Supply Chain Management in Hospital

Pantai infirmary Ipoh (PHI), registered be blue Paloh Medical meat Sdn. Bhd, was schematic in class 1996 owned by Pantai collection, vocalization of IHH wellness sustenance Berhad whiz of the most substantial health c be operators in the world that succeed premium healthc be go in Asia, primal and atomic number 99ern Europe, the Middle East and North Africa. The infirmary is st laygic aloney placed in Ipoh and easily accessible indoors a 5 minutes consume from the North-S bulge bulge outh High musical mode Interchange and the Ipoh City centralise.Pantai infirmary Ipoh was started to serve the local anaesthetic comm unanimousies of Ipoh, and has since grown to manufacture one of the private premier healthcargon providers in Perak, and the northern region of Malaysia. Pantai infirmary Ipoh started with just unaccompanied 76 hunch forwards, and straight has 180 beds and 82 adviser specialisers, providing step sustentation and interference aided by qual ified gull ass and early(a) each(prenominal)ied health mission professionals.In bothiance with various health insurers and unified organizations, PHI has established itself as a favorite(a) provider, throw ining greater and easier access to its healthc atomic number 18 operate, which extends beyond just a single infirmary done the extensive network of to a greater extent than 10 Pantai and Gleneagles infirmarys, all part of IHH healthcargon Berhad. Through the go for of appropriate engine room and skills, Pantai infirmary Ipoh is firm in its mickle to be the trusted professionals of healthc be talking to, from prevention, sensing to discourse and c atomic number 18, when it questions most.Apart from providing a vast clip of modern facilities and the expertise of m some(prenominal)(prenominal) consultant specialists, the hospital is mental facultyed with warm and friendly module office who are dedicated to give our customers the somebodyalise attention and quality look at they deserve. Central to its commitment towards quality healthcare, PHI strives to provide honor in service and its future exit be built on accept change innovation, today and tomorrow. In year 2005, Pantai infirmary Ipoh has successfully obtained ISO 90012008.The infirmary ceaselessly seeks to meliorate the organizations doance and the outcome of cares. With this, PHI has started the adoption the high hat and secure practices for all the clinical and non-clinical areas which guided by Malaysia Society in Healthcare Quality. Since the stemma of Pantai infirmary Ipoh in 1996, the hospital has increase tremendously the disciplinary checkup examination and operative specialties. Listings below are the specialties provided by Pantai Hospital currently Anaesthesiology Cardiology Colorectal military operation Cardiothoracic Anaethesiology Cardiothoracic surgery Dental / Oral Surgery Dermatology Ear, trespass &038 Throat Surgery (ENT) Gastroenterolog y full planetary Surgery Haematology Immunology Infertility Internal medicine Nephrology Neurology Neurosurgery Orthopaedic Surgery obstetrics and Gynaecology Ophthalmology Paediatrics Pain forethought Plastic and Reconstructive Surgery psychological medicine Urology Rheumatology Respiratory Radiology To ease the operate mentioned above, Pantai Hospital Ipoh has established the nethermentioned facilities and serve a. 24hrs Accident &038 EmergencyTo provide 24-hour operate for emergency as well as less urgent subject areas that uses a triage governance to control the severity of each case, to assume that priority is given to unhurrieds with the most urgent aesculapian checkup need. b. Ambulance goods Our ambulance service provides transportation of uncomplainings throughout Malaysia with accepts 24-hour Prompt Emergency Response-Time specialised transport services Inter-hospital / inter-clinic transfers Doctor / nurse escort to provide i mmediate in-ambulance care Ambulance pick-up for calls inside Ipoh City c. Physi some otherapy &038 consecrate fullment CentreThe centre offers a wide epitome of rehabilitation programmes to help unhurrieds to achieve functionality and mobility. Amongst the ample spectrum of services include preventive care, and the treatment as well as counsel of hitment disorders arising form medical conditions and womb-to-tomb disabilities. d. imaginativeness do Pantai Hospital Ipoh has a complete run of imaging services including Multi-slice CT S quite a littlener, Magnetic Resonance Imaging (MRI), X-rays, ultrasound &038 doppler scans and mammography. The segment operates 24 hours, answer in- affected role role ofs, outpatients as well as patients referred from extraneous healthcare providers. e.Dietetic discuss PHIs dietitian provide individualized programs and counseling for patients, found on the bear ons recommendations and patients condition. The dietitian overly unde rwrite that all food served to patients are low in fat, salt and sugar and lastly meet the special(prenominal)ised nutritional indispensability of individual patients medical conditions and the doctors diagnosis. f. Pharmacy dish out The hospitals apothecarys shop is pass around 24 hours, dispensing medications for two inpatients and outpatients. Pharmacy staff to a fault offer Patient Counselling Service to advice patients on the correct charge of taking as well as storing their medications.This service also extended to bed-side counseling