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COLLABORATIVE MANAGEMENT OF INVENTORY FOR IMPROVING THE EFFICIENCY OF APEX HOSPITAL JAIPUR: AN ANALYTICAL STUDY
A Report of Project Work Submitted in Partial Fulfillments of The Requirements for the Award of Degree of

MASTER OF BUSINESS ADMINISTRATION BHUPENDER KUMAR MEHTO ENROLMENT No:-BM11/005 Under The Guidance of Associate Prof. Dr. SANDESH KUMAR SHARMA

NIMS Institute of Management & Computer Sciences NIMS University Rajasthan Jaipur- 303001 Rajasthan

NIMS INSTITUTE OF MANAGEMENT AND COMPUTER SCIENCES

Jaipur 303 001 RAJASTHAN

BONAFIDE & FORWARDING CERTIFICATE

It is to certify that the Bhupender Kumar Mehto S/O Mr. Hari Har Mehto is a bonafide student of this institute with enrolment number BM11/005 Based on the written consent of the faculty guide Associate Prof. Dr. Sandesh Kumar Sharma we are forwarding his project report titled COLLABORATIVE MANAGEMENT OF INVENTORY FOR IMPROVING THE EFFICIENCY OF APEX HOSPITAL JAIPUR: AN ANALYTICAL STUDY for further evaluation to The Controller of Examinations NIMS University, Jaipur Rajasthan.

Ms. PallaviTomar (Director NIMSIM&CS)

Certified that this dissertation is approved in quality and form

External Examiner

Internal Examiner

NIMS INSTITUTE OF MANAGEMENT AND COMPUTER SCIENCES Jaipur-303001 Rajasthan Faculty Guides Certificate

TO WHOMSOEVER IT MAY CONCERN

This is to certify that the dissertation titled COLLABORATIVE MANAGEMENT OF INVENTORY FOR IMPROVING THE EFFICIENCY OF APEX HOSPITAL JAIPUR: AN ANALYTICAL STUDY is a bonafide work done by Bhupender Kumar Mehto S/o Mr. Hari Har Mehto under my guidance in partial fulfillment of Master of Business Administration programme of NIMS University Rajasthan. This report has been checked by me on the basis of the rough draft submitted and the view expressed in the report is only that of the researcher and not of this institute.

Date: Place: -

Associate Prof. Dr.Sandesh Kumar Sharma

(NIMS INSTITUTE OF MANAGEMENT & COMPUTER SCIENCES NIMS UNIVERSITY, JAIPUR, RAJASTHAN)

STUDENT DECLARATION
I do hereby declare that the project work title COLLABORATIVE MANAGEMENT OF INVENTORY FOR IMPROVING THE EFFICIENCY OF APEX HOSPITAL JAIPUR: AN ANALYTICAL STUDY is a record of bonafide work done by me under the supervision of Associate Prof.Dr Sandesh Kumar Sharma, NIMS Institute of Management & Computer Sciences Jaipur- 303001 and submitted to NIMS University, Rajasthan in partial fulfillment of the requirements for the award of degree of Master of Business Administration.

Bhupender Kumar Mehto

MBA (HOSPITAL MANAGEMENT +OPERATION&PRODUCTION) NIMS INSTITUTE OF MANAGEMENT & COMPUTER SCIENCE NIMS UNIVERSITY, JAIPUR, RAJASTHAN.

ACKNOWLEDGEMENT
Though it is difficult to express thanks in words, but it is pleasure to express my gratitude to all those who in their own helped me in accomplishing this work .Firstly, I humbly express my respect and full gratitude to Dr.
.

Sudhinder

Singh Chawhan the Principal of NIMS University, Jaipur for providing all the requisites. I am obliged to Managing Director of the APEX Hospital for granting the permission to do my project. I am very much delegated to thank manager of APEX Hospital for being continuous source of inspirations to me. I am grateful to my faculty member Dr.Sandesh Kumar Sharma who have encouraged and guided me throughout my project .At last with special

attention I give heartily thank to all the staff members of inventory departments and HR department of APEX Hospital under whom guidance, I could perform my work successfully

THANK YOU BHUPENDER KUMAR MEHTO

S.NO 1 2

PARTICULATES Executive Summary Chapter-I Introduction of Topic Chapter-II Profile of The Organization& Literature Review Chapter-III Research Methodology Chapter-IV Data Analysis & Interpretation Chapter-V Finding & Inferences Chapter-VI Conclusion & Recommendation Chapter-VII Bibliography

