To study Inventory control with respect to ABC, VED and FSN in Hospital

1

Acknowledgements

I take this opportunity as privilege to express my deep sense of gratitude to Dr. Rajendra

Takale, Director Ashoka Institute of Healthcare, Nashik for his continuous

encouragement, invaluable guidance and help for completing the present research work.

He have been a source of inspiration to me and I am indebted to him for initiating me in

the field of research. I am deeply indebted to Prof. Dr. Shilpa Bhalgat, my research guide,

the Ashoka Institute of Healthcare, Nashik without her help completion of the project was

highly impossible.

I take this opportunity as privilege to articulate my deep sense of gratefulness to Dr.

Vijay Saraswat (COO), Mr. Robin Phillip (HR manager), Dr. Mangesh Jadhav

(Marketing Head), Mr. Bharath Reddy (Material manager), Mr. Shiva Reddy, Mr. Tabish

Shaikh and other staff members of the Apollo Hospitals for their timely help and positive

encouragement.

I wish to express a special thanks to all teaching and non-teaching staff members, the

Ashoka Institute of Healthcare, Nashik for their forever support. Their encouragement

and valuable guidance are gratefully acknowledged. I would like to acknowledge all my

family members, relatives and friends for their help and encouragement.

Place: Nashik Dr. Tamboli Hafeez Jamal.

Date:

2

Chapter 1

INTRODUCTION

3

“STUDYING INVENTORY MANAGEMENT WITH RESPECT TO ABC, VED &

FSN ANALYSIS IN MULTISPECIALITY HOSPITAL”

Inventory Management In Multispeciality Hospital

Materials Management

It is concerned with planning, organizing and controlling the flow of materials from their

initial purchase through internal operations to the service point through distribution.

Aim of Material Management

To get,

1. The Right quality

2. Right quantity of supplies

3. At the Right time

4. At the Right place

5. For the Right cost

Basic principles of material management

1. Effective management & supervision

It depends on managerial functions of

Planning

Organizing

Staffing

Directing

Controlling

Reporting

Budgeting

2. Sound purchasing methods

3. Skillful & hard poised negotiations

4. Effective purchase system

5. Should be simple

4

6. Must not increase other costs

7. Simple inventory control program.

Inventory control

It means stocking adequate number and kind of stores, so that the materials are available

whenever required and wherever required. Scientific inventory control results in optimal

balance.

Functions of inventory control

To provide maximum supply service, consistent with maximum efficiency & optimum

investment.

To provide cushion between forecasted & actual demand for a material

Principle of inventory control

The basic principle is to control cost related inventory.

It can be 30% of actual cost of inventory.

Maintain balance between purchase cost and carrying cost of inventory.

Classification of inventory control

Classification of Hospital inventory is based on Pareto’s Law.

Pareto a German economist, states that, “20% of people have got 80% of total

money, while 80% of people have only 20% of money.”

This finding of Pareto is equally applicable to inventory in healthcare.

Types of selective inventory control :

1. ABC

Based on cost criteria, i.e. cost of consumption.

Does not depend upon unit price of an item.

It is also known as Always Better Control (ABC)

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2. VED – Vital, Essential, Desirable.

Based on Importance, criticality, shortage cost of an item in terms of

function& availability.

Commonly used for consumable items.

3. FSN – Fast moving, Slow moving, Non moving.

Based on issuing hospital stock from stores.

Speed of consumption of an item.

4. SDE – Scarce, Difficult, Easy to obtain.

5. SOS – Seasonal, Off seasonal

6. HML – High, Medium, Low, unit price of item.

7. XYZ – Based on value inventory in hospital store.

Scope of Inventory control :

Reduces operational cost of running hospital.

Improves service delivery in patients care.

Increases return on investment.

Improve service conditions.

Increase efficiency of man & machines.

Improve pt satisfaction & goodwill of hospital.

Improve liquidity.

Cost associated with inventory :

1. Item cost

2. Inventory carrying cost

. Capital cost

. Storage cost

6

. Space

.Labor

.Equipment

. Risk cost

.Obsolescence – model change, outdated

.Damage in handling

.Pilferage- lost, misplace, stray, stolen.

3. Ordering cost

4. Stock out costs

5. Capacity associated costs

To reduce Inventory cost;

1. Fixing up maximum limit of inventory in terms of value.

2. Fixing up responsibility of inventory control with senior level person.

3. Meticulous material planning & forecast.

4. Well designed & planned inventory control system.

5. By reducing lead time treat pts in time i.e. within Golden Period.

6. Inventory levels should be adjusted as per change in requirement/consumption.

7. Strict control on obsolete, slow moving, non moving items.

8. Reducing number of stock points.

9. Standardization & variety reduction.

10. Maintain close coordination with other departments.

11. Computerize the inventory control system.

12. Select right source of supply & vendor relationship.

Hospital Supply Chain / Materials Management

Hospital supplies are often seen as a major source of inefficiency and excess cost, and

materials managers are under growing pressure to address these issues. Yet time-

consuming manual processes for hospital supply management create barriers to success.

7

When the bulk of staff time is spent manually checking par levels and tracking usage in

various supply locations, it’s hard to find time to keep the warehouse organized and

optimize inventory levels. Filling last-minute orders from nurses who have run out of an

item also takes time away from more strategic hospital materials management work.

In supply and medication dispensing automation, Hospital supply management systems

that can dramatically streamline your inventory management tasks. With these systems,

not only improve staff efficiency and lower medical supply inventory costs but also

increase revenue through improved charge capture and reimbursement.

Considering that the healthcare delivery is highly dependent on how fast and efficient

care givers are able to attend to patients and provide them with vital drugs and other

associated medical needs, the requirement for short lead times are vital to the realization

of quality health care delivery. This means that hospitals and other firms must put in

significant efforts to reduce lead times.

8

Lead time can be defined variedly depending on the part of firm that is focused on. Lead

time starts right from the onset of receiving an order from a customer to the time when

the customer receives the product or service asked for.

STORE:

Storage

Store must be of adequate space

Materials must be stored in an appropriate place in a correct way

Group wise & alphabetical arrangement help identification & retrieval

First-in, first-out principle to be followed (FIFO)

Monitor expiry date

Follow two bin or double shelf system, to avoid Stock outs

Reserve bin should contain stock that will cover lead time and a small safety stock

Important techniques in inventory control;

ABC ANALYSIS

(ABC = Always Better Control)

This is based on cost criteria.

It helps to exercise selective control when confronted with large number of items

it rationalizes the number of orders, number of items & reduce the inventory.

About 10 % of materials consume 70 % of resources



‘A’ ITEMS

Small in number, but consume large amount of resources

Must have:

Tight control

Rigid estimate of requirements

Strict & closer watch

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Low safety stocks

Managed by top management

‘B’ ITEM

Intermediate,

Must have:

Moderate control

Purchase based on rigid requirements

Reasonably strict watch & control

Moderate safety stocks

Managed by middle level management

‘C’ ITEMS

Larger in number, but consume lesser amount of resources

Must have:

Ordinary control measures

Purchase based on usage estimates

High safety stocks

ABC analysis does not stress on items those are less costly but may be vital

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CUMMULATIVE CUMMULATIVE

COST COST [Rs.]ANNUAL COST ANNUAL COST

[Rs.]ITEMITEM COST %COST %ITEM %ITEM %

70 %70 %

20 %20 %

10 %10 %

10 %10 %

20 %20 %

70 %70 %

ABC

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WORK

SHEET

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VED ANALYSIS

Based on critical value & shortage cost of an item

It is a subjective analysis. Items are classified into:

Vital: Shortage cannot be tolerated.

Essential: Shortage can be tolerated for a short period.

Desirable: Shortage will not adversely affect, but may be using more resources. These

must be strictly Scrutinized

FSN ANALYSIS

Depending upon movement of an items.

Fast

Fast moving items, requires on regular basis.

Slow

Slow moving items, requires intermittently.

Nonmoving

Items required occasionally.

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NEED FOR THE STUDY

Health Industry inventory management is not only required to run Hospital smoothly, but

also to be efficient at the time of saving patient’s life in emergencies.

Inventories are the lifeblood of a business and are essential to running it efficiently and

profitably. When doing Healthcare business, customers or hospital often will not tolerate

product unavailability or delays in delivery. In some cases, a shortage may be only a

small inconvenience (such as shortage of nursing material), while sometimes it may

cause a severe problem (such as interrupting operative procedures or emergency drug

needed in casualty or emergency dept). On some occasions, sporadic shortages can be

expected, but frequent shortages may ultimately erode a Hospital’s reputation and reduce

their market share. There is the danger of the drugs not being utilized before the date of

expiry, of pilferage, of the stock lost some sight and not being utilized, better and cheaper

substitute available.

Inversely, overabundant, slow-moving inventories can place a serious strain on a

Hospital’s available capital and a large stock will also imply a large storing space and

will require a staff to store and handle various items. But the disadvantage is that huge

stock amounts to the locking up of the money which would have been spend more

gainfully in some other ways the company’s ability to take advantage of financial

opportunities.

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Hospital Inventory Management: 4 of the Biggest Challenges

Tracking materials and supplies in any industry can be a challenge. But it’s especially

complicated in health care, where inventory needs constantly fluctuate, inventory must be

closely guarded and detailed tracking is required.

Below are four of the biggest hospital inventory management issues. These issues not

only face hospitals, but other health care facilities as well.

1. Complex Patient Needs

Hospital inventory needs aren’t as cut and dry as, say, a hardware store. It’s rarely one-

size-fits all, and you can’t settle for the closest match. Patient needs are complicated and

very specific. That means hospitals must manage a universe of inventory and keep it

orderly enough to effectively assist each patient.

2. Volatile Demand

Fluctuations in inventory are natural. In a hospital setting, they are even more

pronounced. Contagious illnesses come and go, or any given day could see more of a

need for emergency response. For that reason, hospitals often find themselves facing

unexpected shortages in supplies, or a chaotic situation could prevent them from locating

limited supplies on short notice.

3. Temperature-and Age-sensitive Items

Certain medicines and chemicals have a limited shelf life. Others are prone to damage

during changes in temperature. As a result, medical facilities face the challenge of

protecting sensitive inventory and ensuring items are used in the right order to prevent

expiration. Disorganized facilities can waste a lot of resources if they don’t properly track

inventory.

4. Security

Security has long been an issue with hospital inventories. Drugs and chemicals can be

stolen, or sensitive items can be tampered with. Both issues can pose significant safety

and legal liabilities for a hospital.

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OBJECTIVES OF THE PROJECT

The objectives of the study are:

To study inventory management of the multispeciality corporate hospital

To study different inventory control techniques

To use these techniques for control of consumable inventory

To categorize inventory according to ABC analysis

To categorize inventory according to VED analysis

To study the movement of items in Hospital Inventory stock

To find out solutions for reducing inventory carrying cost

To study and suggest solutions to avoid inconvenience due to unavailability of

inventory in patient care.

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Chapter 2

REVIEW OF LITERATURE

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On the way of preparing project, literature of various authors, project studies of many

students, paper published in various magazines, informational columns by various

Management Gurus were studied.

For production Industry Inventory Management is proved as area of interest for every

Manager. But for Service Industry its use questionable, as product of Service Industry –

service offered to customer is cannot be measured, and its quantity & quality is not same

every time. It is also very difficult to calculate the inventory required for production of

particular service.

Specially in Health Industry inventory management is not only required to run Hospital

smoothly, but also to be efficient at the time of saving patient’s life in emergencies.

Some of literature studied which explain how useful the inventory management for

Hospital Industry. Here it has been included some of the literature that study different

aspect of inventory management that may helpful for managers in Health Industry.

Duangpun Kritchanchai et. al. states that, Single inventory policy has been applied to

entire types of drugs in hospitals, despite several different drug and demand

characteristics. Shortages regularly occur, which may affect patients’ lives.

