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CHAPTER V: THE VIRTUAL WAREHOUSE IN A SANITARY DISTRICT

5.1.5 SUPPLYINGS

The decisions that define politics of supplyings of a sanitary company regard:

  • the corrected definition of the requirementses of goods and services to acquire;
  • the choices of Make or buy;
  • the location of the supplying sources and the ideal profile of the suppliers;
  • the choice of the tipologia of relation to establish with they;
  • the location of the variable ones regarding which monitorare the relationship in the time with they.
Until or today the companies mostly they have been concentrated on a relationship of traditional type with the suppliers.
The management of the supplying processes has realized in one series of essentially administrative activities and modest strategic content.
The evolution of the normative context of reference ( in particular the application of the D.lgs 229-reform ter ) has favorite a meaningful increase of the margins of autonomy of the manager that it will be found to take these decisions and to answer of the chosen goodness of the own ones in function of turns out obtained to you.
From the plan of institution of a cetralized system of management of the logistics of the sanitary material (drugs, garrisons, medication, prosthesis, dialitico material, etc), the whose objective is that one to concur to the rationalization and qualification of the performances of acquisition of necessary the druggist products to the garrisons and sanitary services of the sanitary Companies that have it undersigned, can effectively derive processes of rationalization-innovation of the activity of the field supplyings of the pharmacies hospitals worker.
In order to pick the opportunities of improvement tied to a management evoluta of the supply chain go aware however recognized the complexity of the problem and rationally governed and the relations that tie the sanitary company to the suppliers or partner.
For the attainment of the objective they are necessary:
  • a precise programming of the requirementses of drugs and necessary sanitary products;
  • a efficient and effective cetralized procedure of purchase that concurs a control of the costs, the quality and the uniformità of the products to the inside of homogenous categories.
Given the extreme differentiation of the characteristics of the Companies been involved in the plan, one in particular thinks that the phase of homogenization of the requirementses is a long process is difficult to realize, in particular when doctors will come faced problematic of purchase relative to specialistici products to high technology as an example in the within of the devices you or the protesico material, where the requirementses and the characteristics of the materials is closely correlates you to the tipologia of the patients deals to you and to the houses-mix total of the single Companies.
In the objective more general than control of the druggist expense the obtaining of prices of greater favor for the purchase of the products represents only one of the elements that can influence the economic data - moreover not even most important - from the moment that the composition of the costs for druggist productive factors mostly concentrates on a reduced number of products (the law of Pareto, in so far as, is of all the transferable one).
In kind as an example for the field drugs 80% of the expense are concentrated on drugs innovated to you, to high technology-high cost for which it thinks that the more effective operation for the rationalization of the expense consists in placing in action business initiatives that they see been involved various operating sanitary, medical and the druggists, in order to adopt initiatives times to the rigorous selection of the patients to deal, to the location of specific protocols of treatment, to the monitoring of the prescription, the appraisal of the outcomes.
In fact the recent outbreak of lines guides to which it has been assisted in the last years is gushed just from the requirement to induce the improvement of the quality and of the effectiveness of the clinical decisions with consequent improvement of it turns out you for the patient, reduction of the charitable variability and optimization of the resources.

5.1.6 ANALYSIS OF THE CETRALIZED WAREHOUSE

Wanting to make a short analysis of the cetralized management of the warehouses, some positive points can be put in prominence and others denied to you to you.
In the first place, in spite of the national directives they are those to pursue one political of centralization, every Company before to proceed in such sense, and therefore to change puts into effect it them managerial structure, it is called in the first place to carry out an inner surveying finalized to become account of puts into effect them logistic costs and organizational deriving from the situation it puts into effect them; then a finalized study to comprise the advantages and disadvantages to which encounter would go if it passed to the centralization; in order then to be able to carry out an analysis cost-benefits deriving from the comparison of the 2 previous points.
From the business point of view, the main problem to face is that one of localization of the druggist warehouse following two criteria: the criterion of the minimal distribution cost, that localization of the warehouse in function of the geographic positioning of the question points must hold in particular consideration (every weighted one in function of the volume of the demands); the criterion of the minimal cost of warehouse constituted from the operating costs of the supplyes and from the fixed cost of structure.
An only cetralized druggist warehouse that supplies more Companies and that it replaces the warehouses of the pharmacies territorial hospitals worker and, could involve a possible total reduction of the supplyes of pharmacy - previa standardization of articles - with remarkable economies in the management of the warehouses, a saving in the spaces to they as an example dedicates to you and one simplification of the procedures administrative-accountants (the reference to an only "supplier" with consequent centralization also of the purchase orders).
But such it turns out to you can be only caught up to pact to manage an only warehouse that has the full responsibility of the management of the same one also in terms of supplying near the supplier s and is just this the critical point: this solution involves the sostenimento of costs necessarily elevates to you.
draft to sopportare of the cost added you regarding the state put into effect them. Moreover, if on one side such solution in along period stretches to make to diminish the structure costs, from the other involves an unavoidable increase of the incidence of the shipping charges.
Currently they are the suppliers who deliver the materials order you to the pharmacies and to support the transport costs.
In the hypothesis that the suppliers deliver to the cetralized warehouse, this last one they will weigh on the costs of second delivery to the companies.
The preparation from part of an external subject of the druggist products demands routinariamente does not produce economies of scale. In other words, if daily in a company "who" prepare in average 50 "undercarriages of unit" not ago difference prepares them. Always 50 remain and the partial recovery of personal inside to the company with the minimizzazione of the inner warehouse would come compensated from the staff who will have to take care itself some near that outside to the company.
As far as the efficiency of the service: the complexity of the deliveries and the tempistica will have carefully to be estimated in order not to pull down put into effect it them levels of performance.
The geographic distribution of the units and services of an big area needs to organize the distribution with means of transport used after the transport on road, with long times of transfer that demand ulterior guarantees and equipment for the corrected conservation of the materials also during you is made of transport.
If in consequence of the cetralized distribution cost a reduction of the distributive frequencies had to be assumed (es. one week rather than two as it is currently for the prevalence of the reparti/servizi) it would obtain the immediate consequence to increase the supplyes near the units, creating problems also on the forehead of the necessary spaces.
Residuare to inner the druggist warehouse the sun amount of materials for the "urgencies" means must in any case "stop" in supply the greater part of the products.
In fact, any druggist product, potentially, could be demanded " with urgency " to second of the various described situations over, that it means it must be equipped however of a business warehouse with the relative resources, in order to guarantee puts into effect it them levels of performances.
I1 druggist, in virtue of its preparation, is the only professional in a position to adding to value to the distributive activity of the drug supplying all the necessary information why I use it happens more in the appropriated way.
From the point of view of the responsibilities, it is not doubt that in case dì exsternalizations of the distribution would unavoidablly accompany parallel and also the transfer to the logistic operator of the responsibilities connected to the distributive action in order to:

  • eventual deficiencies of availability of the products demands near the druggist cetralized warehouse;
  • qualitative control of the products in entrance and escape;
  • management of not the conformities of the products delivered to the utilizzatori regarding the demanded characteristics;
  • rintracciabilità of the lotteries and procedures of recall in the case of business and/or ministerial signallings;
  • withdrawal of the past due products;
The druggist business in fact could not makes itself loaded with the responsibility of all that that is connected to the stock and to the distribution of materials whose manipulation is not carried out to the inside (meant like premises) of the U.O of Pharmacy, from staff in operating it and directly employee from the structure.

 


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