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SYPNOSIS
PROJECT TITLE : COLLEBORATIVE MANAGEMENT OF INVENTORY MANAGEMENT FOR IMPROVING EFFICIENCY OF APEX HOSPITAL: AN ANALYTICAL STUDY

ORGANISATION

: APEX HOSPITAL

PROJECT DONE BY

: BHUPENDER KUMAR MEHTO

PROJECT GUIDE

: DR.SANDESH KUMAR SHARMA

(ASSOCIATE PROFESSOR) NIMS UNIVERSITY OF MANAGEMENT IM& C.S NIMS UNIVERSITY, JAIPUR, RAJASTHAN

DURATION

: 45 DAYS

EXECUTIVE SUMMARY:The inventory management is an indispensable part of health care organization. Due to emergent nature of work in hospital the role of inventory management is very crucial. The purpose of this study is to determine the ways of achieving the effective inventory management system at APEX hospital, jaipur. In first chapter we have given a general introduction of inventory management, objective of the study, need of study and scope of study. In chapter two, the hospital profile and literature review talks about the issue in inventory management, empirical studies that have been carried out. In chapter three gives research methodology, which consist type of research, research design, sampling, sample size, sample unit and limitations of the study. Chapter four is an analysis of the collected data using pie- charts and interpretations are given. Chapter five and six consists findings and conclusion& recommendations respectively. To enhance the effectiveness of the existing inventory management system, the recommendations are as follows: Well defined procedure of inventory management. Responsibilities should be clearly defined. Hospital should adopt accurately measure inventory level and forecast supply needs methods. Use of advance technology in inventory management.

CHAPTER-1
INTRODUCTION

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INTRODUCTION:What is inventory management? Inventory management is primarily about specifying the size and placement of stocked goods. Inventory management is required at different locations within a facility or within multiple locations of a supply network to protect the regular and planned course of production against the random disturbance of running out of materials or goods. The scope of inventory management also concerns the fine lines between replenishment lead time, carrying costs of inventory, asset management, inventory forecasting, inventory valuation, inventory visibility, future inventory price forecasting, physical inventory, available physical space for inventory, quality management, replenishment, returns and defective goods and demand forecasting. In health care organization, inventory management and supply chain is a new way of conceptualizing medical inventory management. Supply chain is an indispensable component in inventory management. A supply chain as a virtual network that facilitates the movement of product from its production, distribution and consumption. In considering supply chains, health care manager are not only concerned with their relationship with the companies at the upstream source of the product to minimize their overall cost in supply management. The health care manager, as a leader of the provider link in the chain, is in a strategic position and should facilitate collaborative partnership with the adjacent links of the chain. Let us closely examine the various links in the supply chain from the perspective of a health care provider. WHY KEEP INVENTORY? Why would a firm hold more inventory than is currently necessary to ensure the firm's operation? The following is a list of reasons for maintaining what would appear to be "excess" inventory. a) MEET DEMAND. In order for a retailer to stay in business, it must have the products that the customer wants on hand when the customer wants them. If not, the retailer will have to backorder the product. If the customer can get the good from some other source, he or she may choose to do so rather than electing to allow the original retailer to meet demand later (through back-order). Hence, in many instances, if a good is not in inventory, a sale is lost forever.

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b) KEEP OPERATIONS RUNNING. A manufacturer must have certain purchased items (raw materials, components, or subassemblies) in order to manufacture its product. Running out of only one item can prevent a manufacturer from completing the production of its finished goods. Inventory between successive dependent operations also serves to decouple the dependency of the operations. A machine or work center is often dependent upon the previous operation to provide it with parts to work on. If work ceases at a Work center, then all subsequent centers will shut down for lack of work. If a supply of work-in-process inventory is kept between each work center, then each machine can maintain its operations for a limited time, hopefully until operations resume the original center. c) LEAD TIME. Lead time is the time that elapses between the placing of an order (either a purchase order or a production order issued to the shop or the factory floor) and actually receiving the goods ordered. If a supplier (an external firm or an internal department or plant) cannot supply the required goods on demand, then the client firm must keep an inventory of the needed goods. The longer the lead time, the larger the quantity of goods the firm must carry in inventory. A just-in-time (JIT) manufacturing firm, such as Nissan in Smyrna, Tennessee, can maintain extremely low levels of inventory. Nissan takes delivery on truck seats as many as 18 times per day. However, steel mills may have a lead time of up to three months. That means that a firm that uses steel produced at the mill must place orders at least three months in advance of their need. In order to keep their operations running in the meantime, an on-hand inventory of three months steel requirement would be necessary. d) HEDGE. Inventory can also be used as a hedge against price increases and inflation. Salesmen routinely call purchasing agents shortly before a price increase goes into effect. This gives the buyer a chance to purchase material, in excess of current need, at a price that is lower than it would be if the buyer waited until after the price increase occurs.