However, hospitals cannot store a large amount of every drug because of limited space

and budget. The objective of this study was to develop a hospital inventory management

system to minimize the total inventory costs, while maintaining patient safety levels.

The study is concerned only with the medicines that have a high consumption value and

took place in a large public hospital in Thailand. The most suitable policies are proposed

for each drug category with the best performance obtained. The historical demand is

classified by drug characteristics, consumption value and clinical importance, as well as

the demand characteristics.

The study found that a single inventory management system cannot be effectively

applied for all medicines. It is because there are also categories of medicines

characterized by their value and clinical importance. This is called the ABC/VEN

classification. The inventory management in hospitals should be fitted to drug categories

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and demand characteristics, which are quite unique in the healthcare supply chain and are

different from those applied to general manufacturing.

Galarneau et. al. explained using a model of Clinical Events to Determine Supply

Requirements for Marine Corps Shock Surgical Team/Triage (SST) and Acute Care

Ward Units.

Moving toward a concept of medical organization that achieves the objectives of Marine

Corps guidance such as Operation Maneuver from the Sea brings particular challenges

when examining forward medical treatment facilities. These units must be small enough

to perform abbreviated, staged resuscitative procedures in forward areas to accommodate

today's operational requirements for greater mobility. The primary objective of this paper

was to reduce the logistic footprint of the Shock Surgical Team/Triage (SST) and Acute

Care Ward units by developing a model of the far forward medical supply stream that

linked specific clinical requirements to individual medical treatment items. One hundred

twenty five clinical

Subject Matter Experts (smes) with operational experience assisted in the development of

Marine Corps specific treatment profiles for 319 DEPMEDS Patient Conditions (pcs).

Medical consumables and equipment were then assigned to each of the SST and Ward

care tasks identified in the profiles, establishing the clinical requirement for each item. A

patient generating model (PATGEN) was used to determine which pcs would present at

an SST or require Ward care. This information was loaded into the model and used to

generate the medical items required for the SST and Ward care blocks. When compared

to the current Marine Corps SST and Ward care blocks, the proposed amals resulted in

weight reductions of 31.9% and 26.4% for the SST equipment and consumable amals,

respectively and 11.2% and 20.7% for the Ward equipment and consumable amals,

respectively. Similar reductions were also realized in cubic volume. This approach, which

also resulted in an increase in clinical capability, produced an audit trail for each item that

allows medical logisticians to substantially improve the AMAL configurations because

only items that can be Clinically related to a treatment task conducted in theater are

considered for inclusion.

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Specially in healthcare industry where unavailability of some vital drug or equipment

may results in serious losses or death of patient, as a manager we cannot wait to till stock

out to reorder the inventory. Manager has to Replenish the inventory according to use.

Graves et. al., studied SAS Inventory Replenishment Planning uses historical demand

data to determine inventory replenishment policies for single location or two-echelon

distribution systems.

In addition to the demand data, it uses the cost of replenishment, the cost of holding

inventory, the cost of backordering (stock outs), and target service levels to drive the

policy identification. These inventory replenishment policies perform better than the

standard EOQ (economic order quantity) policies that do not account for variation in

customer demand and replenishment order lead times.

Impact of Inventory

In most industries, inventory is the foundation of conducting business. Consider the

manufacturing industry, where it is necessary to coordinate both inventory-producing and

inventory-consuming activities. There are inventories for multiple processing stages at

multiple locations in the course of turning raw materials into components, producing

spare parts, and ultimately creating finished goods.

In the retail industry, companies maintain large volumes of different items at various

locations. They must monitor quantities, estimate usage, and place orders for

replenishment. Slow-moving items are discontinued, while new items are introduced.

In the service industry, inventories are critical in providing the services that customers

require. For instance, where would the hospital industry be without adequate supplies of

surgical instruments and medicines? And how would a major package delivery company

function without an inventory of trucks and spare parts?

Inventories are the lifeblood of a business and are essential to running it efficiently and

profitably. When doing business with a company, customers often will not tolerate

product unavailability or delays in delivery. In some cases, a shortage may be only a

small inconvenience (such as selecting a different video at the rental store), while

sometimes it may cause a severe problem (such as interrupting production-line activity at

18

a computer manufacturer). On some occasions, sporadic shortages can be expected, but

frequent shortages may ultimately erode a company’s reputation and reduce their market

share.

Inversely, overabundant, slow-moving inventories can place a serious strain on a

company’s available capital and the company’s ability to take advantage of financial

opportunities.

Frequent shortages or excessive inventories are telltale signs of a company headed in the

wrong direction. Zipkin (2000) notes that “we have understood for some time, at least in

principle, that sound, careful inventory management is critical to a firm’s strategic

viability.”

The scope of inventory-dependent operations is tremendous. In March 2002, U.S.

businesses alone maintained about $1.117 trillion worth of inventories, or roughly 1.38

times their total monthly sales. Thus, effective management of inventory can have a big

impact on profitability. Recently, much success has come to retailers that focus their

operations on keeping their inventories lean. Less has become more, and intelligent

inventory replenishment planning is a major key toward realizing that goal. In order to

compete effectively in today’s business world, it is imperative that adequate inventories

are maintained efficiently.

Function of Inventory

Zipkin(2000)states that “most of the important functions of inventories can be understood

in terms of the various types of mismatches that arise between supply and demand

processes.” Typically, these processes cannot be matched perfectly—as a result,

inventory acts as the buffer between them to reduce the effect of their incompatibilities.

As expected, conflicts often arise. The most common of these is a shortage — the failure

to meet demand when it occurs. Thus, one primary function of inventory is to prevent or

limit shortages. Consider some of the characteristics of supply and demand processes that

Zipkin (2000) suggests can contribute to this inherent incongruity:

Supply

• economies of scale (production and delivery)

• capacity limits (production and delivery)

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• delays in replenishment (order lead time)

Demand

• steady or intermittent demand

• variations in demand over time (trend, seasonality)

• unpredictable demand variations (random)

Each of these factors can contribute to uncertainty. When dealing with uncertainty, the

traditional objective of inventory control models is to minimize expected costs.

Consider some of the costs associated with most inventory control systems.

Inventory-Related Costs

#replenishment cost (or fixed ordering cost)

– cost of processing orders

– cost is independent of replenishment quantity

# inventory holding cost

– opportunity cost of capital invested in inventory

– warehousing cost

– handling and counting costs

– other costs such as insurance and taxes

# stock out cost

– cost of backordering

– penalty cost for lost sales

When ordering, holding, and stock out costs are all known, SAS Inventory

Replenishment Planning can be used to calculate optimal inventory replenishment

policies. However, estimating stock out costs can be difficult, so a service level

requirement is often substituted. In this case, a heuristic algorithm can be used to

calculate nearly optimal policies, subject to requirements based on a choice of several

different service measures.

Zipkin (2000) states that “the distinction between predictable (deterministic) and

unpredictable (or stochastic) processes is perhaps the single most significant dividing line

between different [inventory] systems.” SAS Inventory Replenishment Planning takes

20

into account this unpredictability (uncertainty) when calculating inventory replenishment

policies for use in inventory management.

Summary of Functionality

SAS Inventory Replenishment Planning provides essential aid to decision making in

inventory management by answering two fundamental questions:

• When should orders be placed to restock inventory?

• How much should be ordered?

The IRP procedure in SAS Inventory Replenishment Planning provides the ability to

transform raw demand transaction data and order lead time estimates into rules for

managing product inventory levels. Using estimates of review-time demand and

replenishment order lead time along with the associated inventory costs for ordering,

holding, and stock outs, the IRP procedure calculates optimal (s, S) or (s,nq) policies.

If the stock out penalty cost is unknown, one of several service measures can be

substituted and the IRP procedure can calculate nearly optimal (s, S) or (s,nq) policies. In

both cases, PROC IRP provides an estimate of service measures for the purpose of

evaluating projected policy performance.

Some time manager may not able to predict exact requirement of different departments of

hospital or unexpected rise in demand in cases like epidemics, emergencies or mass

casualties or disasters etc. There is need of efficient supply chain to manage Emergency

Demand of inventories.

In Journal of Supply Chain Management in September 1993, publish topic,

Hospital Inventory Management for Emergency Demand

Inventory management is receiving increased emphasis in a variety of organizations. One

important area is inventory that is subject to emergency demand situations. A hospital

materials manager, for example, must establish efficient inventory system policies for

normal operating conditions that also ensure the hosp ital's ability to meet emergency

demand conditions.

21

A simulation model of a hospital inventory system was developed to determine the

relative significance of several common inventory system variations on a hospital's

ability to operate successfully under normal and emergency demand conditions. Results

of the simulation reveal that review frequency plays a major role in the success of

operations under shock demand conditions. The simulation also suggests that

generalizing from the results of an inventory system under normal conditions to expected

results under shock conditions is inappropriate. Several common assumptions flowing

from these generalizations were challenged by the results of the study.

This supply chain management results in timely procurement o f inventory. The study by

Agbugbla et. al. explain The Effect of Procurement Lead Time on Healthcare Delivery.

The study has been carried out at the Koforidua Regional Hospital

This has been a study to assess the effect of procurement lead time on healthcare delivery

at the Koforidua Regional Hospital. This study found that the main source of medical

supply at the hospital is the central medical stores of MOH even though the hospital

relies on other sources such as vendors and selected local/foreign manufacturing

companies. It was also found that the number of inventory turns per year at the hospital

was over 10 times and that the average procurement lead time for drugs and laboratory

supplies at the hospital is within four (4) weeks. Also it was found that the factors

affecting average procurement lead time are effective need identification leading to

prompt reordering of medical and laboratory supplies; adequate and timely release of

funds to the procurement unit; adequate knowledge of Ghana’s Procurement Act;

motivating staff and seeking top management support and effective supplier selection. It

was additionally found that the procurement lead time has a positive impact on the

performance of the hospital’s staff as well as the overall performance of the hospital.

Shorter the Lead Time more efficient the supplier chain. Managers in order to reduce lead

time incorporate different tools. The article published in Journal for Healthcare Quality

32(1):59-66 · January 2010 on topic Lead-Time Reduction Utilizing Lean Tools Applied

to Healthcare: The Inpatient Pharmacy at a Local Hospital goes on to explain…

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The healthcare arena, much like the manufacturing industry, benefits from many aspects

of the Toyota lean principles. Lean thinking contributes to reducing or eliminating non

value-added time, money, and energy in healthcare. In this paper, we apply selected

principles of lean management aiming at reducing the wasted time associated with drug

dispensing at an inpatient pharmacy at a local hospital. Thorough investigation of the

drug dispensing process revealed unnecessary complexities that contribute to delays in

delivering medications to patients. We utilize DMAIC (Define, Measure, Analyze,

Improve, Control) and 5S (Sort, Set- in-order, Shine, Standardize, Sustain) principles to

identify and reduce wastes that contribute to increasing the lead-time in healthcare

operations at the Pharmacy understudy. The results obtained from the study revealed

potential savings of > 45% in the drug dispensing cycle time.

There is another project carried out in Nairobi, Kenya by Gabriel P. Tarty

This study establishes the factors that influence lead time and the impact logistics

management have on lead time in public healthcare in Nairobi, Kenya. The researcher

makes use of questionnaires to collect the primary data. The questionnaires consisted of

two parts. The first part contained bio data of the respondent and the second part

contained questions on the objectives of the study. Closed ended questions were used to

collect the data. The questionnaire was administered through drop and pick later method.

The respondents mainly constituted procurement officers and in some cases

administrators who implemented procurement functions.

The data was analyzed by the use of factor, regression and descriptive statistics.

The analysis indicated that logistics management is influence by 10 factors that impact on

lead time among healthcare facilities in Nairobi. They included: Equipment failures; poor

warehouse management; poor flow of information; poor order shipping, poor order

listing; poor order sorting; ordering costs; bureaucracy in government; order packaging

challenges and poor warehouse planning.

