The Research On Logistics Management Of Medical Device In One Hospital In Shanghai

【BACKGROUND】With the economic development,the continuous emergence of high-new technology,the enhancement awareness of patient rights,the government's increasing strength on macro-control of medical services,the reducing balance of revenue and expenditure in some medical institutions,medical institutions have more dynamic to improve not only medical services and the medical quality,but also the operating cost. The time of logistics management development in enterprises is earlier than development in hospitals.As the increasing competition pressure and the enhanced awareness in medical institutions,the hospital gradually pays more attention to logistics management.Logistics is the third space to be developed for hospital.Most of the current logistics management in hospital is traditional model-extensive management, which cause the operation of logistics in a high cost and low efficiency.Medical device is one of the most important part in hospital management,because the field which medical device involves is wide,the security requirement is strict,the time of demanding is prompt,the categories is huge,the proportion of funds is at a large proportion.Optimizing medical device logistics management not only lead to the lower hospital operating cost,the efficient logistics and flexible market responsiveness,but also greatly improve the efficiency of hospital clinics,the quality of service,operation concept,the business model and management style.【OBJECTIVE】This study analyse the external environment(including the policy of China's logistics management of the medical device and the general situation of the hospital) and the internal situation(including the relevant departments human resources of the hospital logistics,the operation of the logistics flow,the direct logitics cost of the medical,the inventory and consumption of the medical device,the department staff's cognitive and satisfaction for logistics management of medical device)of the logistics system of a secondary hospital in Shanghai.To provide the reference information for the decision-making on the improvement of the hospital logistics management and implementation of effective cost control in hospital.To provide qualitative and quantitative analysis experience for hospital management. 【CONTENTS】1.The general condition of the hospital and the logistics management of the medical device.The former involves the number of beds,human resources,medical care service,the revenue and expenditure situation and so on;the latter involves human resources condition of the logistics management department(device and the storehouse) of medical device.2.The analysis of medical device logistics flow and operation management.3.The analysis of the inventory and consumption of the medical device.The inventory analysis of the non-implantable medical device and the ABC classification analysis of medical materials,the species,quantity,amount,origin and distribution of supplier analysis on implantable medical device.The inventory analysis of medical device,the economic order model for the major medical device inventory analysis and the Monte Carlo method for sensitivity analysis.4.The analysis of the direct logistics cost of the medical device(measured by the dimension of the expenses and the item).5.The evaluation of the department staff(the cognitive and satisfaction for the logistics management of medical device).【METHODS】1.Investigation in hospital.Collect the general state of the hospital,the using status,inventory of medical device,logistics cost of medical device between 2005 and 2007.2.Questionnaire for workers.Conduct a survey on the vice president of the hospital in charge of logistics management,all the medical device department of logistics management staff,randomly selected 50%of the clinical and medical technical personnel to know about the cognitive and satisfaction of the logistics management of medical.3.Interview with key insiders.The vice president of the hospital in charge of logistics management,the sectional chief of the device and the chief person in charge of storeroom(three persons) are interviewed to know about the processes and suggestions of the logistics management of medical device.4.Analysis methods.(1) The direct logistics cost of medical device.Account and analyze the direct logistics cost of medical device from the dimensions of expenses and items.The principle of accounting is that directly account the direct logistics,if the cost is not obtained directly,allocation according to the number of workers,working hours and the area①measured by the dimensions of expensesIncluding personnel expenses,public service and operating expenses,materials and easily consumed cost,depreciation of fixed assets,entrusted logistics cost and other special cost.The count of personnel expenses is based on actual working hours and the actual payment of basic wages,allowances,bonuses,benefits and social insurance payment,The public service and operating expenses which include the expenses of the water,post and telecommunications cost,publicity expenses,office cost,printing cost, transportation cost,travel cost,training expenses,hospitality expenses and other cost is assessed according to the number of workers,the count of electric and fuel is based on the area,lease payment is based on the actual rental price of the house,the cost of device depreciation is calculated by the year depreciation rate-12%which is formulated by the Health Bureau.According to the amount percentage of the medical device in the total good which is purchased by the department of the logistics,the direct logistics cost of the medical device is formed.