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e) QUANTITY DISCOUNT. Often firms are given a price discount when purchasing large quantities of a good. This also frequently results in inventory in excess of what is currently needed to meet demand. However, if the discount is sufficient to offset the extra holding cost incurred as a result of the excess inventory, the decision to buy the large quantity is justified. f) SMOOTHING REQUIREMENTS. Sometimes inventory is used to smooth demand requirements in a market where demand is somewhat erratic. There are three basic reasons for keeping an inventory: 1) Time - The time lags present in the supply chain, from supplier to user at every stage, requires that you maintain certain amount of inventory to use in this "lead time" 2) Uncertainty - Inventories are maintained as buffers to meet uncertainties in demand, supply and movements of goods. 3) Economies of scale - Ideal condition of "one unit at a time at a place where user needs it, when he needs it" principle tends to incur lots of costs in terms of logistics. So Bulk buying, movement and storing brings in economies of scale, thus inventory.

SUPPLY CHAIN MANAGEMENT OF HOSPITAL:The healthcare supply chain is composed of three major players at various stages: 1) producers, 2) Purchasers, 3) Healthcare providers.

PRODUCER/MANUFACTURER:Producers include pharmaceutical companies, medical-surgical products companies, device manufacturers, and manufacturers of capital equipment and information systems. Purchasers include grouped purchasing organizations (GPOs), pharmaceutical wholesalers, medical-surgical distributors, independent

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contracted distributors, and product representatives from manufacturers. Providers include hospitals, systems of hospitals, integrated delivery networks (IDNs), and alternate site facilities. At a broader level, healthcare supply chains are very fragmented. The three players are largely operating independently from one another and coordinated supply chain management hardly exists. The Journal of the American Medical Association found that 85 90% of hospital cost structure is comprised of fixed costs (Roberts, 1999). This finding puts hospitals more in a league with transportation or heavy manufacturing than with most other service industries (Ward, 2006). Neumann indicates (2003) that supplies constitute 25% to 30% of a hospitals total operating expense. In addition, 25% of those expenses are tied to administration, overhead, and logistics. The healthcare industry is slow to adopt the supply chain management techniques that have had proven success in other industries.

Distributors, Wholesalers, and Electronic data interchange (EDI):Distributors for medical-surgical suppliers are independent intermediaries who operate their own warehouses; they purchase the product from manufacturer and suppliers to sell to providers. The intermediaries are called distributor or wholesalers depending on whether the products final resale has another layer before reaching the customer. One of the most significant contributions of distributors to the health care supply chain was the deployment of electronic order-entry systems to their customer base. Linking providers through electronic communication to their distributors is formally defined as electronic data interchange (EDI). EDI provides direct, real time computer to computer electronic transmission of purchase orders, shipping notices, invoices, and the like between providers and distributors. The cost for standardized EDI transactions for a purchase order, as compared to costs with manual systems, saves operational costs for both providers and distributors.

Group Purchasing Organizations (GPOs):Group purchasing organizations provide a critical financial advantage to providers, especially hospitals and hospital systems, by negotiating purchasing contracts for products and nonlabor services. A typical GPO has many hospital organizations as its members and uses this as collective buying power in negotiating contracts with many suppliers: of pharmaceuticals, medical-surgical supplies, laboratory, imaging, durable medical equipment, facility maintenance, information technology, insurance, and food and dietary products and services. The contracts usually last three to five years, giving providers price protection.