The analysis also revealed that the regression results indicated that the independent

variables;

Demand variability, ordering costs, shortage costs, Changes in holding costs and

Utilization rate explain 64.9% of the variance in lead time changes. This is an indication

23

that 38.1% of the variance is explained by other variables outside the ones mentioned

above.

The coefficient for xl is 0.456 which have moderate direct relationship between demand

variability and lead time. The coefficient for ordering costs is 0.671 which is a strong

direct relationship hence very significant. The coefficient for shortage costs is -0.500

which is a moderate inverse relationship between lead time and shortage costs. It

significance tend towards zero thus a sign that it is very important. Changes in holding

costs have a strong inverse relationship of -0.697 and a significance of zero which is an

indication of very high significance. Utilization rate has a weak direct relationship and a

significance value of 0.26 which is a weak factor.

The factors and Variables which show strong relationships to demand variability and lead

time can be taken seriously in reducing lead time in public healthcare. Healthcare

providers in Nairobi, Kenya can place more emphasis in these areas so that patients and

others medical facilities users can be served effectively and efficiently.

Mr. Jinglin Li in his thesis studied JIT innovations and sates that;

Reducing costs and improving quality are two of the most important goals in managing

healthcare operations. In this study, we explore how to improve healthcare operations by

integrating Just- in-Time (JIT) management system. He first introduce the JIT

management system, and then discuss how it can generate benefits in healthcare

operations. We investigate implications for healthcare practice, which include how JIT

techniques can be applied to healthcare operations, how hospitals and general practices

can use JIT techniques, how JIT can help the patient throughput rate, and how

technological advances can speed up healthcare processes. Implications for management

and directions for future research are discussed.

Holter Monitoring Systems:

The Holter Monitoring System is a small device that features Software that is designed to

be easy to use and informative without being invasive. It uses a recorder to detect

abnormalities in a patient’s heart rhythm over a long period of time. They are

comfortable for the patient to wear, and lightweight and compact.

24

Stylet for Endotracheal Intubation:

The new Glide Scope is a reusable stylet that allows for easy intubations in surgeries and

the ER. Since it is made from stainless steel, it can be cleaned and sterilized just as other

surgical instruments. This decreases the inventory of stylets that are needed in a hospital.

It also is rigid and shaped to the trachea, allowing for doctors to not waste time manually

shaping a stylet.

Asset Tracking System:

The Homer asset tracking system is a new technological system with a single, mobile

antenna that uses radio frequency identification to locate and recover hospital equipment.

This device does not need a large space for major infrastructure, and can be seamlessly

integrated with minimal installation.

Pneumatic Patient Positioners:

These positioners help hospitals and surgery centers to save time and resources. It is

designed to be placed under the patient and inflated in order to help support some of the

weight of the patient so that they can be slid from the hospital bed onto the surgical table.

OR Integration System:

An Integrated system that manages electronic images and patient data during surgery. It

offers a live transmission of images and video recording.

This allows security for both the patient and the doctor. This system can also help to see

bottlenecks and inefficiencies in the system.

Portable Vital Signs Monitor:

Portable monitors check patient’s vital signs and help to decrease the amount of

inventory required. Due to this monitor, health care organizations no longer needs to have

large, very expensive machines, which are moved from room to room. The new

technology has brought portability and efficiency to the healthcare facilities.

25

Inventory Management System Uses radio frequency identification and networking:

Technologies to track medical inventory. This allows for a much smaller inventory

Because it allows no stealing or loss of product. Each and every unit that is purchased

can be accounted for. This allows for better managing expiration dates on time sensitive

products. Everything is online for the key decision makers to account for.

He conclude that ,While countless academic research focused on JIT in manufacturing

firms are being revealed, we hardly see JIT management research in service sector,

especially in Healthcare operations. Through our study and research in JIT management

in healthcare Operations, we analyze the similarities and differences between

manufacturing sector and Service sector, then we conclude that JIT management is an

appropriate access to improve Healthcare operations, in particular, in effective inventory

management and supply chain management area. As a result, we can ultimately increase

the patient throughput rate. In addition, abundant evidences about current technologies

and leading firms in which implemented JIT management are provided in our research

paper. With the rapid development of technologies, we believe that more and more

hospitals or general practices will apply JIT management to their healthcare operations.

Hospital Inventory Management and How It Works RFID:

Materials Managers are now gradually shifting to a more automatic inventory

management methods, and shying away from manual countings.

. Hospitals and medical institutions are facing great challenges and pressures in terms of

maintaining medical supplies and devices. Previous systems are prone to mistakes and

errors and it is hard to track who got the medical stocks, which and when.

There is always that particular dilemma in terms of regulating the supplies that come in

and out of a stock room.

Hospital inventory management can actually be done conveniently by using methods

such as RFID and stock box for an easy access and inventory control – in real-time.

The hospital inventory lean management provides a dependent and inexpensive approach

to control and track every supply and need by medical doctors, nurses and sta ff as well.

Efficiency is maximized, therefore, time and effort are channeled to other tasks.

26

Having an accurate inventory means immediate pulling out of recalled and expired

products; reduction of waste, minimize back stocks and deciding quickly when to

replenish and order bulk supplies.

Hospital inventory management also eliminates time waste and inaccuracies of manual

methods. It can also monitor temperatures 24 hours remotely. Patients are taken care of

better as nurses have more time to spend with them, not with inventory. In addition, the

use of RFID, Stock box and smart cabinets can lead to a more precise, organized and up-

to-date control of inventories. Indeed, the benefits and advantages of this type of

inventory can greatly help material managers for an effective account of relevant supplies

and materials possible.

Therefore, if you are in-charge of inventory management in a particular hospital,

retirement home, or any other medical establishments, you will understand how

significant it is to maintain a precise, perfect and effective technique. The tiniest hitch or

mistake can immediately put things in a mess and this should not happen especially when

the patients are dependent on the medical stocks that your facilities holds. Hence, for this

very reason, an upgrade of your hospital inventory management system can be the best

option to make.

An accurate, simple and convenient to use inventory system is a serious consideration of

any hospital and similar facilities. There will always be a need to track usage and

replenishments from the smaller items such as syringes, masks, gloves and cotton which

are extremely significant. Now, if you are using that type of monitoring which is difficult

and complicated to use, and in some instances very inaccurate, then it is high time for you

to upgrade and try a new innovative inventory procedure.

The hospital inventory management system is the only solution if you want to streamline

a certain inventory procedure which your facilities need. It may be in a laboratory,

surgery room, emergency room or any other possible areas, you will only be requiring a

simple and efficient inventory system. Opt for the one that can really work for you and

see what it can possibly do to your facilities. You will never go wrong using this type of

inventory control.

27

Richard H. Epstein et. al, studied Operating room (OR) scheduling information systems

can decrease perioperative labor costs. Material management information systems can

decrease perioperative inventory costs. We used computer simulation to investigate

whether using the OR schedule to trigger purchasing of perioperative supplies is likely to

further decrease perioperative inventory costs, as compared with using sophisticated,

stand-alone material management inventory control. Although we designed the

simulations to favor financially linking the information systems, we found that this

strategy would be expected to decrease inventory costs substantively only for items of

high price ($1000 each) and volume (.1000 used each year). Because expensive items

typically have different models and sizes, each of which is used by a hospital less often

than this, for almost all items there will be no benefit to making daily adjustments to the

order volume based on booked cases. They conclude that, in a hospital with a

sophisticated material management information system, OR managers will probably

achieve greater cost reductions from focusing on negotiating less expensive purchase

prices for items than on trying to link the OR information system with the hospital’s

material management information system to achieve just-in-time inventory control.

In study of Inventory Management in Multispeciality Hospital I firstly go through ABC

and VED Analysis of the Pharmacy Store of a Tertiary Care Teaching, Research and

Referral Healthcare Institute of India, by M. Devnani& A. K. Gupta.

(Department of Hospital Administration and Pharmacy, Post Graduate Institute of

Médical Education and Research (PGIMER), Chandigarh, India)

The ABC and VED (vital, essential, desirable) analysis of the pharmacy store of Post

Graduate Institute of Médical Education and Research (PGIMER), Chandigarh, India,

was conducted to identify the categories of items needing stringent management control.

The annual consumption and expenditure incurred on each item of pharmacy for the year

2007-08 was analyzed and inventory control techniques, i.e. ABC, VED and ABC-VED

matrix analysis, were applied. The drug formulary of the pharmacy consisted of 421

items. The total annual drug expenditure (ADE) on items issued in 2007-08 was Rs.

40,012,612. ABC analysis revealed 13.78%, 21.85% and 64.37% items as A, B and C

28

category items, respectively, accounting for 69.97%, 19.95% and 10.08% of ADE of the

pharmacy. VED analysis showed 12.11%, 59.38% and 28.51% items as V, E, and D

category items, respectively, accounting for 17.14%, 72.38% and 10.48% of ADE of the

pharmacy. On ABC-VED matrix analysis, 22.09%, 54.63% and 23.28% items were

found to be category I, II and III items, respectively, accounting for 74.21%, 22.23% and

3.56% of ADE of the pharmacy. The ABC and VED techniques need to be adopted as a

routine practice for optimal use of resources and elimination of out-of-stock situations in

the hospital pharmacy.

29

Chapter 3

ORGANIZATION’S PROFILE

30

Apollo Hospitals is Asia's largest and most trusted healthcare group and its presence

includes 9,215 beds across 64 Hospitals, 2,200 Pharmacies, over 90 Primary Care and

Diagnostic Clinics, 110 plus Telemedicine Centers and 80 plus Apollo Munich Insurance

branches panning the length and breadth of the Country. As an integrated healthcare

service provider with Health Insurance services, Global Projects Consultancy capability,

12 plus medical education centers and a Research Foundation with a focus on global

Clinical Trials, epidemiological studies, stem cell & genetic research, Apollo Hospitals

has been at the forefront of new medical breakthroughs with the most recent investment

being that of commissioning the first Proton Therapy Center across Asia, Africa and

Australia in Chennai, India.

Focus on clinical excellence has led to 8 JCI Accreditations and 11 NABH

Accreditations.

Centers of Excellence

Busiest solid organ transplant program in the world since 2012

Best surgical team of the year awarded by BMU for robotic surgery in India

First ever reported surgical separation of pygopagus twin boys

Heart transplant in a 65 year-old patient

Joint replacement surgeries on patients aged over 100 years

It was in 1983, that Dr. Prathap C. Reddy made a pioneering endeavour by launching

India's first corporate hospital - Apollo Hospitals in Chennai. Now, as Asia's foremost

and trusted integrated healthcare services provider, the group's presence includes

Hospitals, Pharmacies, Primary Care & Diagnostic Clinics and Telemedicine units across

10 countries, Health Insurance Services, Global Projects Consultancy, Colleges of

Nursing and Hospital Management and a Research Foundation with focus on Global

Clinical Trials, epidemiological studies, stem cell & genetic research. Today, Apollo

Hospitals are consistently ranked amongst the best hospitals globally for advanced

medical services and it has touched the lives of over 45 million patients, from 121

countries.

https://www.apollohospitals.com/procedures/proton-treatment-centre/proton-treatment-centre

https://www.apollohospitals.com/departments/robotics-surgery/about-robotic-surgery?utm_source=apolloexcellencepage&utm_campaign=apollo-connect-newsletter&utm_medium=desktop

https://www.apollohospitals.com/departments/transplantation/organ-specific-transplant-care/heart?utm_source=apolloexcellencepage&utm_campaign=apollo-connect-newsletter&utm_medium=desktop

https://www.apollohospitals.com/

https://www.apollohospitals.com/

31

Over the past three decades, Apollo Hospitals' transformative journey has forged a legacy

of excellence in Indian healthcare. One of Apollo's significant contributions has been the

adoption of clinical excellence as an industry standard. Alongside, its ethos rests on the

pillars of technological superiority, a warm patient - centric approach, affordable costs

and an edge in forward-looking research and academics.

