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Structure
Objectives
~ntroduction
Defmition, Goals and Objectives of Logistics Management
1.2.1 Definition
'
lo-w of Goods
Transportation System
1.8.1 Transport and Traffic importance
1.8.2 Modes of Transport
1.8.3 Miscellaneous
1.9
Security of Stores
1.10
Hospital Stores
1.11.1 Types
I. 11.2 Pharmacy Serv~ces
I 1 1.3 Stores Management-Organisation and s~&I&
1 . 1 1 4 Physical Facilities of Pharmacy
1.12
Let Us Sum Up
1.13
1.0 OBJECTIVES
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plan and coordinate various activities of materials planning and management catering
for optional stqck of items;
In this unit, we introduce you to the concept of Logistics Management with particular
reference to hospitals. This has been explained by the way of understanding the
objectives, principles and functions involved in the logistics management.
Logistics is a broad, far-reaching function, which has a major impact on a society's standard
of living. In a health care institution, we have come to expect excellent logistics services,
and tend to notice logistics only when there is a problem. Logistics has been called by
many names, including the following : Materials management, Supply management,
Industrial logistics, Business logistics, etc.
What these terms have in common is that they deal with the management of flow of goods
or materials from point of origin to point of consumption, and in some case, even to th$
point of disposal.
The LogisticsISupply management in any health-care institution is that part of the entire
hospital activity which deals with procurement, storage, transportation, distribution,
maintenance and evaluation of drugs and equipment. Sufficient stocks of these varied
types of items are to be maintained, primarily because it will be too costly to initiate
action to procure an item at the time of need. Non-availability of an item when required by
the user in a hospital could lead to 'Stock-Out' and adversely affect the treatment of a
patient, or even create a life-threatening situation. On the other hand, over-stocking of
items could lead to blockage of finance, which in turn would be a costly proportion to any
hospital.
Hence, planning of logistics and supplies is a process of deciding what and how much of
various items are to be kept in stock at a given time. It is also necessary to determine the
lead-time involved and the appropriate quantity to be procured.
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Given the goals, let us now identify the objectives of logistics management, which can
ensure the best performance, and use of materials in a hospital. These are as follows:
Primary Objectives
a) Good information system regarding the items
b) Right pnce of purchase
c) High turnover of the items
d) Low procurement and storage cost
e) Continuity in supply of stores
f ) Consistency in quality of the product
g) Good supplier relations
h) Development of personnel carrying out materials management
Secondary Objectives
a) Forecasting requirement
b) Favourable reciprocal relationship between supplier and purchaser
c) Awareness of new materials and products.
d) "To make" or "to buy" decision.
e) Standardization of items.
Principles
a) Right itendmaterial
Value Analysis
Standardization
Codification
b) Right quantity
PurcPasing
Balancing of Inventories
EOQ (how much to buy and when to buy)
c) Right price
d) Right source
Market research
Purchasing techniques
Selection process
e)
f)
Right methodslsysterns
and procedures
g) Right people/attitda
oriented towards
,
innovative improydments
Procurement technique
Follow up
- PERTIOR
Work study
System analysis
Management information s y s t e p -
Organisational analysis
Behavioural sciences
Integrity
Logimticm Mnm8gemeot
Right transport
k)
Right packaging
1)
IT$
n) Right contract or legal aspects: This should cover all the above purchase parameters.
To co-ordinate the activities amongst the various departments in the hospital, for
optional and equitable utilization of the items being procured.
e)
To ensure that the receipt of stores is timely, and thereafter distribution time is also
within a reasonable time frame.
f)
To procure the items necessary from the best, reliable and authentic source either from
within or outside the country at economical prices.
To carry out effective and judpious distribution of the stores throughout the hospital.
f)
To develop an effective and realistic record-keeping system of the medical stores and
equipment (manual /computerized).
g) To minimize losses through pilferage and damage, and utilization of the stores within
the shelf life.
h) To carry out disposal of waste and scrap which cannot be utilized in the hospital.
i) Employing personnel conversant with logistics management of hospitals.
To ensure good performance of the personnel handling the system.
j)
...........................................................................................................................................................