②measured by the dimensions of item.According to the time ratio of workers in every aspect of the logistics,the logistics cost on the dimension of expenses is classified into the cost on the dimension of item in detail.The cost of handling medical device,the personnel cost of medical waste recycling dealing,entrusted logistics cost and other special cost are classified into related projects.Eventually the direct logistics cost of medical devices on the dimension of item is formed-including logistics cost(logistics operation cost,logistics information cost,logistics management cost) and inventory-related cost.(2) ABC classification.The method of Pareto is use in this study,the non-implantable is classified into ABC categories according to the amount of the annual average consumption of medical devices.(3) The Economic Order Quantity(EOQ) model and sensitivity analysis.EOQ model is used to analyze the best order number and the best order quantities of three health materials(electrodes,infusion sets and medical gloves) which are rank in the first to eighth medical materials categories in the amount of inventory quantity and inventory during 2005-2007.The sensitivity of the main parameters of the EOQ model is done with Monte Carlo after the optimal solution in EOQ model obtained.【RESULTS】 The staff of logistics in medical device comes from the department of logistics management and the outsourcing sector.Nine workers coming from the the department of hospital logistics management which is mainly responsible for medical device procurement,inventory and information management services is low educational level, non-professional knowledge of logistics background.The outsourcing staff(about 30 workers) is mainly responsible for the handling medical device in hospital.The standard of logistics management of medical device in hospital has just started, the flow of logistics management in medical device is clear,the electronic information management system is gradually setted up.the A class of non-implantable medical devices in hospital by calculating the amount of the annual average consumption is x-ray tablets,infusion device,20ml-plastic injection,electrodes,medical gloves, 5ml-plastic injection and 2ml-plastic injection,the prior three of the implantable medical devices ranking by the amount of money is implantable cardiac pacemakers, biology fixed total hip and intraocular lens,all of the absolving medical device should be on the focus during the process of logistics management.The main material of the inventory of medical device is medical materials and medical easily-consumed material. If the purchasing strategy of the three main materials(electrodes,infusion sets,medical gloves) is in accordance with the best purchasing order number and the best purchasing bulk which are determined by the EOQ model.The total cost of the purchasing and inventory of every material will respectively reduce 35.14%,7.26%and 21.90%.The parameters which include the best purchasing order number,the best purchasing bulk, the total cost of procurement and inventory have better stability.Implantable medical device is zero-inventory management.Hospital direct logistics cost of medical device calculations showed that the human cost is the major components(about 50%of the whole direct logistics cost of medical device) in the dimension of expense.Pocurement cost is the major components(about 30%of the whole direct logistics cost of medical device) in the dimension of item.However,the hospital's inventory management is relatively weak,simple storage facilities,individual medical devices backlog,the chaos channel flow of goods and people.The lack of the appraisal in logistics management can not fully mobilize the staff of logistics activities of the medical device.In addition, the hospital staff are lack of concerned about the logistics management of medical devices in hospital(15%~ 35%of the workers do not understand the related situation of the logistics of medical device),the overall evaluation is not high(less than 60%in the better or best evaluation). 【RECOMMENDATIONS】Logistics management involves a number of aspects and have an impact on the various deparrment of the hospital.logistics is the third space which is going to develop, the research give a suggest that the hospital will strengthen the logistics management from the following aspect:1.Streamline the procurement process,make scientific decision and strengthen the management of suppliers.2.Manage the inventory scientifically,the combination of zero inventory management and vendor managed inventory.3.Speed up the management of logistics information.Gradually use the bar code technology and modern logistics transmision system.4.Improve the flexibility of the logistics operation.5.Enhance the professionalism of the logistics staff.