proposal for a deshboard to measure the perfermance of the

International Journal of Advancements in Research & Technology, Volume 3, Issue 9, September -2014 102 ISSN 2278-7763

Copyright © 2014 SciResPub.

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 ap-proach to measuring the performance of hospital logistics. The third part explains the principle of the dashboard with measura-ble 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

Health facilities are now facing the same constraints of eco-nomic efficiency and industrial companies. They discover the importance of the logistics process as a new approach for effi-cient 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 perfor-mance 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 perfor-mance of particular hospital pharmaceutical supply chain Do-main 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 ana-lyzing the different processes of this chain. This analysis al-lowed us to identify a dashboard for evaluating the perfor-mance of this channel. We aim through this work to demon-strate 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, pro-duction, distribution) could be categorized as peripheral ser-vices. The provision of care is a combination of the two services, The

figure below helps map the two types of services generally pre-sent 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 transporta-tion 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] 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] :

Fig. 2. Costs of logistics activities CHOW and HEAVER 1994 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 pharma-

ceuticals and layout of storage facilities); • Malfunctions in the organization and identification pro-

cesses (for the sake of objectification) supply chain of the hospi-tal;

• Malfunctions at supply management, inventory manage-ment 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 re-sources to tasks, scheduling and planning.

- Problems of the information system: it is able to coordi-nate tasks, communication, random events (delay, failure, fail-ure, ...).

- Problem dashboard: it depends forecasting tools dedicated to users to help them make decisions.

To master the problems mentioned above, we will seek to es-

2 Consulting Group

tablish a panel that evaluates the performance of the supply chain.

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 im-provement actions in the future and there is the definition of "a performance indicator is information to help an actor, individu-al or collective, more generally, to drive the price of a stock to achieve a goal or to enable it to evaluate the results. "

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]

Step Indicator Features

Conception indicators

Face validity / content validi-ty: with what degree of accu-racy the indicator does meas-ure 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?

Application indicators

Acceptability: how the indi-cator is it acceptable for peo-ple to be evaluated and the evaluators? Feasibility: how valid, relia-ble and consistent data can they be collected? Reliability: to what extent is he has an error minimal or measuring the extent to re-sults 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

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to which indicator may pre-dict 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 organ-ization and improve processes. It also seeks to demonstrate the achievement of objectives and accountability. Thus, to under-stand 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 organiza-tion. A system of performance management is part of a man-agement cycle that lasts throughout the year, even over a longer period, in the case of elements of strategic significance. High-lights 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]

2.4 Dimensions of the Dashboard Logistics for

measuring Performance 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 learn-ing. It is interesting that Lynch and Cross and Kaplan and Nor-ton converge in common [9].

However, consider the importance of the operational dimen-sion in the measurement of performance, it is important to un-derstand the processes involved in hospital management struc-ture 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 pro-cessing [10].

Fig .3 The Dimensions of Performance

3 DASHBOARD PROPOSED

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 us-ers, service delivery, promote quality, safety, traceability, mini-mize costs..

3.2 Supply chain in the hospital of child The Pharmaceutical Logistic Chain consists of processes shown in the figure below:

Fig .4 Circuit medicament in children hospital

-Process forecasts and procurement: Ensure requests pur-chases and forecasts in the annual budget approved by man-agement. -Process-monitoring and stock markets and reception: En-sure the availability of products to customers through a rigor-ous 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 quali-ty 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 con-trol and is perceived as "unreliable" by hospital officials.

Furthermore, the stock management is not effective. In-deed, the current storage method does not take into considera-tion the care environment and changes in consumption, the storage method used is the conventional storage cabinets, and the scheme is not trolleys unused.

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3.3 Case Study: Dashboard proposed

Process

Indicators Performance

Objectives Corrective Action if the

Lower Threshold Value

Process forecasts and

procurement

Turnover rate product Financial - Optimize Supply -Make Inventory on stock and analyze con-sumer product since the date of entry

%Purchased by suppli-er

Financial ,Customer -Know Rate of active suppliers & avoid de-lays in deliveries caused by supplier

-Eliminate Suppliers imposed

%Imprévue needs Financial ,Customer -Evaluate Annual fore-cast

-Analyze Forecasts annual budget

%Compliance rate pos-sible purchases

Customer, Operational -Evaluate Efficient supply

-Analyze Demand / Delivery

Process-monitoring and stock markets and

reception

Rupture rate Financial -Avoid the risk of stock-out

-Review Quantity Min and Max stock follow-ing the analysis of con-sumption

Rate of expired prod-ucts in stock

Financial -Reduce Storage costs -Analyze Needs medi-cation Period

Preparing and making available

Rate of patient satisfac-tion

Customer -Reliable distributio -Analyze Causes of customer complaints

Planning Process and improve the service

Taux de réactivité aux réclamations clients

Customer -Satisfy the customers need

-Analyze Causes of claims by process

% Realization training Financial, Customer, Operational

-Improve Efficacy of the pharmaceutical chain

-Analyze Staff efficien-cy

% Process Efficiency Financial, Customer, Operational

-Ensure Implementing quality of process

-Analyze Quality poli-cy management

Results of process improvement after three months of the application dashboard proposed :

process

Perfermance before Perfermance After Objectives

Process forecasts and pro-curement 15% 24% 30%

Process-monitoring and stock markets and recep-

tion 20% 25% 30%

Preparing and mak-ing available 12% 22% 30%

Planning Process and im-

prove the service 3% 8% 10%

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Conclusion and outlook This article has helped shed light on hospital logistics. We have shown the importance of logistics activities costs in health facili-ties, then the means of performance measurement (Financial, Customer, Operational) and we proposed indicators processes of the pharmaceutical supply chain from the hospital child for peri-odically measuring and implement corrective actions to keep continuous improvement of the overall performance of the hospi-tal. Also, the objective of this work was to lay the foundations for a more comprehensive reflection on systems of performance meas-urement 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 oppor-tunity to validate the objectives or service results by senior man-agement levels. We will integrate the measurement of these indicators in the pe-riodic instructions and internal procedures of the quality of chil-dren'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.

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