Proceedings of 10th Asian Business Research Conference
6 - 7 October 2014, Novotel Bangkok on Siam Square, Bangkok, Thailand, ISBN: 978-1-922069-62-7
A Study on the Need for Logistics Personnel in Hospital: Case
Study in Bhutan
1
Rinzin Choden, Aussadavut Dumrongsiri and Pornpimol Chongphaisal
Healthcare personnel shortage is one of the problems affecting many countries as there are jobs
that are tedious, tiring, and requiring devotion from the jobholders. The healthcare personnel do
not necessarily receive high pay while their responsibility high has to deal with life and safety of the
patients. This situation is prevalent in both developed and developing countries. Doctors, nurses,
pharmacists and other health care related personnel have been running around doing several jobs
that are not patient-care related. A large amount of their time is spent on administrative task s and
logistic task s as well. This paper investigates the logistics situation in Bhutan through the job of
nurses at different types of hospitals and medical units. The research purposes to uncover if there
is any need for logistics personnel (logistician) to help do and manage the logistic jobs in the
hospitals. If not, should the logistic jobs continue being handled by nurses themselves. If so, what
are the education, sk ills, and logistics k nowledge nurses or logisticians should have to be able to
handle the logistic job well. The method of data collection is done through surveyed questionnaire
with the approval from the Bhutanese government Ethics Board. 350 sets of questionnaires from
the total of 799 nurses (Pelden, 2013) have been distributed nationwide to nurs es to investigate
the issue during June to July 2014. 166 copies have been returned. Questionnaire is of three
parts: profile of the nurses, logistic system and operation frequency, and logistics task s and
education requirement, sk ills and competency of the person who should perform logistics job well.
Nurses responding to the survey mostly are from IPD department (115 people) or 69.2% and ED
(28 people) or 16.8%. Their main responsibility covers operational (68%) as well as managerial
levels (22.8%). 78 nurses or 46.9% from total of 166 are GNM nurse whose work represent the
main type of nursing jobs in Bhutan. The findings uncover that nurses who believe there should be
logisticians to handle the logistics job are GNM nurse. Considering what type of hospi tal would
support the use of logistician, the national Referral Hospital which is the most modern and
considered best in the country yielded the highest number of support. Lik ewise, when we
investigate the average number of logistics hours nurses spent on logistics job, it is found that the
group of nurse who support utilizing logistician, have longer average hours doing logistic jobs (10.6
hours/week ). The groups that do not support hiring logisticians have normally work ed less on
logistics jobs on the average (7.5 hours/week ). Lastly, the education, sk ills and competency of
nurses and logisticians were discussed.
Field of Research: Health Care Logistics Personnel Management
1. Introduction
Logistics system has come to be known as factor that directly linked to cost savings and
therefore profit margin. Increases sales would mean additional cost of goods and transaction
costs. Such costs would eat up some profit. Thus logistics management is essential for every
business and industry. By (Ghiani et al., 2004) Logistics deals with the planning and control
of material flows and related information in organizations, both in public and private sectors
with the mission to get the right materials to the right place at the right time, while optimizing
a given performance measures (example; minimizing total operating costs) and satisfying a
given set of constraints (example; budget constraint). In the developing countries due to slow
growth of industries and business, they don’t have much familiarity with logistics is being a
part of their working areas. Even the people don’t understand the importance and needs of
1
Corresponding author address: School of Manufacturing Systems and Mechanical Engineering (MSME),
Sirindhorn International Institute of Technology, Thammasat University, Rangsit campus. P.O. Box 22, Pathum
Thani 12121, Thailand. Email address: choden2rinzin@gmail.com
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Proceedings of 10th Asian Business Research Conference
6 - 7 October 2014, Novotel Bangkok on Siam Square, Bangkok, Thailand, ISBN: 978-1-922069-62-7
logistics to increase efficiency and reduce the costs. In addition, some countries have
geographical terrains and environmental changes problems, such as, they don’t have
maintained road where the equipments can be carried/transported from one place to another,
due to road blocks with landslides, disruption of communication due to storm, etc (Jamtsho,
2010). And the best example is Bhutan.
Bhutan is also one of the developing country and its landlocked country in South Asia at the
end of the Himalayas. Bhutan is bordered by India to the west, south and east and China to
the north with the population 744,000 with area of 38,364sq.km. Currently, as per my
research very few people understand about the logistics. Though the business and the
industry are still growing and it’s mostly small scale, there exists logistics in Bhutan.