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The overwhelming majority of hospitals participate in group purchasing. Often a hospital belongs to one or more GPOs. The GPOs can be either for-profit and investor owned, or nonprofit. They differ in geographic coverage, size, and scope. . E-Distributors:E-commerce in health care can be viewed from different perspectives. Here we will concentrate on two aspects: business-to-business (B2B) commerce and business-to-customer (B2C) commerce. B2B e-distribution provides efficiencies in many areas for providers, GPOs, and suppliers in the chain through reduced transaction costs and prices, reduced cycle times with automatic replenishments, deliveries on a JIT basis, and dynamic planningall the way to upstream forecasting for pull-demand, rather than push-demand sales by suppliers. Firms provide e-Catalog, e-Request for Proposal (eRFP), e-Auction, and eSpecials (limited discounts on some items), which emulate traditional systems on-line and are available to both hospitals and physician offices.

NEW CONCEPT OF MATERIAL MANAGEMENT Materials Management in Healthcare (A patient-centered approach)

Materials management plays a crucial role in providing efficient healthcare by touching three vital aspects of medical supplies used in the hospital viz.
a) b) c)

Availability, Safety and Affordability.

Supply chain is the lifeblood of a healthcare organization. As most departments depend heavily on supplies, materials management can ease or cramp a hospitals operations. From a low cost needle to a high-end orthopedic implant, micro steel instruments or pieces of linen, supplies are indispensable during a patients stay at the hospital. Quality care cannot be provided on time unless required material is available in adequate quantity. Materials management plays a crucial role in providing efficient healthcare by touching three vital aspects of medical supplies used in the hospital viz. availability, safety and affordability.

Timing (The most crucial aspect):-

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The time factor is probably not as crucial in any other field as it is in healthcare delivery where delay of a few seconds can cost a life. Moreover, availability of a low cost catheter is as critical as a high value pace maker when it comes to medical care. Therefore, inventory managers have the huge responsibility of making thousands of diverse medical consumables available on time. The challenge is even greater as the number of expected patients are unpredictable; suppliers are unreliable and costs are rising. With recent developments in automation and information technology and emerging trends in the medical supplies industry, materials managers are now better equipped to handle time constraints. Innovative inventory supply models like consignment and rental contracts have eased the pressure of making critical supplies available on time. Life-saving products like defibrillators, drug eluting stents and heart valves are available at hospitals at zero investment. The responsibility for replenishing the stock lies on the vendor. In addition, the patient benefits from the latest technological innovations without the hospital having to carry the fear of obsolescence.

Patient safety (The first priority)

The safety of patient is the top priority in healthcare, and materials managers play a crucial role in protecting his / her interest. The biggest responsibility of a materials manager is to ensure that the products purchased for clinical use are of good quality. It can be achieved by developing a product evaluation system consisting of well-defined parameters to guarantee that only approved products enter a hospitals stockroom. Despite cost being an important criterion in assessing new products, safety and clinical efficacy concerns are prioritized. Physicians should be consulted to help determine if a new product is performing and producing desired clinical impact. Another effective way of determining the safety of a product is to check for CE mark or FDA approval. The vendors access needs to be restricted and back door sales discouraged to ensure that only properly reviewed products are brought into the facility. Materials managers need to take initiative in organizing hands-on training for caregivers to ensure safe use of complex and critical equipment like laparoscopic graspers, staplers and arterial filters. Absence of proper training can result in patient injury leading to serious medico-legal issues. Training programmes conducted by experts can be held either in-house or at specially

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designed state-of-the-art institutes equipped with ergonomically designed simulation labs and conference halls with telesurgery facilities. In many instances, clinical outcome improves with the use of advanced techniques and hence regular training should be encouraged.

Cost(An important variable)

There is tremendous pressure on materials mangers to initiate serious cost cutting measures. While the cost of medical supplies has been spiraling up, greater number of patients is demanding high quality and reasonably priced healthcare services. Since cost of supplies forms a significant portion of healthcare expense, materials mangers should continuously strive to get better deals. Economical prices help ensure affordable medical care for vast majority. The healthcare organization in turn reaps the benefit of better revenue realization stemming from increased number of patients. While the prices available to an organization are influenced by the purchasing volumes, negotiation skills of the purchasing personnel also play an important role. Knowledge of competitive products, awareness of current market trends and capability to use the database for price/volume information helps tremendously in the bargaining process. Other sources for product related information, including regulatory issues are product fairs and conferences, internet articles and periodicals. Collaborative relationships with clinicians and networking with other hospitals and vendors can help in keeping abreast with latest products and upcoming technological trends. Such close and continuous interaction also gives important clues about non-performing products. Instituting an efficient system for payables is effective in getting rebates and discounts, which can be passed on to the patient. The medical supplies industry is flooded with innovative products and services. Materials managers should continuously scout for competitive alternative product / techniques that can give better outcome. While cost is an important criterion, quality of the product needs to be the primary concern to ensure that patient care is not compromised. Conclusion A good inventory management programme is always patient-centred. While inventory is concerned with monetary issues, hospitals are in the business of serving patients. Although technology has an important role to play, the emphasis should be on using it in a way that makes a difference to the quality of

