hospital Ipoh enumerate to a great extent on supplies, materials management can ease or cramp a hospitals operations. From a low cost needle to a high-end orthopaedic implant, special instruments or pieces of linen, supplies are indispensable during a patients stay at the hospital. Quality care cannot be provid ed on cadence unless needful material is available in adequate quantity. As such Pantai Hospital Ipoh, has established a buy department to centralize the get all medical supplies, medical equipment and instrument, consumables, stationeries and toiletry within the hospital.The department not only to purchase but to perform cost negotiation to ensure every power point that purchased is the low price but of course without comprising the quality. Together with submit Department, Purchasing Department determines the minimum and maximum aim for every single item for re- tell purposes. To determine the minimum and maximum level, a few factors volition be observed the usage of them item / product, location of the supplier, the availability of the item / product in the market and delivery schedule.Thus, the acquire needs to communicate with all the applicable departments and the supplier to ensure that is no shortage of all supplies and at the same time to ensure our store dep artment is not holding too very much timeworn. At our Pharmacy Department, the department also performed the comparable task as buy department but limited to pharmaceutical products. This is because pharmaceutical products need change person who is the pharmacist with the consultation of specialist consultants to control the drugs usage and its complication.Pantai Hospital Ipoh not only subscribes to patent / original drugs but also generic wine drugs that provide the same effectiveness comparing to the original drugs but much lower in price. As generic drugs are less expensive, it could help to lower down the overall treatment cost that could enjoyed by the patient. The bring out chain does not stop at the purchasing and pharmacy department. It is important that the purchased medical supplies and drugs are delivered to all the respective wards, clinics, operation theatre and other relevant departments to ensure no interruption of patient care.Hence, a deliver chain outlin e has been developed from proterozoic stage of sourcing and ordering to the patient consumption. As mentioned earlier, sourcing and ordering is done by purchasing and pharmacy department. at one time the goods arrived to hospital, the respective store cosmopolitan store and pharmacy store, will received their goods. The respective store will entered the fund into our Hospital Information System, and from there the communication channel will be arranged in the store systematically. The wards, departments and operation theatre will requisite their items base on their pre-set minimum and maximum level.For those high activities department for example operation theatre, they are allowed for three time requisition a week and as for less or average activities, will allowed to requisite their convey two propagation a week. As if any urgent requisition, store will allowed with valid reason. The receiving wards or departments will then store their stock in their respective store and l abel all stocks. The ward or department will consume the item(s) ground on first in first out (FIFO) method to ensure no there is no expiry products. Ward and departmental clerk will ensure all the availability of the stocks is at a path level.At Pantai Hospital Ipoh, we also understand that render chains may be more businesslike and brassy by outsourcing of certain services. The main services that outsources are housekeeping. UMC Service scale, a well-known keep company in healthcare providing housekeeping services, has been appointed to manage housekeeping in the hospital. The programs offered by UMC Service Master has successfully provided measurable results by improving quality, containing costs, schooling and motivating employees and minimize risks. The company also takes over some of the nurses daily routine jobs for example bed make for inpatient and discharge patient.This enables the nurses to concentrate on the more critical matter which is patient care. Beside the purchasing, stock management and outsourcing, Pantai Hospital Ipoh also involved in a put up chain with international and local insurance companies and managed care organization or ternion party executive. The insurance companies, managed care organization and deuce-ace party administrator will signed a partnership agreement with the hospital to become add-in hospital and to provide cashless healthcare facilities for their policyholders that are cover under their purchased policy.The treatment requested could be outpatient, daycase and/or inpatient depending on their policy terms and conditions. The process started when a patient requested for treatment front office staff will request a guarantee garner (GL) from the respective insurance company, managed care organization or third party administrator by providing an initial medical report to them. The company will process the claim based on the initial report and if the case is covered, the company will issue the hospital a gua