Reducing the stock items – Need to look at the whole picture

J. Santhi1,*, A. Jakkulin²

¹Director of Nursing, Kauvery Hospital, Chennai, Tamilnadu, India

²Assiatant Nursing Superintendent, Kauvery Hospital, Chennai, Tamilnadu, India

*Correspondence: Email: santhi.j@kauveryhospital.com; Tel:+91 95510 75131.

Abstract

Background: In the 1980s, hospitals began implementing innovative supply chain strategies in order to reduce stocks. The intention was to improve service levels at hospitals. It was also to save quality-hours for nurses by reducing the stock as stock management consumes more than 45 min of nurse’s time.

Inventory control: Not all the items in each unit are always used, some of them are rarely used and some become redundant as consultants who requested had moved away from the system.

Core team: Feedback from the floor-in-charges and staffs were collected to come to a consensus on the appropriate stock maintenance.

Implementation: Started with trial implementation which was successful, which was followed by real implementation.

Conclusion: Reducing and streamlining the stock items ensures un-interrupted care to the patient and to earns consultant satisfaction.

Keywords: Stock items, Time saving

Background

Reducing the stock items (medicines and consumables) to save the quality-hours of nurses has been a priority item in the agenda in ward management of hospitals.

Stock items are list of medicines and consumables which are stored in each ward and ICUs. The requirements are decided by the consultants and by the nursing HOD and the items, quantity of items are finalized. Based on the different consultants’ request items are added, there by the number of items ted to steadily increase. In wards the number of items became more than 150.

During the time of emergency, the ward /ICU nurse will take the items from the stock and will use for the patients immediately so that time delays will be avoided. The items taken from the stock will be written in the drug due book. After usage the nurse will intend the items on the particular patient and will replace the stock before finishing her duty.

Each shift nurse needs to check the stock items before patient assignment to ensure the replacement.

As the number of items increased, stock checking was consuming more than 45 min of nurse’s quality time. In few occasions without checking also nurses were documenting in the stock register [1,2].

3 shifts × 45 min thus consumed 2 h 15 min on this process.

Inventory Control

The number of items increased as per the recommendations of the consultants but the unused items were not reduced from the stock which was affecting the quality care of the patients because nurses were spending more time to check the stock items and to replace it.

Though the consultants moved from the system, the items which were requested by them were not removed so total stock quantity became more in numbers.

Number of items and the quantity stocked were taken in count and discussed with all the consultants.

Out of 150 items, consultants were asked to select only the required items which should be stored in the ward/ICU for emergency usage.

Drug replacement list for past one year was reviewed to identify the commonly used items and the items which were rarely used. This also helped us to identify the items which are never used.

Core team

Core team included of specialty wise consultants, nursing-in-charges and seniors from each area. Because nursing-in-charges and senior nurses are at the floor, are at the user end and know the pros and cons of maintaining excess stock items and reducing the stock items.

Individual opinions were obtained and the list of required stock items were received from each staff and compiled. Most of the required items were common and it was helpful to finalize the items.

Finalized quantity of stock items quantity was 48.

Trial Implementation

As an initial phase of implementation, one ward was identified and the stocks were reduced as per the revised list. One-month trial implementation was conducted and daily requirements were monitored. There were no extra items which were required. It gave us confidence to implement this in all the in-patient areas.

Implementation

Clinical pharmacists help was obtained in reducing the stocks. The unused stocks were removed from all the IP areas. Clinical pharmacists helped to check the expiry dates of the medicines which were to be removed from the stocks, and which were chosen to stay on the list.

The stocks that were removed were returned to the pharmacy and only the required items were made available in all the in-patient areas stock. The updated list was given to the clinical pharmacist to do regular audit to ensure the adherence.

Nurses were privileged to follow the updated stock list. Quantity was also reduced appropriately.

Post Implementation

Feed backs received from all the ward staff; they found it easy to check daily. Time taken also monitored. It was less than 15 min. Audits were done to verify the adherence with reduced stock items.

Register Transformed into A Check List!

When the number of items were more stock registers were maintained for daily check. When the number of items were reduced, stock register converted into stock checklist. The staff found it easy to check and maintain stock check list.

Reliability

When the number of stocks were more, staffs were not checking all the items. Especially when they were busy with patient care they were just mentioning the numbers without checking the items in the stock. After reducing the stock items nurses were checking all the items. It gave more reliability.

Before

After

Before

After

Conclusion

We have streamlined our process and reduced the stocks to ensure an effective utilization of Nursing quality time towards patient care, the stocks were reduced based on the frequency of utilization and requirements. The average time taken for stock checking reduced from 45 to 15 min and the reliability towards stock checking also improved. Trial implementation gave us the confident to execute the same initiative in all the wards. There by our intervention vertically carried out in all the wards. Our future plan is to implement the same in all the Kauvery hospitals. Saving the nurses quality time are beneficial to improve patients and consultant’s satisfaction. Thus, we are very happy towards the successful implementation of our project.

“Less time for stock verification – More time for patient care & Health Promotion”

References

Anon. Practical Pharmacy. Available at: https://www.who.int/management/resources/drugs/practicalpharmacy21b.pdf. 2021.
DeScioli, DT. Differentiating the Hospital Supply Chain For Enhanced Performance. pp.15–17. Available at: https://core.ac.uk/download/pdf/4398705.pdf. 2021.

Reducing the stock items – Need to look at the whole picture

Reducing the stock items – Need to look at the whole picture

Journals