Apollo Hospitals was the first to invest in the pre-requisites that led to international

Quality accreditation like the Joint Commission International and Indraprastha Apollo

Hospitals was the first hospital in India to be accredited with this gold standard in 2006.

An early adopter of technology, Apollo Hospitals was one among the first few in the

world to leverage technology to build integrated healthcare delivery models, which

facilitate seamless healthcare delivery through electronic medical records, hospital

information systems and telemedicine-based outreach initiatives. Another critical

manifestation of widespread technology has been the amazing advancement in medical

equipment and Apollo has repeatedly pioneered the introduction of such innovations in

India. Soon the country will have its very first Proton Beam Therapy centre at Apollo

Cancer Hospitals.

Tender Loving Care (TLC) was at the core of Apollo Hospitals' model of care and it

continues to be the magic that inspires hope, warmth and a sense of ease in the patients.

Processes are relentlessly improved upon to ensure maximum patient-centricity.

Apollo Hospitals has taken the spirit of leadership well beyond business metrics. It has

embraced the onus of keeping India, healthy. Taking cognizance of the undeniable fact

that India is reeling under the onslaught of Non Communicable Diseases (NCDs), Apollo

Hospitals has assumed the responsibility to educate and influence mind set of the people

of India. Increased focus on tactical initiatives like personalized preventive healthcare

bears testimony to this new thrust. On January 1, 2015, Apollo Hospitals declared war on

NCDs, and is leading the entire healthcare fraternity into this battle. The Billion Hearts

Beating Foundation was envisioned by Dr. Reddy to keep India heart healthy and over

half a million people have taken a pledge on www.billionheartsbeting.com

Apollo Hospitals has always strongly believed in social initiatives that help transcend

barriers. In keeping with this, the group has started several impactful programs.

https://www.apollohospitals.com/procedures/proton-treatment-centre/what-is-proton-therapy

32

SACHi (Save a Child's Heart Initiative) - a community service initiative was introduced

with the aim of providing quality paediatric cardiac care to children from underprivileged

sections of society suffering from heart diseases. Apollo also runs the SAHI (Society to

Aid the Hearing Impaired) and the CURE Foundation, focused on cancer screening, cure

and rehabilitation for those from a financially challenged background.

Apollo Hospitals, Nashik

Apollo Hospitals, Nashik, is a NABH Accreditated Hospital, 118 bedded unit situated on

a scenic campus. It has more than 20 speciality with some of the best Doctors in Nashik.

Apollo Hospitals, Nashik is spread across 1,25,000 Sq. Ft of land near Panchavati, a holy

place near Nashik. Apollo's mission of bringing healthcare of international standards

within the reach of every individual has inspired the group to start this facility at Nashik.

https://www.apollohospitals.com/departments/personalised-health-check/packages/cancer-screening-packages

33

Highlights:

A Multi-disciplinary Intensive Care Unit which has successfully treated more than 100

Neurology patients in the initial month of the launch.

Emergency & Trauma Care: Round-the-clock facility to manage any medical emergency

with an ambulance designed as a mobile ICU, supported with an emergency call no 1066.

Contact

Apollo Hospitals, Swaminarayan Nagar, Near Lunge Mangal Karyalaya, New Adgaon

Naka, Panchavati, Nashik – 422003. Maharashtra

+91-253 2510 250 / 350 / 450 / 550 / 750

Emergency Contact: -1066+91-253 2510350

VISION

Apollo’s Vision for the next phase of development is to “touch a billion lives”

MISSION

“Our Mission is to bring healthcare of international standards within the reach of

every individual. We are committed to the achievement and maintenance of

excellence in education, research and healthcare for the benefit of humanity.”

https://www.apollohospitals.com/departments/icu

https://www.apollohospitals.com/departments/emergency-trauma-care-services

34

Chapter 4

RESEARCH DESIGN

&

METHODOLOGY

35

Nature of Data

In accordance with the above objective primary data were collected from the Hospital

during winter internship training.

Primary data were collected by:

Demand History and movement of inventory.

Day to day interaction with store executive

Day to day interaction with store in charge

Day to day interaction with Store keeper.

Day to day observation and tracking inventory.

Secondary data were collected from the hospital and others journals and books

related to the topic referred.

Standard operating procedures (SOP’s)

Purchase Dept. Manual

Hospital Purchase Database

Purchase policy and vendor policy

Sample Size

A sample size of 150 items from OT store were randomly selected for study purpose

Method for Data collection

Observation of movement of items at OT store and retraction of data from purchase dept.

system.

Day to day evaluation of consumption.

Research Design:

The study is a about categorization of items according to its consumption and valuation,

it’s importance and functions and its turnover on biannually basis.

It is a Qualitative and quantitative research.

36

Qualitative Research is primarily exploratory research. It is used to gain an understanding

of underlying reasons, opinions, and motivations. It provides insights into the problem or

helps to develop ideas or hypotheses for potential quantitative research. Qualitative

Research is also used to uncover trends in thought and opinions, and dive deeper into the

problem. Qualitative data collection methods vary using unstructured or semi-structured

techniques. Some common methods include focus groups (group discussions), individual

interviews, and participation/observations. The sample size is typically small, and

respondents are selected to fulfill a given quota.

Quantitative Research is used to quantify the problem by way of generating numerical

data or data that can be transformed into useable statistics. It is used to quantify attitudes,

opinions, behaviors, and other defined variables – and generalize results from a larger

sample population. Quantitative Research uses measurable data to formulate facts and

uncover patterns in research. Quantitative data collection methods are much more

structured than Qualitative data collection methods. Quantitative data collection methods

include various forms of surveys– online surveys, paper surveys, mobile surveys and

kiosk surveys, face-to-face interviews, telephone interviews, longitudinal studies, website

interceptors, online polls, and systematic observations.

https://www.snapsurveys.com/online-surveys/

https://www.snapsurveys.com/paper-surveys/

https://www.snapsurveys.com/mobile-surveys/

https://www.snapsurveys.com/mobile-surveys/

https://www.snapsurveys.com/phone-surveys/

37

Limitations of study

Following are the Limitations of the Study

The Study is focused on OT Store only.

The Study period is two months only.

The Study is limited to observation method and interaction with hospital staff

only.

Due to company privacy policy it was not possible to gather all the information.

As trainee, not eligible to get detail information.

38

Chapter 5

DATA PRESENTATION

AND

ANALYSIS

39

40

ORGANOGRAM of PURCHASE DEPARTMENT

C

E

O

Asst. Manager - Materials

Junior Supervisor

Assistants

Helpers

41

Co ordination with other Department

42

↓

↓

Send the information along with the

date of delivery to purchase

department. Notice send to vendor for approving for

specifications

STO P

43

Selected items were categorized as ABC, and sorted by consultation with Organisational

guide

A Category _ Top 10 % of items that Contributes to the maximum value of

overall inventory.

B Category _ 20 % of items that constitute 20 % value of total Inventory.

C Category _ Remaining 70 % of items constituted 10 % of total value of

Inventory

ABC Categorization

Following are the list of “A” Category Items

Sr.

