Authors (including presenting author) :
Fung PC(1), Chu LM(1), Lee CF (1), Chan YC(1)
Affiliation :
(1)Pharmacy, Tuen Mun Hospital
Introduction :
Currently in the pharmacies of general outpatient clinics (GOPCs) in NTWC, drug stock are monitored and ordered by individual pharmacies. Stock levels kept in different pharmacies vary depending on the space available for storage and the perceived need of individual pharmacists or senior dispensers. Some items may have up to 3 months of stock kept. Overstocking may render wastage when there is change in consumption pattern, while understocking may render the need for patient to return for refill. When there is service expansion, the current storage space may not be enough if a stable regular delivery cannot be guaranteed. This project implements a new stock replenishment workflow for GOPC pharmacies and pilots in Kam Tin Clinic (KTC), Tin Shui Wai Health Center (TSWHC) and Wu Hong Clinic (WHC). For KTC, drug stocks are delivered from TMH pharmacy due to small capacity. For TSWHC, WHC and other GOPCs, drug stocks are ordered by pharmacists or senior dispensers and delivered by vendor.
Objectives :
This project pilots the enhancement of drug replenishment process of GOPC pharmacies by centralizing and standardizing the procurement workflow. It aims to standardize stock ordering practice to optimize stock level, save storage space and save pharmacist’s time for patient care.
Methodology :
Three clinics with different stock size are selected for pilot implementation. KTC has small stock holdings serving 1 half-day consultation room by a one-man pharmacy, while TSWHC and WHC has much larger stock holdings serving 6 consultation rooms and evening clinics, and 5 consultation rooms respectively. Drugs with stable consumption pattern are selected in each clinic. The new workflow for stock management is implemented on these drugs as their consumption is less fluctuating and thus require less monitoring. The stock of these items is managed centrally by procurement section of TMH pharmacy, instead of manual monitoring by individual pharmacies. For KTC, stocks are replenished monthly with fixed quantity from TMH. Items with varying consumption are monitored by pharmacist adopting min-max monitoring used in other GOPCs. For TSWHC and WHC, stocks for steady items are ordered by TMH every 2 weeks with fixed quantity. Thus, fixed quantity of drug stocks arrive KTC, and TSWHC and WHC from TMH and vendor respectively at fixed intervals. The replenishment quantity for all items is reviewed by procurement section of TMH pharmacy and clinic’s pharmacist i/c every 3 months.
Result & Outcome :
For KTC, stocks of 57 (29% of total) selected items are delivered monthly from TMH pharmacy. Pharmacist does not need to monitor these items. Stock levels are reduced by 25%, from 2 months’ to 1.5 months’ consumption, which is an optimum level adequate for dispensing without overstocking. Stock holding value is reduced by 37%. Time required for stock management is reduced by 37.5% per week. Pharmacist can utilize the saved time for direct patient-care service. For TSWHC and WHC, 10 and 8 most consumed items are selected respectively. Stock levels for these items are reduced by approximately 50%, from 1.5 months’ to 3 weeks’ consumption. Stock holding value is reduced by 15.5% in TSWHC and 21.5% in WHC. Storage space in drug store room is saved by 40% in TSWHC and 20% in WHC. Storage space saved can be used for storing other items and prepared for storing more stocks when service expands. The new system is well accepted by all pharmacists and dispensers of KTC, TSWHC and WHC, and TMH pharmacy procurement staff. Pilot implementation of new replenishment system standardizes the workflow and eliminates interpersonal variations on stock ordering. With central management of items with stable consumptions by procurement section of TMH pharmacy, stock levels are optimized and time and space for clinic pharmacy is saved. With the successful implementation in the two pilot clinics, the workflow can be extended to more items and GOPC pharmacies.