2)
f)
In addition, there are also other functions which will need close attention ofthe logistics manager:
a)
b) Keeping liaison between the various departments of the hospital, andor with the
supplierslmarket, and
c)
Essentials o f Logistics
Equipment Managcme
generally refers to the actual buying of materials and those activities associated with the
buying process. Procurement is broader in scope and includes purchasing, traffic,
warehousing/storage and all activities related to receiving inbound materials.
Purchasing activity starts with the recognition of a need. When materials requisition
emanates either from the user department, stores department or materials planning,
purchase department has to ensure its timely supply.
'
The next step is the selection of the right source of supply. Often, the purchase department
has to develop alternative sources of supply and arrange for potential substitutes.
The responsibility of the purchase manager is from ascertaining the price of the item, which
is aprime factor in source selection, timely delivery, quality assurance, reliability, credit
availability, etc. according to the policy of the hospital.
Maintenance of records and files and good vendor-vendee relations are also important
phases of purchasing activities.
The main Abjectives of purchasing may be delineated as follows:
a) To ensure uninterrupted flow of materials;
b) To buy economically in a competitive market;
c)
With these objectives in mind, the functions of the purchasing department may be
summarized as follows:
a)
Selection of supplies
b) Analyzing of bids
c)
Price negotiations
Follow-up actions
Cost analysis and market study
financial capacity,
b) manufacturing capacity,
c)
d)
service facilities,
b) Limited tender: Often advertising is costly and increases the lead time, then bids are
solicited only from reputed limited pre-qualified parties.
c)
Simple tender: In case of only a single source, that firm is asked to submit his quotation
in writing. Simple tender purchases should be avoided, as it leads to monopoly of
proprietary item, which is against the basic objective of purchasing.
d)
Global tender: When bulk purchase of special artioles is involved, global tenders are
invited through advertisements both in India and abroad.
b)
c)
g) Award the contract for the lowest responsible bidder by taking a total view of the final
le
product. Lowest implies being below the average standard. ~ k s ~ o n s i bmeans
answerable legally and morally.
h) The quotation should be low, consistent with the quality requirement.
3 The lowest bidder need not be the best bidder from the buyer's view.
J]
Discounts such as cash discounts, trade discounts and quantity discount should be
familiar to the buyer to ascertain the final price.
'Logistics Management
1.5.4 Negotiations
In the purchasing context; negotiation is essentially a discussion between a buyer and a
seller with a view to reaching an agreement. The price agreement is a major factor in
purchase and sale contracts, but other factors are also determined in such discussions.
These parameters may be with regard to: price and payment schedules, delivery, quality
and/or performance characteristics, specification variations, accessory benefits, insurance,
spares, guarantee, warranty, freight, and other special features.
In any case, negotiation is considered very important in the buying process and when it is
actually held, it creates a good buyer-seller relationship. Negotiation is an art, and the
hospital purchaser must familiarize himself with the requisite details of the product, prior to
the meeting.
Law of agency: This states that the acts of the purchaser (agent on behalf of the hospital)
done within the apparent scope of his authority binds his hospital with respect to third
parties (seller), in respect of any contract concluded.
Law of contract: A formal contract of purchase duly signed by an authorized hospital
purchaser binds both the seller and the buyer. An offer becomes a contract only when it is
accepted by the seller. A valid contract has four basic elements:
a) An agreement resulting fiom an offer and acceptance, understood in the same sense by
both the buyer and the seller.
b) A consideration or an obligation imposed on both the parties.
c) Parties should be competent to contract.
d) The purpose of the contract should be within the existing laws of the land.
Legal Status of Buyer: The purchase officer whlle signlng a purchase contract does so on
behalf of the hospital. The buyer must, therefore, know the extent of his scope and
delegated authority, either express or implied, to bind his hospital with the supplier.
'
Logistics Management
with the requirements. IS0 9003 is applicable only when capability is demonstrated in the
field of final inspection. These are various criteria for quality of material, depending upon
the buyer's price consideration, availability of the item, their possible substitution and
relfable sources of supply. In purchasing the right quality of materials, the following
cflnsiderations are significant:
a)
c)
The consideration of quality of the material has direct ;elationship to the :pchnicai
suitability, physical availability and the economic consideration of pric,. T'he other two
aspects are relative to the procedures of procurement.