No. Item Name

UNIT

Price in

Rupees

OPE

NING

QTY

QOH

RCVD

QTY

Total

Stock

Qty

Value

of Stock

Cat

ego

ry

1 0.6 MM 2 HOLE GAP

PLATE 531.72 0.00 1.00 1.00

531.72 A

2 ACRYS OF IQ, 6000 0.00 1.00 1.00 6000 A

3 ARTERIAL FILTER WITH

LOOP 2768.22 1.00 0.00 1.00

2768.2 A

4 CANNULATED

CANCELLOUS SCREW 466.40 0.00 1.00 1.00

466.4 A

5 CANTATA

MICROCATHETER 14476.35 0.00 1.00 1.00

14476 A

6 CERVICAL PLATE 4861.44 0.00 1.00 1.00 4861.4 A

7 DIAGNOSTIC CATHETER 1568.80 1.00 0.00 1.00 1568.8 A

8 DISTAL FEMUR LOCKED

PLATE 8978.20 0.00 1.00 1.00

8978.2 A

9 EMBOLECTOMY

CATHETER FOGARTY 1581.45 1.00 0.00 1.00

1581.5 A

10 ENDO BRONCHIAL TUBE 3281.96 1.00 0.00 1.00 3282 A

11 ESTERLUS 2-0 2284.61 1.00 0.00 1.00 2284.6 A

12 NASAL BILIARY

DRAINAGE SET 6659.10 1.00 0.00 1.00

6659.1 A

13 PERITONEAL DIALYSIS

CATHETER KIT 5200.00 0.00 1.00 1.00

5200 A

14 A O TYPE CLAMP

DOUBLE PIN 742 0.00 2.00 2.00

1484 A

15 BLOOD TUBING - SINGLE

PRE PUMP 121.5 0.00 2.00 2.00

243 A

16 CABG KIT, CAT 2641.73 0.00 2.00 2.00 5283.5 A

17 CERVICAL PEEK CAGE 9836.8 0.00 2.00 2.00 19674 A

18 CERVICAL SPINE

LOCKING PLATE 1704.48 0.00 2.00 2.00

3409 A

19 CUSTOM TBING PACK, 2894.25 0.00 2.00 2.00 5788.5 A

20 E.T TUBE 3.0 UNCUF 76.28 2.00 0.00 2.00 152.56 A

44

21 ENDEAVOR RESOLUTE

STENT 90000 0.00 2.00 2.00

180000 A

22 HEART VALVE

PERIMOUNT 185203.20 0.00 2.00 2.00

370406 A

23 LUMBER PERRI.SHUNT 2805.35 1.00 1.00 2.00 5610.7 A

24 PROLENE MESH, 2211.10 0.00 2.00 2.00 4422.2 A

25 SENSTRACT LARGE VAC

GRANUFOAM DRESSING 9724.00 0.00 2.00 2.00

19448 A

26 VP SHUNT LOW

PRESSURE 2671.28 1.00 1.00 2.00

5342.6 A

27 5MM WEDGE ANCHOR II

WITH NO.2 FORCE FIBER 9158.4 0.00 3.00 3.00

27475 A

28 DENALI FEMORAL VENA

CAVA FILTER 48760.00 0.00 3.00 3.00

146280 A

29 DISPOSABLE TWO-PART

TROCAR NEEDLE 18G 465.25 0.00 3.00 3.00

1395.8 A

30 DISSECTING TOLLS F2 4331.16 3.00 0.00 3.00 12993 A

31 GEENEN PANCREATIC

STENT, 5FR 1473.84 3.00 0.00 3.00

4421.5 A

32 GUIDING CATH H1 5F 8904.00 1.00 2.00 3.00 26712 A

33 MALECOT

NEPHROSTOMY SET 14F 2849.28 1.00 2.00 3.00

8547.8 A

34 SOF-FLEX PEDIATRIC

DOUBLE PIGTAIL

URETERAL STENT

5465.36 0.00 3.00 3.00

16396 A

35 AFFINITY ARTERIAL

FILTER 3178.00 4.00 0.00 4.00

12712 A

36 BILARY PERC DRAIN

STENT 10FR 786.38 3.00 1.00 4.00

3145.5 A

37 BLOWER MISTER KIT 3291.50 0.00 4.00 4.00 13166 A

38 CANCELLOUS LOCKING

SCREW 699.6 0.00 4.00 4.00

2798.4 A

39 CSF FLOW CONTROL

SHUNT 15369.75 4.00 0.00 4.00

61479 A

40 DOUBLE J STENT 5FR 623.60 0.00 4.00 4.00 2494.4 A

41 HIP U DRAPE D-501 945.69 2.00 2.00 4.00 3782.8 A

42 LAUREATE CASSETS 0.00 2.00 2.00 4.00 0 A

43 BILATERIAL KNEE O

DRAPE 1153.28 2.00 3.00 5.00

5766.4 A

44 CANISTER WITH GEL 2571.25 0.00 5.00 5.00 12856 A

45 DERMARK SURGICAL

SKIN MARKER 66.10 0.00 5.00 5.00

330.5 A

46 PACEMAKER LEAD WITH

MRI 16430.00 0.00 5.00 5.00

82150 A

47 UNIVERSAL SOFT

URETERAL STENT AND

POSITIONER SET

968.84 0.00 5.00 5.00

4844.2 A

48 VANGUARD PS TIBIAL

BEARING 12720.00 0.00 5.00 5.00

63600 A

49 B.B SILK 2 R826 ETHICON 312.02 0.00 6.00 6.00 1872.1 A

50 CARDIOPLEGIA

DELIVERY SYSTEM

VISION/ON-LINE

3360.00 1.00 5.00 6.00

20160 A

51 DURAFLOW DUAL 2089.53 1.00 5.00 6.00 12537 A

45

LUMEN CATHETER

52 KNEE O DRAPE D-505 872.89 2.00 4.00 6.00 5237.3 A

53 MAHURKAR MAXID DL

CATH KIT 36C 8505.00 2.00 4.00 6.00

51030 A

54 G-PATCH LARGE, GP02 1187.88 2.00 5.00 7.00 8315.2 A

55 HEMOCER POWDER 2GMS 3816.00 4.00 3.00 7.00 26712 A

56 HIV KIT – AMKAY 164.30 0.00 7.00 7.00 1150.1 A

57 PRISMAFLEX M100 9647.50 3.00 5.00 8.00 77180 A

58 COMBIND SPINAL/

EPIDURAL MINIPAK 16G

WITH LOCK

1245.55 4.00 5.00 9.00

11210 A

59 CUSTOMPACK NON-

CORONARY MEMBRANE 2415.00 4.00 5.00 9.00

21735 A

60 DISPOSALE INJECTOR &

CARTRIDGE FOR OPTHOL 250.00 9.00 0.00 9.00

2250 A

61 GUIDE WIRE 0.035X150CM

STRAIGHT TERUMO 732.90 9.00 0.00 9.00

6596.1 A

62 PROLENE 1 NW896

ETHICON 208.21 9.00 0.00 9.00

1873.9 A

63 BMW GUIDE WIRE 0.014

X 190 J TIP 4240 4.00 6.00 10.00

42400 A

64 VICRYL 3-0 NW2472

ETHICON 221.50 10.00 0.00 10.00

2215 A

65 BACTERIAL AND VIRAL

FILTERS PEDIATRIC

STARMED

129.68 10.00 1.00 11.00

1426.5 A

66 BONE CEMENT 40G

SIMPLEX 1850.00 1.00 10.00 11.00

20350 A

67 GENERAL SURGERY

PACK - MEDISPHERE 879.90 5.00 6.00 11.00

9678.9 A

68 BARD -MC1816 BIOPSY

GUN 1696.00 3.00 9.00 12.00

20352 A

69 CATHETER DIAGNOSTIC

5F JR3.5 CORDIS 991.1 0.00 12.00 12.00

11893 A

70 LOTUS ESTERLUS 2-0 2769.90 12.00 0.00 12.00 33239 A

71 EYE SHIELDS 3.94 13.00 0.00 13.00 51.22 A

72 DISPOSABLE GOWN

REINFORCED,3M 159.00 4.00 10.00 14.00

2226 A

73 DUAL LUMEN CATHETER

11.5FR/19.5CM STRAIGHT 1460.15 1.00 14.00 15.00

21902 A

74 O-SCOPE DRAPE ECO

LARGE 318.59 0.00 15.00 15.00

4778.9 A

75 SURGICEL 2"X3"

FIBRILLAR 1953 ETHICON 676.20 4.00 12.00 16.00

10819 A

76 TRANSRADIAL SHEATH

6F 879.80 0.00 16.00 16.00

14077 A

77 ETHIBOND 5-0 W4846

ETHICON 695.72 5.00 12.00 17.00

11827 A

78 IO DRAPE LARGE, 126.14 0.00 18.00 18.00 2270.5 A

79 ABDOMINAL DRAINAGE

KIT 28FG 87.72 2.00 17.00 19.00

1666.7 A

80 EYE DRAPE 27.30 19.00 0.00 19.00 518.7 A

81 TIG RADIAL CATHETER

5F 1029.26 4.00 15.00 19.00

19556 A

46

82 NEBULIZER MASK ADULT

VINJO 47.41 0.00 20.00 20.00

948.2 A

83 HERNIA KIT ETHICON 1352.24 2.00 20.00 22.00 29749 A

84 Y CONNECTOR KIT 787.50 6.00 21.00 27.00 21263 A

85 DARK GOGGLES (BLACK) 27.24 2.00 26.00 28.00 762.72 A

86 CLING DRAPE CD 32.44 12.00 20.00 32.00 1038.1 A

87 TRUSILK 2.0 19.96 0.00 36.00 36.00 718.56 A

88 MERSILK 2-0 59.73 12.00 25.00 37.00 2210 A

89 SURGICEL FIBRILLAR

1"X2" 1458.56 10.00 30.00 40.00

58342 A

90 TERUMO GUIDE WIRE "J"

TIP 739.88 3.00 38.00 41.00

30335 A

91 OPSITE INCISE 30CM 140.98 12.00 30.00 42.00 5921.2 A

92 SWAN-GANZ CATHETER

7F 5512.00 9.00 35.00 44.00

242528 A

93 TRUSYNTH 2.0 121.28 0.00 48.00 48.00 5821.4 A

94 MICRO SURGICAL

KNIVES CRECENT 42.00 49.00 0.00 49.00

2058 A

95 DRAPES D904

SURGIWEAR 124.70 10.00 42.00 52.00

6484.4 A

96 VISIPAQUE 320MG 50 ML 772.74 15.00 40.00 55.00 42501 A

97 EARTHING PAD 312.13 19.00 40.00 59.00 18416 A

98 OMNISCAN 0.5MMOL

10ML 833.16 10.00 50.00 60.00

49990 A

99 PROLUS 8-0 PL2086F

LOTUS 327.73 37.00 24.00 61.00

19992 A

100 TRIPLE LUMEN

CATHETER 12FR 1762.25 0.00 63.00 63.00

111022 A

101 EPIDURAL CATHETER

MINIPACK-I 16G 525.23 4.00 60.00 64.00

33615 A

102 STELUS 6-0 LS649 LOTUS 585.48 10.00 60.00 70.00 40984 A

103 TRUWAX STERILISED

BONEWAX 2.5G 39.92 0.00 72.00 72.00

2874.2 A

104 3M -6640 DRAPE IOBAN 305.17 12.00 61.00 73.00 22277 A

105 CONNECTOR 1/4 X 1/4

WITH LUER LOCK 29.25 74.00 0.00 74.00

2164.5 A

106 MONOLUS 3-0

LNW3326(M) LOTUS 143.26 16.00 60.00 76.00

10888 A

107 DOUBLE J STENT BIORAD 256.52 66.00 12.00 78.00 20009 A

108 MONOCRYL PLUS 3-0

MCP3326, ETHICON 290.04 21.00 60.00 81.00

23493 A

109 RADIAL PUNCTURE

NEEDLE 20G 76.32 33.00 50.00 83.00

6334.6 A

110 INPUT SHEATH 5F 11CM

38INCH 612.68 14.00 70.00 84.00

51465 A

111 DIATHERMY ESU

DISPOSABLE PENCIL 157.50 41.00 50.00 91.00

14333 A

112 ABGEL (GELOSTAT)

ABSORBABLE GELATINE

SPONGE

70.74 0.00 100.00

100.00

7074 A

113 DISCOFIX 3WAY STOP

COCK PLAIN 14.44 0.00 100.00 100.00

1444 A

114 MICROSCOPE COVER 5

HOLE SP 1033 CLASSIC 78.55 0.00

100.00 100.00

7855 A

47

115 CRAPE-BANDAGE

4"DR.CHOICE 57.24 54.00 52.00 106.00

6067.4 A

“A” Category Items;

Percentage of volume of “A” items= (Volume of A category items ÷ Volume of total

inventory) × 100

= (2567 ÷ 25058) × 100

= 10.244 %

Percentage of value of “A” items = (Value of A category items ÷ Value of total

inventory) × 100

= (2573351.84 ÷ 3766940.7) × 100

= 68.31 %

Following are the list of “B” Category Items

Sr.

No. Item Name

UNIT

Price in

Rupees

OPEN

ING

QTY

QOH

RCVD

QTY

Total

Stock

Qty

Value of

Stock

Categ

ory

1 CHEST DRAINAGE

CATHETER FLEXO CATH 126.14 11.00 100.00 111.00

14001.54 B

2 ROMOVAC SET 12

ROMSON 147.34 4.00 110.00 114.00

16796.76 B

3 INTRODUCER NEEDLES

BIOROD 18G 7CM 44.52 16.00 102.00 118.00

5253.36 B

4 EDWARDS SINGLE LINE

PRESSURE MONITORING

KIT

689.00 11.00 112.00 123.00

84747 B

5 SKIN STAPLERS ETHICON 475.23 17.00 115.00 132.00

62730.36 B

6 PRISMASOL 5 LTR 1272.00 57.00 80.00 137.00

174264 B

7 JELCO NEEDLE 20G 25.97 49.00 91.00 140.00

3635.8 B

8 SOLUS 1-0 150.37 21.00 120.00 141.00

21202.17 B

9 VENTILATOR CIRCUT

(ADULT) LIFETRACK 131.25 13.00 132.00 145.00

19031.25 B

10 C-ARM COVER

MEDISPHERE 52.24 47.00 100.00 147.00

7679.28 B

11 LIGACLIPS LT200

ETHICON 255.16 19.00 144.00 163.00

41591.08 B

48

12 MAYO'S TROLLEY

COVER 62.71 45.00 128.00 173.00

10848.83 B

13 SOFWRAP 15CMX3MM

GOLDWIN 43.57 73.00 101.00 174.00

7581.18 B

14 ET TUBE CUFFED 8.0 MM 104.42 17.00 182.00 199.00

20779.58 B

15 HORIZON LIGATING

CLIP, SMALL RED 423.30 16.00 185.00 201.00

85083.3 B

16 GLOVES MICROOPTIC 7.0 40.58 9.00 200.00 209.00

8481.22 B

17 TRULON 3.0 24.12 0.00 216.00 216.00

5209.92 B

18 CD MOSER BEAR WITH

LOGO PRINTING 9.82 22.00 227.00 249.00

2445.18 B

19 STOP COCK 3-WAY

(100CM) - BD 49.82 0.00 308.00 308.00

15344.56 B

20 ETHILON 2-0 78.21 7.00 337.00 344.00

26904.24 B

21 BACTERIAL HME

FILTERS ADULT 102.71 51.00 300.00 351.00

36051.21 B

22 OXYGEN MASK ADULT

VINJO 22.81 106.00 250.00 356.00

8120.36 B

23 ACT ACTALYKE C-ACT

TUBE BLACK BLS 94.21 85.00 303.00 388.00

36553.48 B

24 VENFLON 20G(BD) 26.66 48.00 350.00 398.00

10610.68 B

25 IV3000 7CM X 9CM 27.00 48.00 452.00 500.00

13500 B

“B” Category Items;

Percentage of volume of “B” items= (Volume of B category items ÷ Volume of total

inventory) × 100

= (5537 ÷ 25058) × 100

= 20.096 %

Percentage of value of “B” items = (Value of B category items ÷ Value of total

inventory) × 100

= (738446.34 ÷ 3766940.7) × 100

= 19.60 %

49

Following are the list of “C” Category Items

Sr.