rantee letter for wages.If the patient was admitted, hospital would to provide discharge unofficial and the total bill to the respective company for payment guarantee. Some companies do cover for the post-hospitalization up to 60 days of discharge. Our Marketing department also practices supply chain in their marketing activities. They has established a programme known as Pantai Putri Member of tie Program (PPMAP) to recruit general practitioner (GP) in Perak region to become part of PPMAP member.The objective is to obtain referral of patients to the hospital from the GPs, as Pantai Hospital Ipoh understands that GPs could be a good source of generating business. In return of the referral, Pantai Hospital will tin their clinic by providing them on-going education and promoting their clinic by recommending to the local public and during any road turn out organized by Hospital Pantai Ipoh. This will generates a strong back to back support and in return benefited.For the past few years, there was a draw of development and improvement taken place in Pantai Hospital in related with supply chain management but the hospital is still lining challenges in managing the effectiveness of supply chain system. The challenges can be classified at below a. need of Product instruction b. Limited Sourcing and Services c. over-the-hill IT systems d. deprivation of Inventory and statistical dispersion trouble Lack of Product Management First, the hospital could categorize the products in terms of cost, criticality and other criteria.For instance, bed linen may be less critical and map out a low cost to the hospital paracetamol may be urgently required but inexpensive while specialist cancer drugs may be both urgent and costly. This product categorization will dictate supply chain design. For example, drugs and medical equipment power be ordered directly from the manufacturers own stock, practically at short notice and in atypical quantities, requiring transshipm ent center relatively nearby. Medical supplies, on the other hand, will be subject to a more regular supply chain, providing greater flexibility in responding to emergencies.Secondly, hospital and specialist doctor should work under one vision and direction in providing the better service at a reasonable cost. In heealthcare industry, we understand specialist consultants are independent trainors with hefty clout and specific preferences for supplies and some variations in supplies and processes are accommodated to ensure patient safety. These Preference Items accountable for more than 50% of total medical supply expense in PHI. This provide an opportunity for supply chain savings in the area of physician buy-in especially with respect to changes in purchase and use of high-cost clinical items.It is commonly perceived that physicians are resistant to change. He points to the fact that entropy which supports the decision to use a particular supply can go a long way in convincing a physician to use a particular supply. PHI could establish a product evaluation and re keep an eye on committees which rest of clinical experts, purchasing and finance personnel to subdue the problem. The purpose of the committee is to decide to purchase and universally adopt cost-effective items for use within all hospitals and the decision making is by team consensus.The finance and purchasing personnel could educate the clinical experts on the financial impact of various supplier options. Therefore, the use of consensus, instead of majority rule, in the decision making process minimizes any postsourcing disagreement and results in the high compliance rate and buy-ins from all physicians. This will helps purchasing to further negotiate and obtain lower price from the supplier as the hospital is now acquire exclusively from the supplier only with bigger quantity.Thirdly, in PHI product cost assessment, hospital must approximate the total cost rather than just unit product cost in determining the types of products to purchase. The cost of a product is evaluated from the types of raw materials employ for the product and how this will impact the disposal cost associated with the product. For example, the use of analog X-Ray equipment may have a lower unit cost initially, but the fauna utilizes X-ray film that contained mercury, may result in a noteworthy disposal fee which needs to be calculated in the total cost.Hence, hospital should to considering total cost has resulted in of import cost savings. Sourcing and Services Effective management of the external supply chain typically covers every facet of procural activity such as supplier selection, swerve negotiation, planning and implementation, distribution and delivery while fetching factors such as risk, reward into account. There are 9 Pantai Hospital and 2 Gleneagles Hospital in whole Malaysia, as such Centralize Group Purchasing is possible.Centralize Group Purchasing have provided significant cost saving opportunities for hospitals by taking advantage of economies of scale in purchasing from select vendors for many an(prenominal) hospitals at once. Cost saving includes better contract terms, price reduction, rebates and overhead costs. Purchasing Systems and Technology Pantai Hospital Ipoh has