Inspection
...
b)
measurement of product,
Inspection of stores are carried out in batches, with each batch being tested to thorough
Sample Inspection. There are different methods adopted to the type of sampling, depending
upon the product and its quantity.
Instruments and accessories have to be functionally checked before these are acceptable to
stores. Sample of drugs and other hospital materials e.g. cotton, gauze have to be sent from
the lots for confirmatory tests. Any defect or deficiency noted has to be reported to the
vexldor for corrective action. Reports of chemical analysis
.
. (if. any)
. have to be preserved for
future reference.
All rejections have to be reported to purchase department so that they know the quality
Pel.formance of various vendors.
.................
and ...................................
f)
.................
and
.................,
to reach
..................
................
and ..................
Receive the materials, check them for quantity, coordinate for inspection and quality
checks, and prepare the stores receipt vouchers.
b)
Accept the passed materials, prepare the rejection notes and complete the formalities
for payment of bills.
c)
Take into stock the accepted materials, store them in respective locations as predetermined.
d) Prepare issue vouchers, make actual issues for disposal and accaunt for the same.
e)
Keep the purchasing team well informed through systematic indents and other reports.
f)
Keep the storage place clean for facilitating handling and movements, and observe all
safety measures and security regulations.The materials are to be arranged in such a
manner so as to enable easy storage, minimized pilferage, proper identification and
quick retrievals with minimum wastage of time and effort.
1.6.2 Standardization
Standardization is the orderly and systeinatic formulation, adoption, application and review
of hospital institution standards,.which leads to simplification or variety reduction. This
implies reducing unnecessary varieties of items and standardizing to the most economical
sizes, grades, shapes and colours or type of stores. It reduces the number of types and
sizes of items to m minimum, consistent with the needs of the departments / hospital.
Logistics Management
Reduction of inventory will require lesser amount of working capital commitment of the
hospital.
d) Items can be easily identified by all the stores personnel, as the bin location can also
be standardized.
e) Reduces the tinle involved in negotiation process with the vendors, with better
communication and prompt delivery,schedules.
t)
j)
k)
1)
. 0)
The process of standardization should be entrusted to a task force in the hospital. They
should obtain the relevant datalfacts from the relevant departments and develop standards.
There should be a constant reviewing, updating and monitoring committee to deliver the
best benefits to the hospital. The role of standardization and variety reduction in inventory
simplification has real significance in hospital logistics management field. This also assists
in rationalized codification.
After the broad classifications as to their nature and use, a code or symbol is allotted to
each of them.
Systems
Examples
a) Alphabetical System
Class
Table operating (TO)
Group
Stainless steel (SS), Hydraulic (H)
Code
TO-SS-H
b) Numerical System
Class
Drug
System
CVS
(01)
(31)
Sub-group II
81
Subgroup I
SP
Code
SP-8 1
d) Brisch System
A comprehensive system with usually a 7-digit numerical code assigned to each item
with digital significance by virtue of their position and value.
e) K d a k System
Developed by Eastman Kodak Company, U.S.A., based upon numerical system and
grouping done on purchase category, with 10-digits.
Class
Sub-class
Matelrial
Class Code Item Sub-class
Furniture
61-70
Chair
63
Sub-class of 63
Class Sub-class
63
2
Kind of chair
Wooden
#a)
b)
c)
.....................................
l?he primary basis for Materials Accounting is cost. Materials are ordered on a continuous
blasis and there is no prescribed procedure which can be used in the determination of
nnaterials cost for accounting purposes. In order to determine the money value of materials
a a hand at a given point of time, the quality of the materials must be known, and a value
n mst be assigned ;to those quantities based on one of the several accounting methods.
The records kept by the logistics department have two broad characteristics:
a) Only quantities are showd in the records; and
b) Regular balancing of materials is done.