No. Item Name

UNIT

Price in

Rupees

OPENI

NG

QTY

QOH

RCVD

QTY

Total

Stock

Qty

Value of

Stock

Cat

ego

ry

1 OMNIPAQUE 350MG

X50ML (IOHEXOL) 424.00 54.00 524.00 578.00

245072 C

2 GLOVES GAMMEX 7 37.80 130.00 455.00 585.00 22113 C

3 PLASTIC APRON DELUXE 6.36 115.00 502.00 617.00 3924.12 C

4 PRESSURE MONITORING

LINES M-F 200CM 23.59 60.00 755.00 815.00

19225.9 C

5 DRAPES D301 SURGIWEAR 71.36 71.00 753.00 824.00 58800.6 C

6 GLOVES STERILE, SIZE: 6.5

- DR.CHOICE 12.49 0.00 1000.00 1000.00

12490 C

7 SYRINGE - 10ML (

ROMSON ) 3.53 96.00 2005.00 2101.00

7416.53 C

8 LAP SPONGE 30X30, 8PLY,

5S 14.24 1681.00 1010.00 2691.00

38319.8 C

9 GLOVES DR.CHOICE

(02774700000073333) 11.55 1744.00 1282.00 3026.00

34950.3 C

10 B.P.BLADE SURGON 2.72 1615.00 3102.00 4717.00 12830.2 C

“C” Category Items;

Percentage of volume of “C” items= (Volume of C category items ÷ Volume of total

inventory) × 100

= (16954 ÷ 25058) × 100

= 67.66 %

Percentage of value of “C” items = (Value of C category items ÷ Value of total

inventory) × 100

= (455142.54 ÷ 3766940.7) × 100

= 12.08 %

50

Selected items were categorized as FSN, and sorted by consultation with Organisational

guide

F Category _ Items that have faster rate of consumption and require recurrent

purchasing

S Category _ Items that have comparatively slower rate of consumtion and does

not need recurrent purchasing

N Category _ Items which are more or less stagnant and does not need to

purchase over a longer duration.

FSN Categorization

Following are the list of “F” Category Items

Sr.

No.

ITEM NAME ISSUED

Qty

Monthly

Consump

tion

CLOSI

NG Qty

Move

ment Category

1 0.6 MM 2 HOLE GAP PLATE 1.00 0.17 0.00 0 F

2 5MM WEDGE ANCHOR II WITH

NO.2 FORCE FIBER 3.00 0.50 0.00

0 F

3 A O TYPE CLAMP DOUBLE PIN 2.00 0.33 0.00 0 F

4 ABGEL (GELOSTAT)

ABSORBABLE GELATINE SPONGE 100.00 16.67 0.00

0 F

5 ACRYS OF IQ, 1.00 0.17 0.00 0 F

6 ARTERIAL FILTER WITH LOOP 1.00 0.17 0.00 0 F

7 B.B SILK 2 R826 ETHICON 6.00 1.00 0.00 0 F

8 BACTERIAL AND VIRAL FILTERS

PEDIATRIC STARMED 11.00 1.83 0.00

0 F

9 BLOOD TUBING - SINGLE PRE

PUMP 2.00 0.33 0.00

0 F

10 CANCELLOUS LOCKING SCREW 4.00 0.67 0.00 0 F

11 CANNULATED CANCELLOUS

SCREW 1.00 0.17 0.00

0 F

12 CANTATA MICROCATHETER 1.00 0.17 0.00 0 F

13 CERVICAL PEEK CAGE 2.00 0.33 0.00 0 F

14 CERVICAL PLATE 1.00 0.17 0.00 0 F

15 CERVICAL SPINE LOCKING PLATE 2.00 0.33 0.00 0 F

16 CUSTOM TBING PACK, 2.00 0.33 0.00 0 F

17 DENALI FEMORAL VENA CAVA

FILTER 3.00 0.50 0.00

0 F

18 DIAGNOSTIC CATHETER 1.00 0.17 0.00 0 F

19 DISCOFIX 3WAY STOP COCK 100.00 16.67 0.00 0 F

51

PLAIN

20 DISSECTING TOLLS F2 3.00 0.50 0.00 0 F

21 DISTAL FEMUR LOCKED PLATE 1.00 0.17 0.00 0 F

22 E.T TUBE 3.0 UNCUF 2.00 0.33 0.00 0 F

23 ENDEAVOR RESOLUTE STENT 2.00 0.33 0.00 0 F

24 ENDO BRONCHIAL TUBE 1.00 0.17 0.00 0 F

25 ESTERLUS 2-0 1.00 0.17 0.00 0 F

26 ETHILON 2-0 344.00 57.33 0.00 0 F

27 EYE SHIELDS 13.00 2.17 0.00 0 F

28 GLOVES DR.CHOICE 3026.00 504.33 0.00 0 F

29 HEART VALVE PERIMOUNT 2.00 0.33 0.00 0 F

30 LAUREATE CASSETS 4.00 0.67 0.00 0 F

31 MAHURKAR MAXID DL CATH KIT

36C 6.00 1.00 0.00

0 F

32 MALECOT NEPHROSTOMY SET

14F 3.00 0.50 0.00

0 F

33 PACEMAKER LEAD WITH MRI 5.00 0.83 0.00 0 F

34 PERITONEAL DIALYSIS

CATHETER KIT 1.00 0.17 0.00

0 F

35 PRISMAFLEX M100 8.00 1.33 0.00 0 F

36 PROLENE MESH, 2.00 0.33 0.00 0 F

37 PROLUS 8-0 PL2086F LOTUS 61.00 10.17 0.00 0 F

38 VANGUARD PS TIBIAL BEARING 5.00 0.83 0.00 0 F

“F” Category Items;

These are the items from inventory that have fast movement.

There are no items in closing stock as per monthly consumption

Following are the list of “S” Category Items

Sr.

No.

ITEM NAME

ISSUED Qty

Monthly Consumption

CLOSING Qty

Movement

Category

1 MAYO'S TROLLEY COVER 169.00 28.17 4.00 0.1420118 S 2 CD MOSER BEAR WITH LOGO

PRINTING 243.00 40.50 6.00 0.1481481 S

3 INTRODUCER NEEDLES BIOROD

18G 7CM 114.00 19.00 4.00 0.2105263 S

4 SYRINGE - 10ML ( ROMSON ) 2011.00 335.17 90.00 0.2685231 S 5 IV3000 7CM X 9CM 469.00 78.17 31.00 0.3965885 S 6 DRAPES D904 SURGIWEAR 48.00 8.00 4.00 0.5 S

52

7 DRAPES D301 SURGIWEAR 760.00 126.67 64.00 0.5052632 S 8 GENERAL SURGERY PACK -

MEDISPHERE 10.00 1.67 1.00 0.6 S

9 PROLENE 1 NW896 ETHICON 8.00 1.33 1.00 0.75 S 10 SWAN-GANZ CATHETER 7F 39.00 6.50 5.00 0.7692308 S 11 OMNIPAQUE 350MG X50ML

(IOHEXOL) 508.00 84.67 70.00 0.8267717 S

12 ACT ACTALYKE C-ACT TUBE

BLACK BLS 341.00 56.83 47.00 0.8269795 S

13 ROMOVAC SET 12 ROMSON 100.00 16.67 14.00 0.84 S 14 PRISMASOL 5 LTR 119.00 19.83 18.00 0.907563 S 15 MONOLUS 3-0 LNW3326(M)

LOTUS 66.00 11.00 10.00 0.9090909 S

16 GLOVES GAMMEX 7 503.00 83.83 82.00 0.9781312 S 17 EPIDURAL CATHETER

MINIPACK-I 16G 55.00 9.17 9.00 0.9818182 S

18 DARK GOGGLES (BLACK) 24.00 4.00 4.00 1 S 19 TRIPLE LUMEN CATHETER 12FR 54.00 9.00 9.00 1 S 20 LAP SPONGE 30X30, 8PLY, 5S

2306.00 384.33 385.00 1.0017346 S

21 TERUMO GUIDE WIRE "J" TIP 35.00 5.83 6.00 1.0285714 S 22 3M -6640 DRAPE IOBAN 62.00 10.33 11.00 1.0645161 S 23 EARTHING PAD 50.00 8.33 9.00 1.08 S 24 OXYGEN MASK ADULT VINJO 301.00 50.17 55.00 1.0963455 S 25 MERSILK 2-0 31.00 5.17 6.00 1.1612903 S 26 SOLUS 1-0 118.00 19.67 23.00 1.1694915 S 27 PRESSURE MONITORING LINES

M-F 200CM 680.00 113.33 135.00 1.1911765 S

28 OMNISCAN 0.5MMOL 10ML 50.00 8.33 10.00 1.2 S 29 EDWARDS SINGLE LINE

PRESSURE MONITORING KIT 101.00 16.83 22.00 1.3069307 S

30 GLOVES STERILE, SIZE: 6.5 -

DR.CHOICE 812.00 135.33 188.00 1.3891626 S

31 STOP COCK 3-WAY (100CM) - BD 250.00 41.67 58.00 1.392 S 32 LIGACLIPS LT200 ETHICON 131.00 21.83 32.00 1.4656489 S 33 CANISTER WITH GEL 4.00 0.67 1.00 1.5 S 34 STELUS 6-0 LS649 LOTUS 56.00 9.33 14.00 1.5 S 35 VICRYL 3-0 NW2472 ETHICON 8.00 1.33 2.00 1.5 S 36 SKIN STAPLERS ETHICON 105.00 17.50 27.00 1.5428571 S 37 CHEST DRAINAGE CATHETER

FLEXO CATH 88.00 14.67 23.00 1.5681818 S

38 MONOCRYL PLUS 3-0 MCP3326,

ETHICON 64.00 10.67 17.00 1.59375 S

39 ABDOMINAL DRAINAGE KIT

28FG 15.00 2.50 4.00 1.6 S

53

40 TRULON 3.0 169.00 28.17 47.00 1.6686391 S 41 JELCO NEEDLE 20G 107.00 17.83 33.00 1.8504673 S 42 ET TUBE CUFFED 8.0 MM 152.00 25.33 47.00 1.8552632 S 43 HORIZON LIGATING CLIP,

SMALL RED 153.00 25.50 48.00 1.8823529 S

44 BACTERIAL HME FILTERS

ADULT 264.00 44.00 87.00 1.9772727 S

45 BARD -MC1816 BIOPSY GUN 9.00 1.50 3.00 2 S 46 BILARY PERC DRAIN STENT

10FR 3.00 0.50 1.00 2 S

47 HIP U DRAPE D-501 3.00 0.50 1.00 2 S 48 INPUT SHEATH 5F 11CM 38INCH 63.00 10.50 21.00 2 S 49 TRUSYNTH 2.0 36.00 6.00 12.00 2 S 50 DIATHERMY ESU DISPOSABLE

PENCIL 68.00 11.33 23.00 2.0294118 S

51 Y CONNECTOR KIT 20.00 3.33 7.00 2.1 S 52 OPSITE INCISE 30CM 31.00 5.17 11.00 2.1290323 S 53 TIG RADIAL CATHETER 5F 14.00 2.33 5.00 2.1428571 S 54 G-PATCH LARGE, GP02 5.00 0.83 2.00 2.4 S 55 VISIPAQUE 320MG 50 ML 39.00 6.50 16.00 2.4615385 S 56 CRAPE-BANDAGE 4"DR.CHOICE 74.00 12.33 32.00 2.5945946 S 57 TRANSRADIAL SHEATH 6F 11.00 1.83 5.00 2.7272727 S 58 HERNIA KIT ETHICON 15.00 2.50 7.00 2.8 S 59 TRUWAX STERILISED

