Journal (Academy of Hospital Administration (India))最新文献

Background: Almost one third of hospital' annual budget is spent on buying material and supplies including medicines. There is wide variation in cost of these items and effective management of store is necessary to ensure optimal use of money spent.

Objectives: (i) To explore the feasibility of alphabetical analysis (where items are classified into A, B and C categories depending on their annual consumption value) in effective management of a medical store and to compare the present (fixed period re-order) and the proposed (fixed quantity re-order) as alternative inventory management technique.

Methods: Using multistage random sample technique, two sub-categories out of total of 37 listed in stock register (medicine) of a large hospital of Delhi were selected for detailed analysis. Alphabetical (ABC) analysis based on total annual consumption value of different items was done. Six medicines, the first and the last from each of the ABC categories, were also analysed for fixed quantity re-order.

Results: It was observed that ABC analysis, if practised, would allow effective control over two third of the total expenditure by controlling only one fourth of the items. The existing order size (based on fixed period re-order) was more than three times order size if based on fixed quantity re-order.

Conclusions: Alphabetical analysis is a feasible and efficient technique for effective management of store in hospitals. Considerable financial savings is possible if the order size is based on fixed quantity re-order.

Recommendations: The Assistant Store Officer should apply alphabetical analysis for more efficient management of the medical store. The present practice of fixed period re-order should be replace by fixed quantity re-order.

To lessen overcrowding in the regular morning OPD and obtain better patient satisfaction, Evening Pay Clinic in a tertiary care hospital with daily OPD attendance between 1000 and 1200 patients was conceptualised. To elicit patients' response to the proposed system a survey with a structured questionnaire among 202 randomised sample of patients was conducted. Patient preference depended on distance of their home from the hospital as well as availability of suitable transport to reach the pay clinic and the likelihood of their being able to go back by the same evening after their encounter with the hospital was over. The majority of the patients preferred the proposed system as it promised quick and personalised service and the attendance by the doctors of their choice.

Varieties of Biomedical Equipment (BME) are now used for quick diagnosis, flawless surgery and therapeutics etc. Use of a malfunctioning BME could result in faulty diagnosis and wrong treatment and can lead to damaging or even devastating aftermath. Modern Biomedical Equipments inevitably employ highly sophisticated technology and use complex systems and instrumentation for best results. To the best of our knowledge the medical education in India does not impart any knowledge on the theory and design of BME and it is perhaps not possible also. Hence there is need for a permanent mechanism which can maintain and repair the biomedical equipments routinely before use and this can be done only with the help of qualified Clinical Engineers. Thus there is a genuine need for well organized cadre of Clinical Engineers who would be persons with engineering background with specialization in medical instrumentation. These Clinical engineers should be made responsible for the maintenance and proper functioning of BME. Every hospital or group of hospitals in the advanced countries has a clinical engineering unit that takes care of the biomedical equipments and systems in the hospital by undertaking routine and preventive maintenance, regular calibration of equipments and their timely repairs. Clinical engineers should be thus made an essential part of modern health care system and services. Unfortunately such facilities and mechanism do not exist in India. To make BME maintenance efficient and flawless in India, study suggests following measures and remedies: (i) design and development of comprehensive computerized database for BME (ii) cadre of Clinical engineers (iii) online maintenance facility and (iv) farsighted managerial skill to maximize accuracy, functioning and cost effectiveness.