For this purpose, the following records and documents are kept:
a) Bin card: It is a record of movement of materials against each kind of stock in respect
of daily transactions, which is attached to each bin or ghelf or any other form of
containers. It shows daily receipts, issues and balance quantity on hand. The card
also shows maximum and ininlmum and re-order levels.
b) Stores ledger: The stores ledger shows the details of the information of each itemi.e, supplier's name and address, quantity ordered, invoice number, price, expected
delivery date and stock levels.
c)
Stock identification card: These cards are kept against each bidrack to identify the
materials. It has the material code number, full description, stores ledger folio and
bin-card numbers.
d) Materials received note: Materials a f t h s p e c t i o n are taken Into stock through this
document. It passes through the Inspection Department to Accounts Department for
recording and accounting of materials.
e) Materials requisition slip: This document conveys the quantity required of the
material from the issue counter. Stores department must ensure that the MR slip is
signed by the authorized person, proper code number, andlor description of material is
mentioned and the quantity issued must be entered and signed.
Materials returned note: When materials are not required by a department, these are
returned to the stores with this note. Stock and stores records are adjusted accordingly.
FIFO method: "First m,first out" method is in most common use. Materials from the
oldest stock is issded, and their unit cost also represents the oldest cost on the stock
ledger. However, when prices are subject to change, this method cannot match costs
against revenue on a current cost basis.
b) LTFO method: "Last in, first out" method assumes that most current cost should be
charged to the goods. This however results in unrealistic inventory valuation for the
balance sheet.
c) Average cost method: This does not take into account which item went out of the
inventory first or last, rather it determines the average cost for each item during a period
of time.
d) Specific cost method: This provides the most realistic valuation of ending inventory as
well as flow of costs. Costs flow and physical flow are identical under this method,
with proper maintenance of records. It is suitable for physical verification of
inventories made round the year.
D
~f Logistics
Manageme
a) Spot location system: Whichever item fits in whichever place. Tt has the proper
utilization of space, but has an admixture of items. Chances of pilferage are high.
b) sequence system: The materials are sequentially arranged and are easy to locate,
However, additional space is required for storage.
c) Popularity system: Items which are used more often and are in greater demand are
readily available at convenient sites.
d) Size system: The bulky items are placed at distant locations and on lower floors, whilst
the smaller items are more easily accessible at decentralized locations.
The physical distribution system in the hospitals is usually one of the following methods:
a) Basket system: Requisition note from the wardidepartment approved by the
authorized signatory is received by thestores department, and items issued in totality
on as required basis. Chances of misuse and pilferage in this system are higher. This
system should usually be utllized in specialized departments.
b) Topping up system or replenishmentsystem: Here the issues made by the stores are
against the number of identified/accountable items utilized in case of disposable, or are
exchanged on one-to-one basis in case of non-expendable items. Chances of pilferage
are reduced, but there is no bufferlreserve stocks available with the ward/departments.
c) Unit dose system: In case of certain operationslprocedures, certain identified items are
issued as a "unit dose" or single item requirement by the stores.
The hospital management should bring out a "materials handling guidelines" for easy
handling and distribution of stores. Some of the recommendations are as follows:
a) Materials should be kept generally at a level at which distribution is most convenient.
b) Materials should be placed Dn pallets, trays or platforms.
c) Distances for distribution should be as short as possible.
d) When distances are long, attempt should be made to handle as large a quantity as
possible on each triplissue, to cut dowri frequency of handling.
e) Straight flow layout is ideal.
f) Gravitational use muvt be encouraged.
load factor is high. Fork liAs/truch
g) Belt and roller conveyors should be utilized NLG~G
help in facilitating movement of bins/containerslwire baskets.
h) Incoming materials should be received in a covered area, amd in-process handling
should preferably be in pallets or in suitable container, wherever direct transfer to the
respective department is not possible.
against
f)
Post parcel: Available between all essential points in the country, but carriage is limited
to small packages and selected commodities only. Primary benefit is door-to-door
delivery.atrelatively low cost.
Each mode of transport has varying service capabilities. The factors enumerated above
affect the cost and priclng of transportation. The materials manager in the hospital weighs
the various factors, keeping cost in the fore-front before contracting an order.
1.8.3 Miscellaneous
Responsibilities of Materials Manager: The important points to ponder over in this issue
are:
a)
Arranging adequate insurance cover for materials in transit, storage and warehouse.
An adequate insurance value is computed by adding the invoice value, freight charges
payable, plus incidental charges and add on percentage to allow for likely increase in market
value during total lead time involved. If the cargo is a total loss, the full insured value is
collectable.