In the developed countries, even the health care systems have well defined logistics
application whereas in Bhutan people and personnel don’t understand of logistics application
in various areas such as transportation of medical equipments and medicines within the
hospital departments to improve the better services. Still, most of the works/jobs are done by
manual basis. The latest technologies and logistics related software programs are used in
few large scale industries only. In the health care section there is already scarcity of human
resources, such as there are only few pharmacists, doctors and nurses for the whole country
as per the report of(National Statistics Bureau, 2013). Therefore, this reason intended to
have the following objectives:
1. Uncover the logistics situation in Bhutan hospital
2. Find out whether there is a need for logistics personnel (logistician) or not.
3. If there is a need for logistics jobs, should it be handled by nurses themselves
or could be given to others.
4. Identify competency that are needed for nurse to perform logistics job better.
5. Find out man power of such personnel (logistics) for the whole country
(projected logistics personnel)
2. Literature Review
2.1. Logistics VS Supply Chain management
As per the (Magayson, n.d.)Logistics management’s primary focus is on optimizing the
delivery of service to customers, by managing complex tradeoffs between customer service,
transportation, warehousing and inventory. Some World Class companies have been able to
reduce the costs of their logistics operations to 50% of the levels of their competitors.
The main difference between the logistics and supply chain management that I can conclude,
supply chain management is a supply of product which includes various activity chains, till
the product reaches to end customers. But logistics is a movement of the product which is
supplied from source is successful reached to end customers with efficient and convenient
ways. Therefore, Logistics involves when there are supply chain management movements.
In hospitals, logistics cover not just support services such as purchasing, stores and the
pharmacy, but also health care services such as patient care units and operating rooms.
They can: (1) improving access to care, we increase expected length of life; (2) minimize the
length of time spent in undesirable states (e.g. at a health care facility awaiting treatment,
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Proceedings of 10th Asian Business Research Conference
6 - 7 October 2014, Novotel Bangkok on Siam Square, Bangkok, Thailand, ISBN: 978-1-922069-62-7
undergoing treatment or recuperating from treatment) and (3) reducing waiting time until
treatment, we improve quality of life when not well(Hall, 2006). Many activities that could be
carried out by support personnel are often on the list of duties performed by health care
personnel. The result is that the internal supply chain within a hospital is often highly
fragmented.
2.1.1. Awareness and application of logistics in developed countries
Thailand is one of the well developed countries with many successful large scales industries
and business which is currently running successfully. Example: Toyota Company in Thailand
involves the logistics concept to reach their products from one place to another. Other
example; The Pfizer Pharmaceuticals Group is the largest pharmaceutical corporation in the
world and company manufactures and distributes a broad assortments of pharmaceutical
products. The Pfizer logistic system comprises 58 manufacturing sites in five continents
producing medicines for more than 150 countries. Fright transportation plays a key role for
their supply chain from the book(Ghiani et al., 2004).
2.1.2.Use of logistics in Bhutan
Bhutan's economy is mainly generated from the agriculture, forestry, tourism and the sale
of hydroelectric power to India. Agriculture contributed 16.80 Percent to the total economy
i.e. as measured by the Gross Domestic Product. It was also the single largest sector that
provides livelihood about more than 60 percent of the population as per (National Statistics
Bureau, 2013). Due to being in a landlocked country a lack of access to the sea, has meant
that Bhutan has not been able to benefit from significant trading of its produce. Bhutan’s
transportation mode is only by air way and road way till now. Bhutan does not have
any railways yet. If I go through generally about Logistics in Bhutan, the logistics and supply
chain management is involved only by road way mostly. Mostly products found in Bhutan are
imported from India and Thailand. Few agriculture products like fruits and vegetables are
export to India only. The mining industry in Bhutan is still under developing and processed in
small operation bases. The manufacturing industry is dominated by a small number of major
operators with the report of (National Statistics Bureau, 2013). Currently, Bhutan sales
electricity by Hydro projects to India which is one of the income generations as well.