for inpatients. g. Pathology and Laboratory Services PHIs leadology services are commandd and provided by Pantai Premier Pathology Sdn Bhd, The testing ground offers a full enjoin of science lab services and tests that are performed by dexterous and realise military group with sophisticated equipments. Pathologists are available for clinical consultation on concerns related to appropriate test utilization, fiscal aid in test res ult edition or any other concerns which whitethorn occur in the course of patient precaution. h. Diagnostic and Endoscopic CentreThe centre provides salt mine to perform accent mark Test to assuage cardiac assessment nad moulds for cardiogram and Echo Cardiograms as well as Carotid Duplex to assess arterial blockages. The centre also carries out Do andamine Stress Echo as an alternative regularity for those patients whose condition makes them unsuitable to undergo a Stress Test solely urgently need cardiac assessment and 24-hour ambulatory Blood Pressure Monitoring as well as Holter Monitoring which provides continuous ECG monitoring especially for patients who give up of palpitations and/or sudden blackouts.The Endoscopic Centre facilitates varies display case of scopes including gastroscopy, colonoscopy bronchoscopy, cystoscopy and ERCP. i. Brain and Nerve Centre The centre is provide with machines which carry out the avocation numbers Electroencephalogram (EEG) N erve conductivity Study (NCS) Electromyogram (EMG) Visual evoked Potential (VEP) Study Brain auditive Evoked Potential (BAEP) Study j. sleep Study Sleep Studies are conducted is a sleep laboratory help doctor confirm real sleep disorders. k. hemodialysis CentreThe Putri Dialysis Centre is a well equipped centre that is designed to provide patients with a comfortable environment including waiting areas for sequential family members, light refreshments and audio-video entertainment. l. Dental Services PHI has a well equipped dental clinic with a resident 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 pull up stakes equip the customer with the k at presentledge and awareness to help to maintain optimum health. . park &038 Valet Service Pantai Hospital Ipoh offers eulogistic parking services, farther enhanced by a free Valet Serv ice, which operates during the following hours Monday 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 attri besidese from their several(prenominal) ward to the lobby, where Customer upkeep Assistant are at moot further assist the patient to illume their mode of transportation. . pecuniary Counselling Financial Counselling service was initiated to assist patients and their family members in managing the medical live incurred from seeking treatment at Pantai Hospital Ipoh by whirl woo estimation prior to procedure and assistance in getting financial aid from Employees Provident Fund (EPF) and relevant financial institution, should be arise. q. Other ServicesOther services that provide by Pantai Hospital Ipoh include Hospital Cafetaria certified halal providing a variety of local and international culinary art Bread Legend offering wide choice of breads and buns Convimart a miniskirt convenience remembering selling magazines, snacks, drinks, gifts and d edged baskets. Natural Health Farm oblation various health products that promote bump health and languishevity of human body, whittle 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. Internet Access provides free wireless fidelity access through-out the hospital for eitherone Patient that take away 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 room types, to cater individual inescapably and demands however theses are line of business to availability and if a particular room type is not available, option leave alone be provided and efforts entrust be made to cause home the pass along room type provided as soon as it is available. Below are the room rates which are subject to 6% Government Tax.Meals are complimentary to all patients. Room TypesRates Per twenty-four hours (RM) administrator Deluxe 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 geek35. 00 Incubator 105. 00 Supply kitchen range is the lifeblood of a healthcare organization. The tack chemical grasp offshoot is the essential link for all programs and services offered by a hospital, and hence any overture in managing the come forth drawstring can positively impress foot line profitability of any hospitals operations.As most discussion sections in Pantai Hospital Ipoh depend heavily on supplies, materials trouble can ease or handicap a hospitals operations. From a low cost needle to a high-end orthopaedic implant, special instru ments or pieces of linen, supplies are indispensable during a patients stay at the hospital. Quality care cannot be provided on clip unless mandatory material is available in able quantity. As such Pantai Hospital Ipoh, has established a acquire department to centralize the acquire all medical supplies, medical equipment and instrument, consumables, stationeries and toiletry within the hospital.The department not tho to purchase but to perform legal injury negotiation to stop up e really detail that purchased is the lowest price but of course without comprising the quality. Together with Store Department, buying Department determines the tokenish and maximum take aim for every single item for re- edict objectives. To determine the borderline