Open policy insurance: To simplify covering repetitive risks during transportation, a blanket
or open cargo contract is resorted to. Under an open policy, an insured party may obtain
contmuous coverage for all shipments for an extended period of time or until cancelled by
the other party. An open cargo policy covering general stores is usually written on "all
risks" basis.
The term "marine insurance" is insurance of transit of materials by ocean voyage, air
consignments and inland transit by road or other means of transport.
Third parties: These are companies similar to channel intermediariesthat provide linkages
between shippers and carriers. Often, third parties partner with a number of carriers who
provide the necessary equipment to transport their shipments. Q e r e are several types of
third parties, including transportation brokers, freight forwarders, third party logistics
service providers,~shippers' associations. With the increasing emphasis on supplies and
management, more companies are exploring the third party option. These third party firms
handle all or most.of the freight offers and dedicated contract carriage.
Carrier pricing related issues: Pricing issues are important in transportatlon. Rates are
developed in general or specific rates are determined by a carrier. These rates are followed
by a description of the Issues the specific rates carrier charges. The most significant
approach is FOB (free-on-board) pricing. Also available are quantity discounts and
allowances provided by the carrler to the buyer. The FOB prlcing items that are offered
have a significant impact on logistics generally and transportation specifically e.g. if a
seller quotes a delivered price to the hospital's pharmacy stores at a distant location, the
total price includes not only the cost of the product, but also the cost of moving the
product to the distant location store.
Security implies prevention of pilferage and theft by employees, vendor's men and carrier
representatives. It also means guarding the assets against burglary and dacoity.
The stores manager by virtue of being custodan of the stores, he is responsible for its
security. Some security and safety considerations playing a crucial role are:
a) The security force or watch-and-ward staff should keep vigil throughout the daylnight,
not only in the stores area but in the entire premises of the organisation. The security
staff must be carefully selected with high integritj. and sufficient strength. They should
be trained in all aspects of security and security checks, and should be headed by a
capable officer. The appointment conditions should indcate that these personnel
must not belnor become members of hospit; unions or indulge in undisciplined
activities. Rotations of shift timings must be worked out, with appropriate handing
over overlap.
b) All storage areas are to have proper locking arrangements and periodic checks must be
carried out.
c)
Personnel entering the stores must be informed that the security staff will check or search
them while leaving. The security staff must forbid unauthorized entry or exit of persons.
The stores premses should be properly fenced, or have high walls or efficient locking
devices, depending on the type of storehouse and design of the hospital. Burglar
alarms and video cameras are aided assets these days. Powerful lighting must be
provided at all strategic areas with automatic switchover to battery lights in the event
of power failure.
f)
i)
......................................
Identity badges
hlnAlinn
rr\-h.;h..ml. .,t
-L--l-------
E s s e ~ ~ t i a lof
s Logistics and
Equipment ~Managerne~lt
Public auction.
It is necessary to associate the fmance and user departments in the process of realizing the
highest value from the items being disposed.
.................
n i ~ 3 ~iss preceded
l
by a
.........................
auctinn.
......................... valus
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'The potential hospital administrators must weigh these aspects during planning and
forecasting, before placement of the requisite quantity of orders.
It is imperative that a sound administrator must deal with the problem of medical supplies.
The chief official must have knowledge and experience in handling of medical supplies. He/
She must have experience in business. It is not necessary that he should have a scientific
speciality e.g. speciality of pharnlacy is not necessary to fill the post of director of medical
supplies, nor this official needs to be a medical practitioner. Basically, he must have a record
of successful management in the field. Yet again, a scientific or medical background is az
added asset.
1.11.1 Types
Hospital is an industry, has hotel management techniques. and is a health care institution,
with a variety of services being rendered and departments being catered for. The types of
hospital stores include:
a)
k)
When planning for the hospital stores, these areas should be carefully demarcated, and
duties, areas of responsibilities and policies of each sub-division identified.
In this unit, the students will be given a resume on Pharmacy or Drugs services and allied
stores affiliated with it e.g. laboratory chemicals, X-ray films and chemicals, gases, etc.
The other type of stores including bio-medical and other medical equipment are being
explained in the other units. 'The endeavour is to generally explain the management
principles of any type of logistic stores.
Logistics Mgaagemen t
to expect quick service from the pharmacy. Likewise, availability and issue of drugs for the
in-patients admitted in the hospital wards has to be carried out, on as per demand of each
department, to bring total efficiency in patient care.