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patient care. Automating inefficient processes may not yield any productive result. Processes should be reengineered to make them more patient-friendly. Cost-effectiveness, time consciousness and safety are key drivers of a patientcentered approach. Once this goal is clear, technology can support and drive the efforts towards realizing efficiencies and improving the quality of health care services.

Requirements for effective inventory:

1. A system to keep track of the inventory in storage and on order. 2. A reliable forecast of demand. 3. Knowledge of lead times and lead time variability. 4. Reasonable estimates of inventory holding costs, ordering costs, and shortage costs. 5. A classification system for inventory items in terms of their importance.

TECHNIQUES USED IN INVENTORY MANAGEMENT

ABC ANALYSIS VED ANALYSIS(Vital, Essential, and Desirable) FSND ANALYSIS(Fast, Slow-moving, Non-moving and dead stock) SDE ANALYSIS(Scare, Difficult and Easy) HML ANALYSIS(High, Medium and Low)

A-B-C ANALYSIS:The ABC analysis is a business term used to define an inventory categorization technique often used in materials management. It is also known as Selective Inventory Control. Policies based on ABC analysis:

A ITEMS: very tight control and accurate records B ITEMS: less tightly controlled and good records C ITEMS: simplest controls possible and minimal records

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The ABC analysis provides a mechanism for identifying items that will have a significant impact on overall inventory cost, while also providing a mechanism for identifying different categories of stock that will require different management and controls. The ABC analysis suggests that inventories of an organization are not of equal value. Thus, the inventory is grouped into three categories (A, B, and C) in order of their estimated importance. 'A' items are very important for an organization. Because of the high value of these A items, frequent value analysis is required. In addition to that, an organization needs to choose an appropriate order pattern (e.g. Just- in- time) to avoid excess capacity. 'B' items are important, but of course less important, than A items and more important than C items. Therefore B items are intergroup items. 'C' items are marginally important.

VED ANALYSIS:VED analysis divides items into three categories in the descending order of their critically as follows: V stands for vital items and their stock analysis requires more attention, because out of stock situation will result in stoppage of production. Thus, 'V items must be stored adequately to ensure smooth operation of the plant. 'E' means essential items. Such items are considered essential for efficient running but without these items the system would not fail. Care must be taken to see that they are always in stock. 'D stands for desirable items which do not affect the production immediately but availability of such items will lead to more efficiency and less fatigue. VED analysis can be very useful to capital intensive process industries. As it analyses items based on their critically, it can be used for those special raw materials which are difficult to procure.

FNSD ANALYSIS:FNSD analysis divides the items into four categories in the descending order of their usage rate as follows: 'F' stands for fast moving items and stocks of such items are consumed in a short span of time. Stocks of fast moving items must be observed constantly and replenishment orders be placed in time to avoid stock-out situations. 'N' means normal moving items and such items are exhausted over a period of a war or so. The order levels and quantities for such items should be on the basis of a new estimate of future demand to minimize the risks of a surplus stock.

