International Journal of Advancements in Research & Technology, Volume 3, Issue 9, September -2014
ISSN 2278-7763
102
Proposal for a deshboard to measure the perfermance of the
pharmaceutical sypply chain case of hopital children
Driss SERROU(1), Abdellah ABOUABDELLAH(2), Hassan MHARZI(3)
(1)
Phd Student ENSA, University IBN TOFAIL, Kenitra, Morroco ,(2)Research Professor ENSA, University IBN TOFAIL, Kenitra, Morroco
(3)
Research Professor ENSA, University IBN TOFAIL, Kenitra, Morroco
ABSTRACT
All hospital systems are forced to better organize and innovate to provide quality patient care while controlling health spending
and budgets. Hospital supply chain is an important part of the budget of a hospital and in particular the pharmaceutical supply
chain, so the consideration of a pharmaceutical supply chain is very useful in the concept of rationalization. The purpose of this
paper is to provide a table for measuring the performance of the pharmaceutical supply chain. The first part of this article is of
interest to study the problem of hospital logistics and its state of the art. The second section describes our methodological approach to measuring the performance of hospital logistics. The third part explains the principle of the dashboard with measurable indicators process for measuring the performance of the pharmaceutical supply chain of the hospital children.
Keywords : Hospital logistics, supply chain, modeling, process, table of bord, indicator.
1 INRODUCTION
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Health facilities are now facing the same constraints of economic efficiency and industrial companies. They discover the
importance of the logistics process as a new approach for efficient management of all the activities of other organizations.
Hospital reforms in recent years have prompted hospitals to
make efforts and to develop new management tools such as
logistics and information system.
Everywhere health networks are faced with the impossible
triad of performance: quality of care, customer satisfaction, cost
reduction. The evaluation and improvement of hospital performance are needed for better process management. The problem
we will address in this paper, is to select the most appropriate
indicators to ensure effective control of the logistics performance of particular hospital pharmaceutical supply chain Domain experts confirm that the choice of indicators in terms of
supply is not an easy exercise. [1]
To answer to our problem, we worked the pharmaceutical
supply chain of the child Ibn Sina Hospital in Rabat, while analyzing the different processes of this chain. This analysis allowed us to identify a dashboard for evaluating the performance of this channel. We aim through this work to demonstrate continuous improvement offered to managers in this area.
1 IMPORTANCE OF THE STUDY
1.1 Review Core Services Hospital
According to Baudry, a service offering can include two types of
services: basic services and devices [2].
Under this categorization, the main basic service of a hospital
system would correspond to care that is provided and logistics
activities related to materials management (procurement, production, distribution) could be categorized as peripheral services.
The provision of care is a combination of the two services, The
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figure below helps map the two types of services generally present in a health facility [2].
Fig. 1. Nature of services in a health facility
1.2 Definitions of Hospital Logistics
Hospital Logistics has been the subject of several definitions.
According to Chow and Heaver, described the hospital supply
chain based on three main logistics activities [3]:
-Supply: Includes purchasing and inventory management of
various products. 1
-Production: Manages the various processing activities such as
laundry, kitchens, sterilization, etc.
-The Distribution: ensure the delivery of various products
from storage areas to the various points of use, or transportation of waste to shipping areas.
According ASLOG1 « the logistics of the hospital is to direct
the patient, products, services and information from supplier
1Association
of Supply Chain and Logistics
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to recipient »[4]
103
tablish a panel that evaluates the performance of the supply
chain.
1.3 Importance of Logistics Costs in Hospitals
Logistics activities account for a significant proportion of
expenditure of the hospital system Figure 1 shows the costs
of logistics activities [3] :
2 METHODOLOGY FOR MEASURING PERFORMANCE OF
HOSPITAL LOGISTICS
2.1 Definitions Dashboard Indicators
The dashboard is a system of performance management is an
ongoing process that is part of an iterative cycle from planning
goals and leading to it, It is a way to select, organize and present
the essential and relevant indicators, briefly and focused. [7]
The indicator is the component of the dashboard that serves
as a tool for performance evaluation and gap analysis to set improvement actions in the future and there is the definition of "a
performance indicator is information to help an actor, individual or collective, more generally, to drive the price of a stock to
achieve a goal or to enable it to evaluate the results. "
Fig. 2. Costs of logistics activities CHOW and HEAVER 1994
2.2 Characteristics of Performance Indicators in the
health Sector
In the health sector, the awareness of the need to manage
performance gains ground, however, one difficulty remains: the
number of indicators that could be interesting is huge to the
point that managers are unable to spot.
According to Smith, the characteristics of good performance
indicators in the health care environment] are divided into two
stages, the design of the indicator and that its application: [8]
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Logistics activities are 46% of total expenses incurred by a
hospital.