2.2. Bhutan’s Health care
The collected information from Ministry of Public Health of Bhutan shows that there is the
shortage in public health manpower in Bhutan. “Health human resource has always been the
weakest link in the Bhutanese health system and strengthening of health facilities is a key
component in delivering a good health care to people” as per the(Ministry of Health, 2013).
Health sector in Bhutan is largely financed by the public systems through general revenues
of the government. This is in line with the country’s commitment as expressed through the
Tenth Five Year Plan that “the Royal Government will continue to attach high priority to
maintain universal access to basic health services and ensure that basic health service are
distributed more widely throughout the country, including the more vulnerable and isolated
communities”. The reason is because; Bhutan has adopted Gross National Happiness (GNH)
than Gross Domestic Product (GDP) as developmental philosophy. As quoted by His
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Proceedings of 10th Asian Business Research Conference
6 - 7 October 2014, Novotel Bangkok on Siam Square, Bangkok, Thailand, ISBN: 978-1-922069-62-7
Majesty the Fourth King of Bhutan “GNH is more important than GDP. The understanding of
what humans need to make them happy is vital to our society(Centre Bhutan Studies, 2012).”
2.3. Background of Bhutan’s Hospitals
Figure 1: Health facility by district, 2012
District
Hospital
BHU I
BHU II
Ind.Unit
Bumthang
1
0
5
3
Chhukha
3
1
12
4
Dagana
1
2
7
3
Gasa
0
1
3
1
Haa
1
1
3
1
Lhuntse
1
0
11
2
Mongar
1
1
23
4
Paro
1
0
3
1
Pemagatsel
1
1
11
4
Punakha
1
0
6
1
Samdrup Jongkhar
2
2
8
4
Samtse
3
0
9
2
Sarpang
2
0
11
1
Thimphu
5*
1 9**
1
Tashigang
3
2
17
4
Trashiyangtse
1
0
7
2
Trongsa
1
0
6
3
Tsirang
1
0
6
1
Wangdue
Phodrang
2
0
9
2
Zhemgang
1
2
12
4
Total
32
14
178
48
ORC
without
shed
ORC with
shed
12
37
27
2
6
32
49
20
29
11
27
41
11
6
54
26
21
12
1
7
3
7
11
1
5
5
5
0
4
0
2
12
0
0
0
1
23
28
474
5
7
76
Source:(Ministry of Health, 2013)
Note: *Indigenous hospital included under hospital
**Satalite clinic include under BHU II
In the above Figure 1, shows the current total number of government health facility in Bhutan,
that is, 32 hospitals which includes one National Hospital in west, two Regional referral
Hospital in East and South and others district hospitals. Bhutan has 14 BHU-I with the
availability of nurses and doctors.
Due to a landlord country, it has nothing to generate, so it have less GDP. So, most part of
the Bhutan is not yet developed and do not have good access with road also. Therefore, we
have more of BHU because just to provide basic health services in remote places which have
less population. If the BHU cannot treat the patients, they are being referred to district.
Patients are served with ambulance with nurse escort to referred to district hospitals
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Proceedings of 10th Asian Business Research Conference
6 - 7 October 2014, Novotel Bangkok on Siam Square, Bangkok, Thailand, ISBN: 978-1-922069-62-7
Districts hospitals has more of facilities than BHU because to use optimal use of facilities,
technologies, human resources, etc. Therefore, district hospital has more beds than BHU’s
with more facilities. District hospitals have dentist, fresh graduate doctors, x ray facilities,
labour room, Dispensary, MCH room and laboratory. The district hospitals likewise refer to
their respective Regional Referral Hospitals and they in turn rely on the National Referral
Hospital.
In Regional Hospitals, there is operation section, few specialist doctors and more facilities
than District level. There are more beds in Regional because one of the reasons is patients
referred to nearby regional hospital and secondly, regional hospitals are located in mostly
populated area as well. District Health centers provide promotive, preventive, curative and
emergency services. Some hospitals are also equipped with Operating theatres where
gynecological and minor surgeries are performed. There is separate Outpatient Department
in all hospitals.
Then to Jigme Dorji wangchuck National regional referral hospital with medical school, which
is one of the oldest and biggest hospitals with medical school. We have all the experienced
specialist healthcare human resources and latest technologies available. E.g.: MRI, CT scan
and ICU sections. We have more number of beds here because it is located in capital.