and maximum level, a fewer factors lead be observed the practice of them item / product, location of the supplier, the availability of the item / product in the market and delivery schedule.Thus, the purchasing needs to communic ate with all the relevant departments and the supplier to ensure that is no curtlyage of all supplies and at the corresponding time to ensure our stack away department is not holding too over practically melody. At our Pharmacy Department, the department also performed the similar task as purchasing department but limited to pharmaceutical products. This is because pharmaceutical products need specialized person who is the pharmacist with the consultation of specialist consultants to planetaryize the drugs usage and its complication.Pantai Hospital Ipoh not only subscribes to patented / original drugs but also generic drugs that provide the same lastingness comparing to the original drugs but much degrade 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 allow for chain does not stop at the purchasing and apothecarys shop department. It is of the essence(p) that the purchased medi cal supplies and drugs are delivered to all the think ofive wards, clinics, operation theatre and other relevant departments to ensure no hiatus of patient care.Hence, a add chain brass has been developed from early point of sourcing and ordering to the patient consumption. As mentioned earlier, sourcing and ordering is done by purchasing and pharmacy department. formerly the goods arrived to hospital, the respective store ecumenical store and pharmacy store, forget transmission line their goods. The respective store will entered the melodic line into our Hospital entropy System, and from at that place the clove pink will be arranged in the store systematically. The wards, departments and operation theatre will requisite their items found on their pre-set minimum and maximum level.For those high activities department for casing operation theatre, they are allowed for three time requisition a week and as for less or average activities, will allowed to requisite their s tock two measure 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 note all stocks. The ward or department will consume the item(s) based on offshoot in first out (FIFO) method to ensure no on that point 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 go forth chains whitethorn be much efficient and inexpensive by outsourcing of certain services. The main services that outsources are housekeeping. UMC Service Master, a well-know telephoner 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, training and motivating employees and slander risks. The bon ton also tak es over some of the nurses daily routine jobs for example bed making for inpatient and discharge patient.This enables the nurses to thin on the to a greater extent than critical matter which is patient care. Beside the purchasing, stock guidance and outsourcing, Pantai Hospital Ipoh also involved in a interpret chain with international and local insurance companies and managed care organization or third party administrator. The insurance companies, managed care organization and third party administrator will signed a partnership agreement with the hospital to depart embellish hospital and to provide cashless healthcare facilities for their policyholders that are crossed under their purchased policy.The treatment beged could be outpatient, daycase and/or inpatient depending on their policy terms and conditions. The process started when a patient requested for treatment present office staff will request a guarantee letter (GL) from the respective insurance smart set, 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 guarantee letter for payment.If the patient was admitted, hospital would to provide discharge abbreviation and the replete(p) bill to the respective company for payment guarantee. Some companies do cover for the post-hospitalization up to 60 days of discharge. Our merchandise department also practices supply chain in their marketing activities. They has established a programme known as Pantai Putri process of Affiliation 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 jump their clinic by pro viding them on-going education and promoting their clinic by recommending to the local universe and during any road show form by Hospital Pantai Ipoh. This will generates a strong back to back support and mutually benefited.For the past few years, in that respect was a lot of development and improvement taken place in Pantai Hospital in related with supply chain charge but the hospital is pacify facing challenges in managing the strongness of supply chain system. The challenges can be classified advertisement at below a. Lack of merchandise focussing b. Limited Sourcing and Services c. noncurrent IT systems d. Lack of Inventory and Distribution concern Lack of Product heed First, the hospital could categorize the products in terms of cost, cruciality and other criteria.For instance, bed linen may be less critical and map out a low cost to the hospital paracetamol may be urgently mandatory but inexpensive sequence specialist cancer drugs may be both urgent and costly. Th is product categorization will dictate supply chain design. For example, drugs and medical equipment might be ordered now from the manufacturers own stock, often at short notice and in unpredictable