Definition : The hospital pharmacy may be defined as a department which deals with all
aspects of drugs except prescribing and administration of drugs, which are exclusive rights
of physician and nurses respectively.
Role and Function: The services rendered by the hospital pharmacy can be categorised as:
a)
b) Purchasing of stores.
c)
Storage and distribution of drugs to in-patients (wards), and dispensing for outpatients.
Imparting training to students of school of nursing, and in the medical intern training
progmnme.
t)
Duties
The prime duty of the hospital pharmacist is to render good service to the patient. This is
achievable by providing medications of the highest standards, promptly available and at
reasonable expense. The pharmacist also renders a valuable professional service to the
medical staff. This is feasible through regular communication between the staff and
pharmacist. The latteris a source of information on merits of different brands of the same
basic drug, as8 W advise on the &sage and strength of innumerable new preparations
being msrkWhy. 'Ibc pbsnnaciot contributes to the education of nurses in the uses,
actions and dosage of drugs, control of narcotics, proper care of perishable items, and
labellng and filling of bottles and containers. A well-organized pharmacy under an efficient
pharmacist can prove to be a revenue-producing department, even in small hospitals. The
medcation cost per patient is reduced by proper management, despite the profitability. An
exception to this may be made on the ordinary drugs stocked in the floor medicine cabinets
which are often dispersed without charge to the patients. Erroneous medication should be
viewed seriously, which are detrimental to patient care and is an economc loss.
Staffing Pattern
I
I
I
This is dependant on the work load i.e. number of items to be served per prescription and
hours of service to be given. Further, the number of pharmacists required varies with the
programme, policies, responsibil~ties,services and their utilization for in-patients, outpat~ents,employees and the public. The workload consists of measurable activities and
quantifiable load. Generally, each category of activity requires about one-half of the time of
the pharrnac~st.More readily measured items include filling of prescriptions, issues to
patient care areas, includ~ngout-patients, compounding and pre-packaging.
Onan average, in a 8-hour shift of OPD Pharmacy, apharrnacist can serve 150prescriptions
with a half-hour break. If the items are 3 to 5, then limit to serve will be reduced to 120
prescriptions in one shift. Hospital having more than 200 beds needs a Head Pharmacist,
and for more than 300 beds requires one additional Asst. Pharmacist.
Studies in India indicate certain guidelines for the staffing pattern of Pharmacy Service,
based on the number of beds in a hospital. These are as follows:
Bed Complement
Up to 50
"
100
"
"
"
200
300
'
500
Number of Pharmacist
3
5
8
10
15
It is imperative that the personnel department must create seope of promotion avenues to
keep the workers motivated amongst the different services/departments.
Supenision and Control
.
Drug stocks in nursing units should be standardized and kept at a useful minimum level.
This should be inspected by the pharmacist, with the nursing supervisor, every month. Old
and deteriorated medication are to be removed; unopened original packages may be
returnable to the vendor for credit. Containers and labels in poor condition to be replaced.
Excess stocking to be curtailed. Some hospital pharmacies work with as two-unit container
system, which provides for a full container remaining on the ward floor while an empty
container is in the pharmacy being refilled. The Head Pharmacist must process managerial
skills, so as to guide the performance of the subordinates towards a common goal.
Purchase and Supplies
The pharmacist's principal function in purchasing is to establrsh standards and
specifications for medication and equipment. HeIShe alone is responsible for sub-standard
or dangerous items reaching the pahent. The pharmacist is familiar with the pharmaceutical
and chemical manufacturers, their distribution system and discounts. A sound purchase
and control system is essential.
Purchase card for each Item stocked in pharmacy must indicate date, quantity and price,
which will assist in reordering of that product in the requisite quantity. Quantity discounts
may be taken advantage of, dependant on business condibons, and over-stocking should
be prevented.
Inventory should be worked out on annual basis to further improve efficiency, but it is
amply simplified when a purcliase record system is already installed. Purchase of drugs and
pharmaceuticals should be on a bid basis where practicable.
Manufacturing
In some institutions, manufacturing selechve preparations could be profitable and
convenient. This includes alcoholic preparations such as elixirs and tinctures, made from
tax-free alcohols.