Figure 2: Health Human Resource, 2012
SI#
1
2
3
4
5
6
7
8
9
10
11
12
13
14
Categories of Health Workers
Doctors (MBBS/Specialists)
Assistant Clinical Officers (ACO)
Nurses (Assistant Nurse/GNM/B.Sc.Nurse)
Health Assistants
Basic Health worker
Drungtsos (Indigenous Physicians)
sMenpas (Sowa Menpas)
Pharmcists
Medical lab.technologists
Physiotherapist
Techicians
Administration and Support Staff (Regular)
General Service Personnel (GSP)
Elementary Service personnel (ESP)
Total
Total
194
39
736
416
162
35
63
11
27
10
780
1202
439
166
4280
Source:(Ministry of Health, 2013)
From the Figure 2 we can see the currently health human resources available in Bhutan in
2012 and there is 736 nurses (Assistant Nurse/GNM/Sc.Nurse) only.
Bhutan health care is unique then other hospitals because as the medicine and medical
service is free, so Bhutan hospital does not have purchasing department. Nurses do
searching/transferring/coordinating inpatients administration and few nurses do for
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Proceedings of 10th Asian Business Research Conference
6 - 7 October 2014, Novotel Bangkok on Siam Square, Bangkok, Thailand, ISBN: 978-1-922069-62-7
outpatients records. Scheduling patients queue, refilling of the medicines, transferring
patients to receive radiology or medical technology treatment, filling the medical bills and
preparing orders for pharmaceutical drugs and medical supplies, estimating medication and
medical equipment, pharmaceutical drugs inventory management such as storing, counting
and checking for expired date, transporting pharmaceutical drugs/medical supplies to
patients, monitor, maintenance, and report broken medical supplies, etc. There are
administration officer and store in charge who takes care of the administration jobs and
stores in every hospital of Bhutan. Even there is ward boy and ward girl who helps nurses in
transporting; cleaning the patients and wards, making work of nurses more efficient to
patients cares.
2.3.1 Kinds of jobs that are considered logistics for nurses
Nurse does three kinds of jobs in the hospital and they are 1. Patient care: care of the sick or
disable, prevention of disease, caring for and monitoring as well as advising pregnant
women, promotion of health, injecting, etc which they are being trained. 2. Administration
jobs such as interfiling papers, answering incoming phone calls, making appointments,
administering medicines, etc. 3. Logistics jobs such as 1) planning and operating that
involves classification of both types and quantity: 2) selecting suppliers (purchasing, storing,
counting, and processing data), 3) distributing medicine and medical supplies (purchasing
and maintaining) and using patient transporting equipments. It also includes 4) specification
of numbers of working hours, personnel scheduling (doctors, pharmacists and nurses) and 5)
general services for patients (triage, queuing, transferring, flowing of food and medicine, and
6) flowing of sample to be analyzed.
2.3.1.Who handles the logistics jobs?
Logistics jobs are handles by nurses in Bhutan
kinds of nurses in Bhutan and they are general
nurse midwives (ANM), clinical nurse, Regular
Royal Institute of Health Sciences (RIHS) (Royal
and they are still not aware of it. There are
nurse midwives (GNM)/staff nurses, auxiliary
nurse and chief nurse. They are trained in
Institute of health Sciences, 2013).
3. Methodology
3.1. Secondary data
I collected data from International Journal, Statistics books of Bhutan, visiting many related
websites. I mostly got data about hospitals from government publication, interviewing the
people and health personnel.
3.2. Primary data
The objective is to survey nurses in Bhutan related to research objectives. The
questionnaires were given to only nurses to be fill in. We collected the data from government
hospitals in Bhutan with Basic Health Unit (BHU-I). Mainly focusing to BHU level-I nurses,
Secondary- at the district level and Tertiary- at the regional and national level.
Questionnaire distribution methods that we used were: firstly, One-on-on data collection.
Secondly, On-line questionnaire and Phone calls.
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Proceedings of 10th Asian Business Research Conference
6 - 7 October 2014, Novotel Bangkok on Siam Square, Bangkok, Thailand, ISBN: 978-1-922069-62-7
Data collection was done by survey, using questionnaire mostly and few interviews as stated
above. We aimed to cover 32 hospitals which include, one National Hospital with medical
school, two Regional Hospitals, 20 district Hospitals and 14 BHU grades 1 under the Ministry
of Health (MoH), government of Bhutan. Sample size of nurse was 300 out of 799 nurses
(Pelden, 2013) and we aimed to cover 50% of the population.