Logistics accounts for 10% of the activity of the nursing body,
supposed to be dedicated and patient, a study of SCC2 confirms
that nurses spend a significant portion of their time managing
logistics activities.
1.4 Previous Research
Hassan highlighted fields problematic at a vast supply chain,
sore encountered revolve around [5]:
• Faults in the design activities (analyzing the flow pharmaceuticals and layout of storage facilities);
• Malfunctions in the organization and identification processes (for the sake of objectification) supply chain of the hospital;
• Malfunctions at supply management, inventory management and estimating needs.
Fateh Mebrek, has identified the following issues and has
been approached in three categories [6]:
- Organizational Problems : they are directly related to the
design of material and human resources, the allocation of resources to tasks, scheduling and planning.
- Problems of the information system: it is able to coordinate tasks, communication, random events (delay, failure, failure, ...).
- Problem dashboard: it depends forecasting tools dedicated
to users to help them make decisions.
To master the problems mentioned above, we will seek to es2
Consulting Group
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Step
Conception indicators
Application indicators
Indicator Features
Face validity / content validity: with what degree of accuracy the indicator does measure what it is supposed to
measure?
Reproducibility: how the
indicator
Would it be the same if the
method by which it was
product was applied again?
Acceptability: how the indicator is it acceptable for people to be evaluated and the
evaluators?
Feasibility: how valid, reliable and consistent data can
they be collected?
Reliability: to what extent is
he has an error minimal or
measuring the extent to results could be replicated if
they were again be collected
by another agency?
Sensitivity to change: to what
extent indicator he has the
ability to detect changes in the
unit of measurement?
Predictive validity: the extent
International Journal of Advancements in Research & Technology, Volume 3, Issue 9, September -2014
ISSN 2278-7763
to which indicator may predict accurately?
TABLE1
CHARACTERISTICS OF GOOD INDICATORS [SMITH.C & ALL, 2008]
PERFORMANCE.
2.3 Cycle Performance Management
The system of performance management is to operationalize
the strategy of the organization, to guide the work of the organization and improve processes. It also seeks to demonstrate the
achievement of objectives and accountability. Thus, to understand the nature of the measures to be adopted, and to guide
the development of a dashboard, it is essential to understand
how to deploy the performance management in the organization. A system of performance management is part of a management cycle that lasts throughout the year, even over a longer
period, in the case of elements of strategic significance. Highlights of this cycle are planning and accountability. The latter
usually takes the form of a report or an annual report. However,
the cycle of performance management is much richer than it
seems at first glance. [7]
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3.1 Importance of the circuit of medicines in the hospital
The pharmacy service is at the intersection of the flow of
pharmaceutical products (medicines, medical devices, objects
dressings and equipment), according DELOMENIE, this service
represents nearly 15% of the hospital budget. [11]
His mastery and profitability are vital and go through a
strong and effective use of resources to improve the quality of
care productivity. It is necessary to optimize the organization of
physical and information flows, to better meet the needs of users, service delivery, promote quality, safety, traceability, minimize costs..
3.2 Supply chain in the hospital of child
The Pharmaceutical Logistic Chain consists of processes
shown in the figure below:
2.4 Dimensions of the Dashboard Logistics for
measuring Performance
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Kaplan and Norton consider, for their part, that the panel
should cover four areas balanced: financial results, performance
vis-à-vis customers, internal processes and organizational learning. It is interesting that Lynch and Cross and Kaplan and Norton converge in common [9].
However, consider the importance of the operational dimension in the measurement of performance, it is important to understand the processes involved in hospital management structure for the dashboard in a logical way. Based on the work of
Landry and Beaulieu (2002), we identify four main processes:
procurement, inventory management, replenishment and processing [10].
Fig .4 Circuit medicament in children hospital
-Process forecasts and procurement: Ensure requests purchases and forecasts in the annual budget approved by management.
-Process-monitoring and stock markets and reception: Ensure the availability of products to customers through a rigorous management of stock.
-Preparing and making available: Ensure the availability of
products to services for patients at any time.
-Planning Process and improve the service: Follows the quality control and personal training support processes, etc.
The need to improve the process of market monitoring,
recieving and stock is justified by the fact that he is out of control and is perceived as "unreliable" by hospital officials.
Furthermore, the stock management is not effective. Indeed, the current storage method does not take into consideration the care environment and changes in consumption, the
storage method used is the conventional storage cabinets, and
the scheme is not trolleys unused.