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'S' indicates slow moving items, existing stock of which would last for two years or more at the current rate of usage but it is still expected to be used up. Slow moving stock must be reviewed very carefully before any replenishment orders are placed. 'D' stands for dead stock and for its existing stock no further demand can be foreseen. Dead stock figures in the inventory represents money spent that cannot be realized but it occupies useful space. Hence, once such items are identified, efforts must be made to find all alternative uses for it. Otherwise, it must be disposed off. HML ANALYSIS Unit value is the basis of this analysis and not the annual consumption value. H- Unit value>1000(Sanctioned by higher officials) M-Unit value 100to1000. L-Unit value<100. SED ANALYSIS:SED analysis classified items into three groups called scarce, difficult and easy and focuses on ease of procurement as the criterion. The information so collected is then used for finalizing purchasing strategies. Scarce group include items of which there is death, are imported or obtained through canalizing agencies of the government. Such items are procured on annual basis without any EQO type analysis, difficult items include those items which are available indigenously but are not easy to procure due to exotic raw material being used. Certain items which are difficult to be produced due to design complexity also come under difficult category. Items under easy category are produced on a mass- scale, locally available, absence of string specification and are easy to produced. For the obvious reason scarce group is taken care by the experienced senior buyers while the easy group procurement is the responsibility of junior and inexperienced buyers.

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STATEMENT OF PROBLEM:A study on effectiveness of Inventory management at APEX HOSPITAL.

OBJECTIVES OF THE STUDY:1. To study the tools and techniques of inventory management adopted at APEX hospital. 2. To study the inventory control measures in inventory management. 3. To study how ABC analysis and VED techniques are implemented in inventory management. 4. To identify problems related to inventory management. 5. To study the inventory management procedure.

NEED OF THE STUDY: To improve and maintain relationship between Buyer Supplier. To reduce inventory by implementation of comprehensive methods of inventory management. To improve supply- chain management. To get best quality material at competitive material. To reduce inventory cost by using methods of inventory management. To improve overall performance of company by adopting comprehensive methods of inventory management. To remove waste full activities by continuous improvement. To reduce input cost and increase output performance. To increase customer satisfaction by providing best service. To ensure cost efficient benefits to the organization. To maintain inventory and predict according to the forecasting techniques.

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To enhance the effective use of resource to increase the productivity. SCOPE OF THE STUDY:Inventory management being a very important concept in all the companys having a void coverage often calls for the managerial attention. In the modern times inventory management has become the integral part of the all companies. So all the firm gives special importance for inventory management. The major objective of the study is to examine the effectiveness of inventory management system adopted by APEX hospital; the study mainly focuses on the techniques used by the hospital to control the inventory.

In supply-chain management. In productivity enhancement. In operation management. In assets management. In inventory forecasting, valuation and visibility. In quality management In demand forecasting

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CHAPTER-2
HOSPITAL PROFILE& LITERCTURE REVIEW

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HOSPITAL PROFILE:Apex Hospital is multi-specialty, 102 bedded, state-of-art medical center, in Jaipur (Rajasthan, INDIA). Established in year 1994, Apex became one of the first institutes in India to attain ISO 9001 under the leadership of the Managing Director, Dr S.B. Jhawar, a renowned name in the field of medicine over the entire belt of Rajasthan. Dr. S.B. Jhawar, M.D. (Medicine), worked in different hospitals in Dept. of Medicine/Geriatric Psychiatry in England (1975-76). He is one of the first practitioners to start and pioneer Ultrasonography in Rajasthan. From 1994, over the next few years, the hospital gained momentum by leaps and bounds as an impressive team of well known doctors joined in. Apex, since its beginning, set continual expansion and enrichment as its goal. Today, apex is one of the very few medical centers in the region with multispecialty facilities for Cardiac care, Renal transplant, Joint replacement, Obesity surgeries etc. under one roof. We are committed to deliver high quality medical care at an economic price. Apex hospital is authorized by state government and other institutes ( Refer complete list ). The hospital is under process of getting NABH accreditation. A quick glance at Apex Hospital Large building with 30,000 sq. ft. built up area Total number of beds: 102 Intensive Care Unit: 15 beds Fully equipped Neonatal ICU 5 operation theatres 200 full-time employees 35 eminent consultants Cath labs & angiographies Kidney Transplants Obesity / Weight loss Surgery Medical Tourism Initiatives Featuring Tele-medicine

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Apex hospital is equipped with most modern technology & machines to provide authentic diagnostic services.