Table 1: Data collection result
Type of the Hospitals
No. of questionnaire
sent out for nurse
BHU
District Hospital
Regional Referral
Hospital
For all 350
questionnaires
distributed
National Hospital with
medical school
Total
350
No. of Hospital Visited
No.of Questionnaire
returned
4
19
13
67
2
29
1
51
20
166
We could get 166 questionnaires out of 350 distributed. Out of from 166 questionnaire
returned, we did not find any error, so, we include all the 166 questionnaires as a valid for our
analysis.
4. Questionnaire divided in to three sections as per the objectives
Three sections of the questionnaires are:
Section 1: Profile (Personnel profile and about Hospital): Information about hospital and
Nurses.
Section 2: Questionnaire about logistics system and operation frequency: From this section
we can know what the logistic tasks nurses perform.
Section 3: Questionnaire about logistics task and skills/Competency
5. Findings
From the 166 returned questionnaire, the result we have found are as below:
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Proceedings of 10th Asian Business Research Conference
6 - 7 October 2014, Novotel Bangkok on Siam Square, Bangkok, Thailand, ISBN: 978-1-922069-62-7
Table 2: Need of logistic resulted by nurses
Want or
Not
Frequency
Percent
Yes
82
49.40%
No
78
47%
Missing
Value
6
3.60%
Total
166
100%
“YES”: Need logistics Personnel
“NO”:Don’t need logistics personnel
Frequency of 82 nurses with the 49.40% says “YES” for the need of logistics personnel in
hospital to help them.
5.1. Profile for respondents
5.1.1.Table below are the general profile of the respondent who filled the
questionnaires.
Table 3: Operation section
Operation
Section
Frequency
Percent
IPD
115
69.20%
ED
28
16.80%
other
section
11
6.60%
OPD
8
4.80%
Missing
Value
4
2.40%
166
100%
Total
The above table is the general profile of the respondent who filled the questionnaires. We
found most of the nurse works in Inpatient Department (IPD) with the frequency of 115 and
69.20%.
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Proceedings of 10th Asian Business Research Conference
6 - 7 October 2014, Novotel Bangkok on Siam Square, Bangkok, Thailand, ISBN: 978-1-922069-62-7
Table 4: Responsibility of the nurses
Responsibili
ty
Frequency
Percent
Operational
level
113
68.0%
Manageme
nt level
38
22.8%
Missing
Value
15
9.0%
166
100%
Total
We found most of the nurse works in Inpatient Department (IPD) with the responsibility in
operational level with the frequency of 113 and 68.0%.
Table 5: Nurse Type
Nurse Type
Frequency
Percent
78
46.90%
23
13.80%
21
12.60%
Chief Nurse
6
3.60%
ANM
5
3.00%
2
1.20%
31
18.60%
166
100%
GNM
Clinical
Nurse
Assistant
Nurse
Regular
Nurse
Missing
Value
Total
Most of the respondents are GNM nurses with the frequency of 78 and others are clinical
nurses and assistant nurses.
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Proceedings of 10th Asian Business Research Conference
6 - 7 October 2014, Novotel Bangkok on Siam Square, Bangkok, Thailand, ISBN: 978-1-922069-62-7
Table 6: Responds from Different Hospital type
Hospital Type
Frequency
Percent
67
40.3%
51
30.7%
29
17.4%
BHU 1
19
11.4%
Total
166
100%
District Hospital
National Referral
Hospital with medical
school
Regional Referral
Hospital
We mostly got the respondent from District hospital and National Referral Hospital with
medical school with frequency 67 and 51 of 40.3% and 30.7% respectively.
1.1.2 Cross-tabulation of key findings
Following tables are the cross-tabulation results.
Table 7: Type of nurses who said “YES” for logistician
Nurse
Type
Yes
No
%Yes
GNM
42
33
56.00%
Clinical
Nurse
10
13
43.48%
Assista
nt
Nurse
9
11
45.00%
ANM
4
1
80.00%
Chief
Nurse
3
3
50.00%
Total
68
61
52.71%
From the above figures, we can see nurse type GNM has highest “YES” with the frequency
of 42 and 56.00%, which means they want logistics personnel to help them.