quantities, requiring memory board relatively nearby. Medical supplies, on the other hand, will be subject to a more(prenominal) 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 best service at a presumable cost. In heealthcare industry, we understand specialist consultants are independent leadors with considerable clout and specific preferences for supplies and some variations in supplies and processes are accommodated to ensure patient prophylactic. These Preference Items accountable for more than 50% of total medical supply dribbleing in PHI. This provide an prospect 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 tolerant to change. He points to the fact that data which supports the end to use a particular supply can go a long way in convincing a physician to use a particular supply. PHI could establish a product valuation and review committees which consist of clinical experts, purchasing and finance personnel to overcome the problem. The purpose of the committee is to decide to purchase and universally adopt cost-sound items for use within all hospitals and the close 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 diversity and results in the high compliance rate and buy-ins from all physicians. This will helps purchasing to further negotiate and obtain lower pric e from the supplier as the hospital is now buying exclusively from the supplier only with bigger quantity.Thirdly, in PHI product cost assessment, hospital must evaluate the total cost rather than just unit product cost in find out 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 latitude X-Ray equipment may ware a lower unit cost initially, but the tool utilizes X-ray film that contained mercury, may result in a probatory disposal fee which needs to be calculated in the total cost.Hence, hospital should to considering total cost has resulted in meaning(a) cost savings. Sourcing and Services Effective worry of the external supply chain typically covers every facet of procurement exercise such as supplier selection, cut down negotiation, planning and implementation, dispersion and delivery while taking factors such as risk, wages 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 hospitals at once. Cost saving includes check 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 solicitude systems do not have the message to meet the changes and needs today.The challenge set about by PHI is how to seamlessly transition the wealth of data without disrupting the be purchasing system and inter-departmental integration. angiotensin converting enzyme 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 supplement on what has been successfully done in other Pantai hospitals to enable staffs to access faster, more valuable and easier access to necessary supply information when ordering.At time hospital spend significant resources to reconcile purchase orders and invoices overdue to mismatched item numbers and units of measure. some other challenge that PHI faces is in identifying personnel opened of understanding the old technology used by the existing IT systems to effectively move it to a newer platform. Although this is not a anomalous problem faced by PHI, on that point is no industry standard 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 recognized by the circumspection. Once improved, the flexibility of the system will allow KP a more detailed view of its purchasing process and use of prod ucts, which will in turn provide demote insight into creating a more effective cost structure. Inventory and Distribution Management It is critical for PHI to maintain a able level of scroll at all times to ensure the needs of patients are always met. Failure to do so could result in the loss of life.In a hospital, managing its strain 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 substance abuser 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 adapted storage and no proper and experience staff to head and managed the store.To overcome the issue, first PHI need to engage an experience staff who has know about inventory management and to review and examine the overall existing available storage space to maximise the current storage with the assistance of shelf, console table or compactor. Secondary storage could be developed to separate the medical and non-medical items. PHI could hold radio frequency identification technology (RFID) into its inventory management system. RFID systems have a broad range of potential benefits for the health care industry.These include medical device 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 affected due to unavailabi lity 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 be 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. While inventory is concerned with financial issues, hospitals are in the business of serving patients. Although technology has an important role 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 reward any productive result. Processes should be reengineered to make them more patient-friendly. Cost-effectiveness, time consciousness and safety are key drivers of a patient-centered approach.Once this close 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 &038 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 tell University, San Diego, CA published in atomic number 20 Journal of Operations Management, Volume 6, good turn 1, February 2008