Fig .3 The Dimensions of Performance
3 DASHBOARD PROPOSED
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International Journal of Advancements in Research & Technology, Volume 3, Issue 9, September -2014
ISSN 2278-7763
105
3.3 Case Study: Dashboard proposed
Indicators
Performance
Turnover rate product
Financial
%Purchased by supplier
Financial ,Customer
%Imprévue needs
Financial ,Customer
Objectives
Corrective Action if the
Lower Threshold Value
Process
Process forecasts and
procurement
%Compliance rate possible purchases
Rupture rate
Process-monitoring
and stock markets and
reception
Preparing and making
available
Planning Process and
improve the service
Customer, Operational
Financial
- Optimize Supply
-Make Inventory on
stock and analyze consumer product since
the date of entry
-Eliminate Suppliers
imposed
-Know Rate of active
suppliers & avoid delays in deliveries
caused by supplier
-Evaluate Annual forecast
-Evaluate Efficient
supply
-Analyze Forecasts
annual budget
-Analyze Demand /
Delivery
-Avoid the risk of
stock-out
-Review Quantity Min
and Max stock following the analysis of consumption
-Analyze Needs medication Period
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Rate of expired products in stock
Rate of patient satisfaction
Taux de réactivité aux
réclamations clients
% Realization training
% Process Efficiency
Financial
-Reduce Storage costs
Customer
-Reliable distributio
-Analyze Causes of
customer complaints
Customer
-Satisfy the customers
need
-Improve Efficacy of
the pharmaceutical
chain
-Ensure Implementing
quality of process
-Analyze Causes of
claims by process
-Analyze Staff efficiency
Financial, Customer,
Operational
Financial, Customer,
Operational
-Analyze Quality policy management
Results of process improvement after three months of the application dashboard proposed :
process
Process forecasts and procurement
Process-monitoring and
stock markets and reception
Preparing and mak-ing
available
Planning Process and improve the service
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Perfermance before
Perfermance After
Objectives
15%
24%
30%
20%
25%
30%
12%
22%
30%
3%
8%
10%
International Journal of Advancements in Research & Technology, Volume 3, Issue 9, September -2014
ISSN 2278-7763
Conclusion and outlook
This article has helped shed light on hospital logistics. We have
shown the importance of logistics activities costs in health facilities, then the means of performance measurement (Financial,
Customer, Operational) and we proposed indicators processes of
the pharmaceutical supply chain from the hospital child for periodically measuring and implement corrective actions to keep
continuous improvement of the overall performance of the hospital.
Also, the objective of this work was to lay the foundations for a
more comprehensive reflection on systems of performance measurement of hospital logistics. To the extent that very often, the
services of the hospital logistics are looking for more recognition
of the management of the establishment, the implementation
process of a performance management system can be an opportunity to validate the objectives or service results by senior management levels.
We will integrate the measurement of these indicators in the periodic instructions and internal procedures of the quality of children's hospital for it to be operational in services.
In terms of perspective, to read dashboard, must be applied to the
case of child hospital in Rabat to measure the performance of
pharmaceutical supply chain. A method of analysis will then be
applied to the chain in order to diagnose and finally modeling
and simulation of the chain must take place.
REFERENCES
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[1] Morgan, J. "How effective are your measurement systems", Purchasing, Vol.
129, No. 10, 2000, p. 26-28.
[2] Baudry, C. Manager services: quality as a unifying principle, Paris, Economica,
1986, 208 pages.
[3] CHOW, G., T. Heaver and Henriksson L., [1994], "Logistics Performance: Definition and Measurement," International Journal of Physical Distribution and Logistics Management, Vol 24, No. 1.
[4] ASLOG - hospital logistics Commission, "Results of the national survey," Symposium: "Hospital and logistics function," May 21, 2002, Hospital Expo 2002.
[5] Hassan Taher 2006, Hospital Logistics: organization of the downstream pharmaceutical and flow optimization consumables and disposable materials supply
chain. "Thesis" UNIVERSITY CLAUDE BERNARD - LYON 1.
[6] Fateh Mebrek 2008 support tools based on the simulation for hospital logistics,
application to a new hospital "Thesis" Blaise Pascal University decision - ClermontFerrand II
[7] Jobin Marie-Helene Martin Beaulieu, Alexis Boivin 2003, managing the performance of hospital logistics, "research paper No. 03-02," HEC Montereal Series notebooks Research CHAIN group.
[8] SMITH.C & All; 2008: "Performance measurement for health system improvement: experiences, challenges and prospects" European Ministerial Conference of
the WHO Health Systems 25-27 June 2008
[9] Kaplan, R. S. and D. P. NORTON. The scorecard, Paris, Les Éditions organization 1998, 311 p.
[10] BEAULIEU.M; LANDRY.S. How to manage the hospital logistics? Two countries - Two realities. Research Paper No. 02-02
[11] P. and DELOMENIE YAHIEL M., [1996] "Expenses of drugs in the hospital, the
French documentation", Paris, 1996.
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