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Proceedings of 10th Asian Business Research Conference
6 - 7 October 2014, Novotel Bangkok on Siam Square, Bangkok, Thailand, ISBN: 978-1-922069-62-7
Table 8: Type of the hospital that says “YES” for the needs of logistician
Hospital
Type
Yes
No
%Yes
National
Referral
Hospital
25
14
64.40%
District
Hospital
20
30
40.00%
BHU 1
13
5
72.20%
Regional
Referral
Hospital
10
12
45.40%
Total
68
61
52.71%
National Referral hospital with medical school needs more help comparing to others. Which
means National Hospital’s health personnel does more logistics tasks than others with the
frequency of “Yes” 25 and 64.40%.
Nurses shifts 3 times a day that is, 8 AM to 2 PM, 2PM to 8 PM and 8 PM to 8 AM.
Table 9: Average working hours of nurse in the hospital who say “YES” for logistics
personnel
Want or
Not
Mean
N
Std.
Deviation
Yes
42.8
61
8.0
No
42.5
68
6.7
Total
42.7
129
7.3
The average working hours of nurses who say “YES” to Logistic personnel is 42.8 hours in a
week.
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Proceedings of 10th Asian Business Research Conference
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Table 10: Average logistics working hours of nurse in the Hospital who say YES
Want or
Not
Mean
N
Std.
Deviatio
n
Yes
10.6
82
14.4
No
7.5
78
12.4
Total
9.1
160
13.5
The average logistics working hours of nurses who say “YES” to Logistic personnel is 10.6
hours in a week. We can see that “YES” is more than “NO”, which means nurses at least
does logistics task more than an hour in a week. Therefore, nurses need help.
Table below is the average percentage of logistics time of nurse who says “YES”.
Table 11: Percentage of logistics working hour by nurses
Want or
Not
Mean
N
Std.
Deviation
Yes
22.23%
64
34.80%
No
16.21%
72
28.56%
Total
19.04%
136
31.67%
At least 20% of their hospital working hours are spends for logistics tasks in the hospital.
5.1.2.Competencies that are needed by the nurses to handle logistics jobs
versus competency that can do the job of the nurses
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Proceedings of 10th Asian Business Research Conference
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Table 12: Minimum educational qualification requirement for logistics personnel
Qualification
Competency
Frequency
Percent
High school
certificate
45
27.1%
Bachelor's
degree
22
13.3%
High Vocation
Certificate
9
5.4%
Vocational
certificate
7
4.2%
lower than high
school
4
2.4%
Master's degree
2
1.2%
Doctorate
0
0%
Others
6
3.6%
Total
95
57.20%
Logistics personnel should have High school certificate and Bachelor’s degree with the
frequency of 45 and 22 with the 27.1 % and 13.3% respectively to help the nurses in doing
health care logistics jobs.
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Proceedings of 10th Asian Business Research Conference
6 - 7 October 2014, Novotel Bangkok on Siam Square, Bangkok, Thailand, ISBN: 978-1-922069-62-7
Table 13: Minimum educational qualification requirement for nurses
Qualification
Competency
Frequency
Percent
28
16.9%
21
12.7%
7
4.2%
Master's degree
3
1.8%
Others
3
1.8%
Master's degree
3
1.8%
Doctorate
0
0%
Total
65
39.2%
High school
certificate
Bachelor's
degree
High Vocation
Certificate
For the nurses, they should have High school certificate and Bachelor’s degree with the
frequency of 28 and 21 with 16.9% and 12.7% respectively to do the logistics tasks in the
hospital with their health care jobs.
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Proceedings of 10th Asian Business Research Conference
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Table 14: Skills requirement for logistics personnel
Skills
Frequency
Percent
English
84
50.6%
Knowledge of medical
technology and supplies
69
41.6%
Calculation
66
39.8%
working Knowledge of
Microsoft office ( Word,
Excel, etc )
56
33.7%
54
32.5%
46
27.7%
Data Management
46
27.7%
Project Management
13
7.8%
Other
2
1.2%
Total
436
Collaboration and
coordination
working knowledge of using
information technology for
management
We can see, English have frequency of 84 with 50.6% than other skills. For the competency
skills logistics personnel need to have good English, have Knowledge of medical technology
and supplies, should know how to do mathematical calculations also.