BONEWAX 2.5G 49.00 8.17 23.00 2.8163265 S

60 SURGICEL FIBRILLAR 1"X2" 27.00 4.50 13.00 2.8888889 S 61 DUAL LUMEN CATHETER

11.5FR/19.5CM STRAIGHT 10.00 1.67 5.00 3 S

62 DURAFLOW DUAL LUMEN

CATHETER 4.00 0.67 2.00 3 S

63 GUIDE WIRE 0.035X150CM

STRAIGHT TERUMO 6.00 1.00 3.00 3 S

64 GUIDING CATH H1 5F 2.00 0.33 1.00 3 S 65 VENFLON 20G(BD)

252.00 42.00 146.00 3.4761905 S

66 GLOVES MICROOPTIC 7.0 132.00 22.00 77.00 3.5 S 67 B.P.BLADE SURGON

2969.00 494.83 1748.00 3.5325025 S

68 SOFWRAP 15CMX3MM

GOLDWIN 107.00 17.83 67.00 3.7570093 S

69 IO DRAPE LARGE, 11.00 1.83 7.00 3.8181818 S 70 PLASTIC APRON DELUXE

372.00 62.00 245.00 3.9516129 S

71 BILATERIAL KNEE O DRAPE 3.00 0.50 2.00 4 S 72 BMW GUIDE WIRE 0.014 X 190 J

TIP 6.00 1.00 4.00 4 S

54

73 VENTILATOR CIRCUT (ADULT)

LIFETRACK 87.00 14.50 58.00 4 S

74 HIV KIT - AMKAY 4.00 0.67 3.00 4.5 S 75 ETHIBOND 5-0 W4846 ETHICON 9.00 1.50 8.00 5.3333333 S 76 DOUBLE J STENT 5FR 2.00 0.33 2.00 6 S 77 KNEE O DRAPE D-505 3.00 0.50 3.00 6 S 78 SENSTRACT LARGE VAC

GRANUFOAM DRESSING 1.00 0.17 1.00 6 S

79 SURGICEL 2"X3" FIBRILLAR 1953

ETHICON 8.00 1.33 8.00 6 S

80 VP SHUNT LOW PRESSURE 1.00 0.17 1.00 6 S

81 C-ARM COVER MEDISPHERE 71.00 11.83 76.00 6.4225352 S

82 TRUSILK 2.0 17.00 2.83 19.00 6.7058824 S

83 MICRO SURGICAL KNIVES

CRECENT 22.00 3.67 27.00

7.3636364 S

84 DISPOSABLE GOWN

REINFORCED,3M 6.00 1.00 8.00

8 S

85 HEMOCER POWDER 2GMS 3.00 0.50 4.00 8 S

86 DOUBLE J STENT BIORAD 32.00 5.33 46.00 8.625 S

87 CLING DRAPE CD 13.00 2.17 19.00 8.7692308 S

88 NEBULIZER MASK ADULT

VINJO 8.00 1.33 12.00

9 S

89 RADIAL PUNCTURE NEEDLE

20G 32.00 5.33 51.00

9.5625 S

90 BONE CEMENT 40G SIMPLEX 4.00 0.67 7.00 10.5 S

91 CARDIOPLEGIA DELIVERY

SYSTEM VISION/ON-LINE 2.00 0.33 4.00

12 S

92 COMBIND SPINAL/ EPIDURAL

MINIPAK 16G WITH LOCK 3.00 0.50 6.00

12 S

93 DISPOSABLE TWO-PART

TROCAR NEEDLE 18G 1.00 0.17 2.00

12 S

94 AFFINITY ARTERIAL FILTER 1.00 0.17 3.00 18 S

95 BLOWER MISTER KIT 1.00 0.17 3.00 18 S

96 CATHETER DIAGNOSTIC 5F

JR3.5 CORDIS 3.00 0.50 9.00

18 S

97 CSF FLOW CONTROL SHUNT 1.00 0.17 3.00 18 S

98 CUSTOMPACK NON-CORONARY

MEMBRANE 2.00 0.33 7.00

21 S

99 O-SCOPE DRAPE ECO LARGE 3.00 0.50 12.00 24 S

100 CONNECTOR 1/4 X 1/4 WITH

LUER LOCK 6.00 1.00 68.00

68 S

101 MICROSCOPE COVER 5 HOLE SP

1033 CLASSIC 2.00 0.33 98.00

294 S

“S” Category Items;

These are the items from inventory that have slow movement.

There is some volume of stock items left in closing stock as per monthly consumption

55

Following are the list of “N” Category Items

Sr.

No.

ITEM NAME ISSUE

D Qty

Monthly

Consump

tion

CLOSI

NG Qty Movement

Cate

gory

1 CABG KIT, CAT 0.00 0.00 2.00 #DIV/0! N

2 DERMARK SURGICAL SKIN

MARKER 0.00 0.00 5.00

#DIV/0! N

3 DISPOSALE INJECTOR &

CARTRIDGE FOR OPTHOL 0.00 0.00 9.00

#DIV/0! N

4 EMBOLECTOMY CATHETER

FOGARTY 0.00 0.00 1.00

#DIV/0! N

5 EYE DRAPE 0.00 0.00 19.00 #DIV/0! N

6 GEENEN PANCREATIC STENT, 5FR 0.00 0.00 3.00 #DIV/0! N

7 LOTUS ESTERLUS 2-0 0.00 0.00 12.00 #DIV/0! N

8 LUMBER PERRI.SHUNT 0.00 0.00 2.00 #DIV/0! N

9 NASAL BILIARY DRAINAGE SET 0.00 0.00 1.00 #DIV/0! N

10 SOF-FLEX PEDIATRIC DOUBLE

PIGTAIL URETERAL STENT 0.00 0.00 3.00

#DIV/0! N

11 UNIVERSAL SOFT URETERAL

STENT AND POSITIONER SET 0.00 0.00 5.00

#DIV/0! N

“N” Category Items;

These are the items from inventory that have No movement.

There is large volume of stock items left in closing stock as per monthly consumption

56

Selected items were categorized as VED, and sorted by consultation with Organisational

guide

VED Categorization

Following are the list of “V” Category Items

Sr. No. ITEM NAME UNIT Price

in Rupees

ISSUED

Qty Category

1 5MM WEDGE ANCHOR II WITH NO.2 FORCE

FIBER 9158.4 3.00

V

2 AFFINITY ARTERIAL FILTER 3178.00 1.00 V

3 ARTERIAL FILTER WITH LOOP 2768.22 1.00 V

4 BILARY PERC DRAIN STENT 10FR 786.38 3.00 V

5 BLOWER MISTER KIT 3291.50 1.00 V

6 BMW GUIDE WIRE 0.014 X 190 J TIP 4240 6.00 V

7 CABG KIT, CAT 2641.73 0.00 V

8 CARDIOPLEGIA DELIVERY SYSTEM

VISION/ON-LINE 3360.00 2.00

V

9 CUSTOMPACK NON-CORONARY

MEMBRANE 2415.00 2.00

V

10 DENALI FEMORAL VENA CAVA FILTER 48760.00 3.00 V

11 E.T TUBE 3.0 UNCUF 76.28 2.00 V

12 EMBOLECTOMY CATHETER FOGARTY 1581.45 0.00 V

13 ENDEAVOR RESOLUTE STENT 90000 2.00 V

14 ENDO BRONCHIAL TUBE 3281.96 1.00 V

15 HEART VALVE PERIMOUNT 185203.20 2.00 V

16 HEMOCER POWDER 2GMS 3816.00 3.00 V

17 NEBULIZER MASK ADULT VINJO 47.41 8.00 V

18 OMNIPAQUE 350MG X50ML (IOHEXOL) 424.00 508.00 V

19 OMNISCAN 0.5MMOL 10ML 833.16 50.00 V

20 VENTILATOR CIRCUT (ADULT) LIFETRACK 131.25 87.00 v

“V” Category Items

Vital: Shortage cannot be tolerated.

57

Following are the list of “E” Category Items

Sr. No. ITEM NAME UNIT

Price in

Rupees

ISSUED

Qty Category

1 0.6 MM 2 HOLE GAP PLATE 531.72 1.00 E

2 A O TYPE CLAMP DOUBLE PIN 742 2.00 E

3 ABGEL (GELOSTAT) ABSORBABLE

GELATINE SPONGE 70.74 100.00

E

4 ACRYS OF IQ, 6000 1.00 E

5 ACT ACTALYKE C-ACT TUBE BLACK BLS 94.21 341.00 E

6 B.B SILK 2 R826 ETHICON 312.02 6.00 E

7 BACTERIAL AND VIRAL FILTERS

PEDIATRIC STARMED 129.68 11.00

E

8 BACTERIAL HME FILTERS ADULT 102.71 264.00 E

9 BARD -MC1816 BIOPSY GUN 1696.00 9.00 E

10 BILATERIAL KNEE O DRAPE 1153.28 3.00 E

11 BLOOD TUBING - SINGLE PRE PUMP 121.5 2.00 E

12 CANTATA MICROCATHETER 14476.35 1.00 E

13 CATHETER DIAGNOSTIC 5F JR3.5 CORDIS 991.1 3.00 E

14 CERVICAL PEEK CAGE 9836.8 2.00 E

15 CERVICAL PLATE 4861.44 1.00 E

16 CERVICAL SPINE LOCKING PLATE 1704.48 2.00 E

17 CHEST DRAINAGE CATHETER FLEXO CATH 126.14 88.00 E

18 COMBIND SPINAL/ EPIDURAL MINIPAK 16G

WITH LOCK 1245.55 3.00

E

19 CSF FLOW CONTROL SHUNT 15369.75 1.00 E

20 CUSTOM TBING PACK, 2894.25 2.00 E

21 DIAGNOSTIC CATHETER 1568.80 1.00 E

22 DOUBLE J STENT 5FR 623.60 2.00 E

23 DOUBLE J STENT BIORAD 256.52 32.00 E

24 DRAPES D301 SURGIWEAR 71.36 760.00 E

25 DUAL LUMEN CATHETER 11.5FR/19.5CM

STRAIGHT 1460.15 10.00

E

26 DURAFLOW DUAL LUMEN CATHETER 2089.53 4.00 E

27 EARTHING PAD 312.13 50.00 E

28 EDWARDS SINGLE LINE PRESSURE

MONITORING KIT 689.00 101.00

E

29 EPIDURAL CATHETER MINIPACK-I 16G 525.23 55.00 E

30 ESTERLUS 2-0 2284.61 1.00 E

31 ET TUBE CUFFED 8.0 MM 104.42 152.00 E

32 ETHIBOND 5-0 W4846 ETHICON 695.72 9.00 E

33 ETHILON 2-0 78.21 344.00 E

58

34 GEENEN PANCREATIC STENT, 5FR 1473.84 0.00 E

35 GENERAL SURGERY PACK - MEDISPHERE 879.90 10.00 E

36 GUIDE WIRE 0.035X150CM STRAIGHT

TERUMO 732.90 6.00

E

37 GUIDING CATH H1 5F 8904.00 2.00 E

38 HIV KIT - AMKAY 164.30 4.00 E

39 INTRODUCER NEEDLES BIOROD 18G 7CM 44.52 114.00 E

40 JELCO NEEDLE 20G 25.97 107.00 E

41 MERSILK 2-0 59.73 31.00 E

42 MICRO SURGICAL KNIVES CRECENT 42.00 22.00 E

43 MONOCRYL PLUS 3-0 MCP3326, ETHICON 290.04 64.00 E

44 MONOLUS 3-0 LNW3326(M) LOTUS 143.26 66.00 E

45 NASAL BILIARY DRAINAGE SET 6659.10 0.00 E

46 OXYGEN MASK ADULT VINJO 22.81 301.00 E

47 PERITONEAL DIALYSIS CATHETER KIT 5200.00 1.00 E

48 PROLENE MESH, 2211.10 2.00 E

49 PROLUS 8-0 PL2086F LOTUS 327.73 61.00 E

50 RADIAL PUNCTURE NEEDLE 20G 76.32 32.00 E

51 SOF-FLEX PEDIATRIC DOUBLE PIGTAIL

URETERAL STENT 5465.36 0.00

E

52 SURGICEL FIBRILLAR 1"X2" 1458.56 27.00 E

53 SWAN-GANZ CATHETER 7F 5512.00 39.00 E

54 TERUMO GUIDE WIRE "J" TIP 739.88 35.00 E

55 TIG RADIAL CATHETER 5F 1029.26 14.00 E

56 TRIPLE LUMEN CATHETER 12FR 1762.25 54.00 E

57 TRULON 3.0 24.12 169.00 E

58 TRUSILK 2.0 19.96 17.00 E

59 VICRYL 3-0 NW2472 ETHICON 221.50 8.00 E

60 VISIPAQUE 320MG 50 ML 772.74 39.00 E

61 VP SHUNT LOW PRESSURE 2671.28 1.00 E

“E” Category Items

Essential: Shortage can be tolerated for a short period.