an outdated Hospital Information System (HIS) to manage their supply chains, known as Procare. These outdated data management systems do not have the capacitance to meet the changes and needs today.The challenge confront by PHI is how to seamlessly transition the wealth of data without disrupting the existing purchasing system and inter-departmental integration. One identified area in supply chain structure that PHI could further improve on is in the area of purchasing systems and technology. PHI can explore new technologies and leverage on what has been successfully done in other Pantai hospitals to enable staffs to access faster, more valuable and easier access to necessary sup ply information when ordering.At time hospital spend significant resources to reconcile purchase orders and invoices due to mismatched item numbers and units of measure. Another challenge that PHI faces is in identifying personnel capable of understanding the old technology used by the existing IT systems to effectively move it to a newer platform. Although this is not a unique problem face by PHI, there is no industry sample that can easily help provide a cost- and time-effective solution.Hence, the technology upgrade for PHIs purchasing system remains an area to be addressed and acknowledge by the management. Once improved, the flexibility of the system will allow KP a more detailed view of its purchasing process and use of products, which will in turn provide better insight into creating a more effective cost structure. Inventory and Distribution Management It is critical for PHI to maintain a competent level of lineage at all times to ensure the needs of patients are always met. stroke to do so could result in the loss of life.In a hospital, managing its inventory is not easy as there are thousands of inventories, both medical and non-medical products. The distribution mechanism is also very important to ensure the product(s) is delivered to the end user in the hospital. PHIs general store often mismanaged of the inventories, the current inventory system is ineffective and inefficient. The challenge that PHI is facing is that the management is unable to provide a sufficient storage and no proper and experience staff to head and managed the store.To drown the issue, first PHI need to engage an experience staff who has know about inventory management and to redirect examination and examine the overall existing available storage space to maximize the current storage with the tending of shelf, cabinet or compactor. Secondary storage could be developed to separate the medical and non-medical items. PHI could incorporate communicate frequency identifi cation technology (RFID) into its inventory management system. RFID systems have a broad range of potential drop benefits for the health care industry.These include medical thingmabob and asset tracking, improved visibility of inventory and supply chain management, and improved patient safety by preventing drug counterfeiting. In our current distribution, the store depend on the departmental clerk to requisite their stock. As mentioned early, some departments / patient care units replenish their stock 3-times a week but some are only 2-times a week. Especially, the patient care unit, inventory management for them is a hassle as they are focusing on patient care. At time, the unit forgot to replenish their stock patient care was stirred due to unavailability of the product.This challenge often faced by the medical staff. The distribution system should be improved to be more effective to prevent and to solve the issue. The general store could establish a system whereby there will b e person in the store to monitor the availability of the stock via our Hospital Information System Procare and since minimum and maximum ordering has already been fixed, the general store staff could deliver the stock(s) which is under path level to the respective patient care unit. The store would have better control of overall inventory and distribution and improvement activities could be carried out more efficient and effective.A good inventory management programme is always patient-centred. sequence inventory is concerned with financial issues, hospitals are in the business of serving patients. Although technology has an important consumption to play, the emphasis should be on using it in a way that makes a difference to the quality of patient care. Automating inefficient processes may not stick out any productive result. Processes should be reengineered to make them more patient-friendly. Cost-effectiveness, time consciousness and safety are tombstone drivers of a patient- centered approach.Once this goal is clear, technology can support and drive the efforts towards realizing efficiencies and improving the quality of health care services. Reference 1. Pantai Hospital Ipohs company profile (K. K. L. I. U. No. (0320/2012/C) 2. Asian Hospital & Healthcare Management article on Materials Management in Healthcare A patient-centred approach 3. Supply Chain Management in Hospital A Case Study by Samuel Toba, Mary Tomasini, Y. Helio Yang, San Diego State University, San Diego, CA make in California Journal of Operations Management, mess 6, Number 1, February 2008