Finishes and lighting: The floors of the pharmacy should be resilient, smooth, easily
cleaned and acid resistant. Rubber or asphalt tiles and heavy linoleum are satisfactory
material. Walls should have a smooth surface with painted or equally washable finish in
light colour. The finish of cabinets and similar items should be light-coloured wood or
whlte enameled. Good lighting and venhlation are imperative. Venetian window blinds
benefit of daylight without glare. In
could be fitted onto windows, to provide maxi~l-m
addition to general illumination,fluorescent lamps should be placed immediately above the
prescription counter where necessary to assure adequate light. Ample electrical outlets
should be provided for in all areas.
Equipment: Equipment lists will be at variance to cater for design and services of
individual hospitals. Equipment includes drug stock cabinets with proper shelving and
drawers for a large assortment of drugs. Sectional drawer cabinets are ideal to fit into any
area. Work tables or counters are required for manufacturing solutions, powers, ointments
and for filtermg; also for loading of word baskets and checking orders. Counters with
drawers has the advantage of providing more storage space. Standard counter height is 0.9
meters, depth 0.75 meters and minimum length of 1.8 meters. The finish of the work top may
be acid resistant or of heavy linoleum.
Also necessary are an acid-proof sink with swivel tap and drain board, with a cabinet below
to provide space for glass equipment. Refrigerator is a must, especially for stocking items
necessitating storage at low temperatures. Space required is variable, but generally at least
0.2 cubic meters (8 cubic feet) in 50-bed hospital, 0.4 cubic meters (16 cubic feet) in 100-bed
hospital, and 0.8 cubic meters (32 cubic feet) in 200-bed hospital.
A "cool-room" temperature controlled by air-conditioning is also necessary for storage of
antibiotics. Office furniture, computers, communicahon facilities like telephone and
intercoms, file cabinets for records and manufacturers current literature, cord index file
system and pharmaceutical library are also to be catered for. Dispensing windowls is a must
through which prescriptions are dispensed to out-patients and ward staff/nurses.
General storage: The ideal area for bulk pharmacy stores would be adjacent to the
pharmacy itself. However, this may often not be feasible. The next choice would be directly
below the pharmacy with dumb-waiters and special staircase connection. Bulk pharmacy
stores should be kept with the general stores area, and must have an access enclosure for
the pharmacy staff.
Equipment required would be open adjustable metal shelving for reserve stock, raw material,
empty bottles, and packaging containers. Separate lockable fueproof room with drum cradle
is necessary for alcohol storage.
1.12 LETUSSUMUP
In this unit you have been given the outlines of Logistics Management. We have exposed
you to the general principles and fbnctions of logistics management. Plaming and
coordination of various activities relating to materials plannlng and purchases have been
brought out in the unit. The procedures involved in the tendering process, procurement
and inspechon, including quality assurance have been explained. The storage system,
standardization methods and codification of stores have being outlined. The methods of
distribution of stores, accounting of materials, and security of stores, have been touched
upon briefly. The various types of transportation of stores have been pointed out. Finally,
identification of stores for condemnation and disposal have been explained.
The students should be able to identify the management techmques outlined and aptly
apply the same in their respective medical institutions, as managers/hospitaladministrators.
The hospital stores, with detailed reference to the pharmacy service, its organisation,
staffing pattern and physical facilities have been illustrated so that the students could
utilize the knowledge in their perspective planning.
a) Obtain materials at the lowest possible price, which must go hand in hand with
consistency in both quality and continuity of supply.
b) Maintain the minimum of inventory of materials so as to free the working capital for
other useful purposes.
c) All activibes should be carned out at a minimum of cost.
2) Right itemhaterial, right quantity, right price, right source, right delivery time, right
methoddsystem and right peoplelattitude.
,ogistics Management
f)
i)
accuracy
b) details
C) quantity
d) fmstin,fustout
e)
manpower; equipment
f)
as required
b) hdspital unions
c)
Reduction; diminshes
a)
~dentification,disposal, surplus
b) overordering, obsolescent
c)
wardstdepartments
d) longer than a
e) management
f')
mmmnm,public
drugs
d) inpatients; outpatients
e) Pharmacy and Therapeutic Corninittee
f)
registered
g) revenue.