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Proceedings of 10th Asian Business Research Conference
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Table 15: Skills requirement for nurses
Skills Competency that is
needed
Frequency
Percent
English
50
30.1%
45
27.1%
38
22.9%
Calculation
43
25.9%
Collaboration and
coordination
38
22.9%
Data Management
37
22.3%
working knowledge of using
information technology for
management
36
21.7%
Project Management
6
3.6%
Other
3
1.8%
Total
296
working Knowledge of
Microsoft office(Word, Excel,
etc)
Collaboration and
coordination
Nurses as well should have good English as per the nurses with the frequency of 50 and
30.1%. Even nurses should have working Knowledge of Microsoft office (Word, Excel, etc),
know Collaboration and coordination, calculation, etc to handle the logistics jobs in the
hospital.
Table 16: Nursing aspects Competency that is needed by logistics personnel
Specialist Skills in Nursing
aspects
Frequency
Percent
Nursing Management
61
36.7%
Health care system and
clinical database
management
60
36.1%
Nursing care
58
34.9%
Technology and information
technology about nursing
53
31.9%
Other
1
0.6%
Total
233
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Proceedings of 10th Asian Business Research Conference
6 - 7 October 2014, Novotel Bangkok on Siam Square, Bangkok, Thailand, ISBN: 978-1-922069-62-7
As logistics personnel will perform the job in nursing field, logistics personnel should at least
have the concept of nursing regarding Nursing management and care.
Table 17: Logistics System Aspect that is needed by logistics personnel
Logistics System Aspect
Frequency
Percent
Facility Management
71
42.80%
Inventory Management
54
32.50%
Logistics Management
53
31.90%
Quantitative Analysis
51
30.70%
Operations Management
41
24.70%
Supply Chain
Management
40
24.10%
Diagnosis-related Group
30
18.10%
Government regulation
20
12%
Ministry of finance
regulations related to
financial management
15
9%
Lean Hospital
14
8.40%
Other
0
0%
Total
430
Logistic personnel should know Facility Management with the frequency of 71 with 42.8% to
do logistic task in the hospital. They should Inventory Management, Logistics Management,
Quantitative analysis, etc.
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Proceedings of 10th Asian Business Research Conference
6 - 7 October 2014, Novotel Bangkok on Siam Square, Bangkok, Thailand, ISBN: 978-1-922069-62-7
Table 18: Logistics System Aspect that is needed by nurses
Logistics System Aspect
Frequency
Percent
Logistics Management
37
22.3%
Facility Management
33
19.9%
Inventory Management
33
19.9%
Quantitative Analysis
27
16.3%
Supply Chain Management
25
15.1%
Diagnosis-related Group
25
15.1%
Operations Management
23
13.9%
Government regulation
18
10.8%
Ministry of finance
regulations related to
financial management
13
7.8%
Lean Hospital
10
6%
Other
1
0.6%
Total
245
Nurses should have good of logistics management jobs with the frequency of 37 and 19,9%
because nurses have to manage their busy health care working hours with logistics jobs
related to it. They should have good Facility Management and Inventory Management skill
too.
6. Conclusion/Implication
6.1. Does Bhutan need logisticians or the nurses have to do the logistics
works
We can conclude nurses need the help in doing logistics works in National Hospital with the
medical school in the operational level.
6.2. Policy Recommendation
6.2.1.Government
Government should introduce clear logistics concept to make the flow efficient and effective.
By adding up the logistic subjects in the schools and in the hospitals studies can create the
concept of logistics in Bhutan.
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Proceedings of 10th Asian Business Research Conference
6 - 7 October 2014, Novotel Bangkok on Siam Square, Bangkok, Thailand, ISBN: 978-1-922069-62-7
6.2.2.Hospital
Ministry of health should upgrade the educational level of nurse up to Bachelor degree or
provide training on Information Technologies and databases as well, so that they can handle
logistics tasks.
6.2.3.Nurses
Nurses should know how to handle the logistics jobs related to health care and should know
Information Technology knowledge as well. Now logistics personnel can give them a hand to
their day-to-day hospital works which includes other than patient care.
6. Acknowledgements
This research is fully supported by the grant coming Excellent Foreign students (EFS)
Scholarship program of Sirindhorn International Institute of Technology, Thammasat
University, Thailand.
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