59

Following are the list of “D” Category Items

Sr. No. ITEM NAME UNIT Price in Rupees

ISSUED Qty

Category

1 3M -6640 DRAPE IOBAN 305.17 62.00 D 2 ABDOMINAL DRAINAGE KIT 28FG 87.72 15.00 D

3 B.P.BLADE SURGON 2.72 2969.00 D

4 BONE CEMENT 40G SIMPLEX 1850.00 4.00 D 5 CANCELLOUS LOCKING SCREW 699.6 4.00 D

6 CANISTER WITH GEL 2571.25 4.00 D

7 CANNULATED CANCELLOUS SCREW 466.40 1.00 D 8 C-ARM COVER MEDISPHERE 52.24 71.00 D

9 CD MOSER BEAR WITH LOGO PRINTING 9.82 243.00 D

10 CLING DRAPE CD 32.44 13.00 D 11 CONNECTOR 1/4 X 1/4 WITH LUER LOCK 29.25 6.00 D

12 CRAPE-BANDAGE 4"DR.CHOICE 57.24 74.00 D

13 DARK GOGGLES (BLACK) 27.24 24.00 D 14 DERMARK SURGICAL SKIN MARKER 66.10 0.00 D

15 DIATHERMY ESU DISPOSABLE PENCIL 157.50 68.00 D

16 DISCOFIX 3WAY STOP COCK PLAIN 14.44 100.00 D 17 DISPOSABLE GOWN REINFORCED,3M 159.00 6.00 D

18 DISPOSABLE TWO-PART TROCAR NEEDLE 18G 465.25 1.00 D

19 DISPOSALE INJECTOR & CARTRIDGE FOR OPTHOL

250.00 0.00 D

20 DISSECTING TOLLS F2 4331.16 3.00 D

21 DISTAL FEMUR LOCKED PLATE 8978.20 1.00 D 22 DRAPES D904 SURGIWEAR 124.70 48.00 D 23 EYE DRAPE 27.30 0.00 D

24 EYE SHIELDS 3.94 13.00 D 25 GLOVES DR.CHOICE (02774700000073333) 11.55 3026.00 D 26 GLOVES GAMMEX 7 37.80 503.00 D

27 GLOVES MICROOPTIC 7.0 40.58 132.00 D 28 GLOVES STERILE, SIZE: 6.5 - DR.CHOICE 12.49 812.00 D 29 G-PATCH LARGE, GP02 1187.88 5.00 D

30 HERNIA KIT ETHICON 1352.24 15.00 D 31 HIP U DRAPE D-501 945.69 3.00 D 32 HORIZON LIGATING CLIP, SMALL RED 423.30 153.00 D

33 INPUT SHEATH 5F 11CM 38INCH 612.68 63.00 D 34 IO DRAPE LARGE, 126.14 11.00 D 35 IV3000 7CM X 9CM 27.00 469.00 D

60

36 KNEE O DRAPE D-505 872.89 3.00 D 37 LAP SPONGE 30X30, 8PLY, 5S 14.24 2306.00 D

38 LAUREATE CASSETS 0.00 4.00 D

39 LIGACLIPS LT200 ETHICON 255.16 131.00 D 40 LOTUS ESTERLUS 2-0 2769.90 0.00 D

41 LUMBER PERRI.SHUNT 2805.35 0.00 D

42 MAHURKAR MAXID DL CATH KIT 36C 8505.00 6.00 D 43 MALECOT NEPHROSTOMY SET 14F 2849.28 3.00 D

44 MAYO'S TROLLEY COVER 62.71 169.00 D

45 MICROSCOPE COVER 5 HOLE SP 1033 CLASSIC 78.55 2.00 D 46 OPSITE INCISE 30CM 140.98 31.00 D

47 O-SCOPE DRAPE ECO LARGE 318.59 3.00 D

48 PACEMAKER LEAD WITH MRI 16430.00 5.00 D 49 PLASTIC APRON DELUXE 6.36 372.00 D

50 PRESSURE MONITORING LINES M-F 200CM 23.59 680.00 D

51 PRISMAFLEX M100 9647.50 8.00 D 52 PRISMASOL 5 LTR 1272.00 119.00 D

53 PROLENE 1 NW896 ETHICON 208.21 8.00 D

54 ROMOVAC SET 12 ROMSON 147.34 100.00 D 55 SENSTRACT LARGE VAC GRANUFOAM DRESSING 9724.00 1.00 D

56 SKIN STAPLERS ETHICON 475.23 105.00 D

57 SOFWRAP 15CMX3MM GOLDWIN 43.57 107.00 D 58 SOLUS 1-0 150.37 118.00 D

59 STELUS 6-0 LS649 LOTUS 585.48 56.00 D

60 STOP COCK 3-WAY (100CM) - BD 49.82 250.00 D 61 SURGICEL 2"X3" FIBRILLAR 1953 ETHICON 676.20 8.00 D

62 SYRINGE - 10ML ( ROMSON ) 3.53 2011.00 D

63 TRANSRADIAL SHEATH 6F 879.80 11.00 D 64 TRUSYNTH 2.0 121.28 36.00 D

65 TRUWAX STERILISED BONEWAX 2.5G 39.92 49.00 D

66 UNIVERSAL SOFT URETERAL STENT AND POSITIONER SET

968.84 0.00 D

67 VANGUARD PS TIBIAL BEARING 12720.00 5.00 D

68 VENFLON 20G(BD) 26.66 252.00 D 69 Y CONNECTOR KIT 787.50 20.00 D

“D” Category Items

Desirable: Shortage will not adversely affect, but may be using more resources. These

must be strictly scrutinized

61

Chapter 6

FINDINGS

&

SUGGESTIONS

62

Share of ABC Categorized Items in total Volume of inventory

It was founded that C category of items constituted maximum share which was 68% of

total inventory based on volume, B – 22 % and A-10 % of total inventory taken into

account for study purpose.

A10% B

22%

C68%

ABC Analysis based on Volume

63

Share of ABC categorized items in total value of inventory

It was found out that A category items constituted maximum amount of share i.e. 70 %,

B- 20 % and C-10 % amongst all the items considered during study.

According to Pareto’s law the items that constitute only 10 % of volume consumes

70 % value of total inventory. While items that constitute 70 % of volume were only

10 % value of Total inventory

Suggestions on ABC analysis:

The items that are from A category should be strictly scrutinized because they constitute

maximum value of total inventory. Storage of A category items should be carefully done

with maximum safety measures, and movement of A category items should be strictly

supervised and timely studied.

A70%

B20%

C10%

ABC Analysis based on value

64

FSN Analysis

F categorized items that are fast moving required timely and frequent purchase. Its

reorder level should be strictly followed. These items are more likely to get stocked out,

hence it needs strict supervision on reorder level.

N category items should not be stored at large volumes.

Slow moving items should be selected with longer shelf lives for purchase.

S category items should follow FIFO as there is chance of expiry of item.

These items contributes more to inventory carrying cost.

F

S

N

% of item in Inventory

Cat

ego

ry

FSN Analysis based on movement

Series1

65

VED Analysis

The vital items may be life saving in patients care. Stock out or shortage of vital items

cannot be tolerated. Stock of essential items should always be under supervision. Stock of

Desirable items should not be stored at large volumes.

These categorizations are used usually in pharmaceutical stores of hospitals, but the

above study reveals that these analysis are equally important and useful for hospitals

other inventory control.

These analysis can reduce the operational costs of running hospital.

It improves service delivery in patient care.

Proper inventory control increases return on investment.

Hospitals can run efficiently on minimum capital investments with the help of these

analytical studies.

0

10

20

30

40

50

V E D

% o

f it

em

s in

Inve

nto

ry

Category

VED Analysis Based on Importance

Series1

66

Conclusion

67

Two months training internship in Apollo Hospital, Nashik as a part of academics for

partial fulfillment of the requirement for MBA – Healthcare administration to submit to

MUHS. During project internship period, as per instructions of internal institutional guide

and organizational guide, the project on studying inventory management in multispecialty

corporate hospital to be carried out. Study was successfully completed during 2 months

tenure of winter internship.

Apollo Hospitals Ltd. is one of the leading hospital chain across India and has branches

across the globe too and still expanding. It is one of the best corporate hospitals in

Nashik. It is 118 Bedded Multispecialty and Superspeciality, NABH accreditated

Hospital.

From the literature reviewed and studies on inventory management reveals that inventory

carrying cost may be upto 30 % of total inventory value. That is why there is a need of

proper inventory control to keep the inventory carrying cost minimum. At the same time

it should be checked that there should not be any obstacles in day to day work of delivery

of patient care.

The study can be concluded that ABC Analysis inventory policy can be applied to entire

types of Inventory in hospitals.

Inventory policy should take into account both Item’s value and clinical importance

factors. By applying suggested inventory policy in this study, it is found that the number

of shortages can be reduced and the total inventory cost can be reduced to certain extent.

Importantly, it must be noted that the inventory policy should be revised every year. This

is due to the VED classification being revised by hospital committees annually. Also, the

ABC classes, which are revised every year according to annual demand and consumption,

should also be taken into account.

Briefly, OT consumables are different from ordinary products in the market. They have

levels of clinical impact. A Min/Max inventory policy is not appropriate to manage all

inventory items in the hospital, as at present, because inventory in the hospital have

several demand characteristics, and the inventory policy should be customized to match

specific items demand characteristics.

68

For further research, it can be noted that the entire order policy presented in this paper

can be considered as passive policy. The ordering is triggered by the ROP or a fixed

period of time. On the other hand, if real-time demand and the stock levels can be shared

with the hospital’s supplier, active replenishment can be accurately undertaken.

This is called a vendor managed inventory (VMI). Its application and implementation in

hospitals is promising, yet challenging.

The above study also proves that Pareto’s law can be applied to hospital inventory also.

It helps in controlling most valuable inventory that is “A” category so that there should

not be any financial burden on hospital.

Similarly the fast moving items needs regular replenishment of inventory. The study also

proves hospital not to invest unnecessarily in non-moving and slow moving items. VED

analysis highlights the items that are vital in delivering patient care.

Hospital management can efficiently manage and control inventory with these individual

analysis as well as combination of these analysis (Matrix of ABC – VED Analysis). In

matrix inventory can be classified as AB items, AE Items, AD Items, BV Items, BE

Items, BD items, CV Items, CE Items and lastly CD Items.

In Apollo Hospitals, in inventory management the issuing of materials, purchase of

request (POR) and supplier’s management are totally computerized processes. There are

no such practices like “Items Categorization”, “reorder level”, “Buffer stock or safety

stock”. There is no special and separate supervision of valuable items. RFID can be used

for tracking and control of valuable items and equipments in the hospital.

69

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