DIAGNOSTIC SERVICES a) Cardiology: Cath Lab Angiography Angioplasty Echo, colour Doppler, CTMT, ECG.

b) ENDOSCOPY: Gastro-duodenoscopy and Sclerotherapy Varicial ligation Sigmoidoscopy Coconoscopy ERCP Bronchoscopy and alveolarlavage Cystoscopy

C) RADIOLOGY:-

CT Scan Digital X-ray Barium studies Intravenous pyelography Ultrasound, HSG

d) CYTOLOGY AND HISTOPATHOLOGY: Analysis of all types of body fluids Histological assessment of various biopsy specimens FNAC Tru cut Biopsy & Laparoscopic Biopsy

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OTHERS:A) ENDOCRINOLOGY : Thyroid function test Growth hormone Prolactin ACTH, Cortisol assay

B) OPHTHALMOLOGY : Complete evaluation with Slit lamp Bimicroseopy Automated refraction Ultrasound scan, Contact lens

C) NEUROLOGY: EEG EMG Nerve Conduction Studies

D) BIOCHEMISTRY: Blood Sugar, GTT, Blood urea, Creatinine, SGOT/PT, Bilirubin Total protein AG ratio Alkaline Phosphatase Acid Phosphatase, Calcium and Phosphate Electrolyte, Total Lipids Profile Amylase and Lipase, Cardiac enzymes (PK, MB, TropT, LDH, etc)

E) MICROBIOLOGY :-

Cultures

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GRAM's Stain Infection Control

F) PULMONARY MEDICINE: Lung function tests ABG

FACILITIES: 24 hours Emergency State of art advanced Cath Lab ( Siemens Artis Zee ) with fully equipped 8 bed CCU Fully equipped Neonatal ICU, Phototherapy, Radiant warmer, & Exchange transfusion. All vaccinations & Nebulizer therapy for asthmatic children Five highly equipped operation theatres with a separate labour room. Super deluxe & deluxe rooms (with A/C, Balcony, TV, Fridge, Telephone) Cafeteria, Dormitory with bath / toilet for the attendants 24 hrs. Medical shop, Ambulance, Laboratory and Radiology services Evening OPD ( 5- 7 PM): Dentistry, ENT, Gynecology, Medicine, Ophthalmology, Physiotherapy, Surgery. Aerobics Center : Fat to Fit with Fun MLC Approved service.

INVENTORY MANAGEMENT IN APEX HOSPITAL:Material management department/ store department is indispensable for any organization. The nature of work in hospital is always emergent and variable in nature, due to unique feature of hospital industry makes it different from other industries and the role of material management becomes very crucial. Material management should keep in mind about this unique feature of hospital industry and take decision for storage of material.

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Apex hospital is multi-specialty 200 bedded, it has a store department in the basement of hospital. Apex hospital is a small set up; therefore it has a single department named as store department, which handles purchasing, storage, issue and inventory control. Store department of apex hospital store consumable, stationary, equipments and lab reagents. HEIRARICHAL STURCTURE OF STORE DEPARTMENT:-

GENERAL MANAGER

PURCHASE MANAGER

STORE- IN-CHARGE

STORE MANAGER

WARD BOY

STANDARD OPERATING PROTOCOLS

Receiving the material at Receiving Bay Receipt of Material in Stores from Receiving Bay Receipt of consignment goods Processing of Invoices for stocked material

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Emergency Cash Purchase Physical Stock Verification

PROCESS
Receiving the material at Receiving Bay Material is first received at the receiving bay, where it is inspected for the items, item quantity, batch no. and expiry date as per the challan or invoice.

Material in checked for Quantity and specifications, as per the purchase order.

If the material is found to be as per PO specifications, the receipt of goods is acknowledged by stamping and signing the challan or invoice.

After accepting the goods in the receiving bay, the details of the goods received are also recorded at the Security post near Receiving Bay. The security stamp and signatures are put on the challan / invoice.

One copy of the challan is retained at the receiving bay and the other copy is returned to the vendor. The Goods Receipt Note is prepared at the receiving bay mentioning the quantity accepted, batch numbers, expiry date, MRP, and details of Taxes and Discounts if any. This updates the Main Store stocks. (Ideally, the stocks should be updated after the quantities are received and verified in Main Stores and are accepted on system by Stores.) One copy of the challan is retained at the receiving bay and the other copy is returned to the vendor.

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The Goods Receipt Note is prepared at the receiving bay mentioning the quantity accepted, batch numbers, expiry date, MRP, and details of Taxes and Discounts if any. This updates the Main Store stocks. (Ideally, the stocks should be updated after the quantities are received and verified in Main Stores and are accepted on system by Stores.) The goods are transferred to main stores along with two copies of the GRN.

Receipt of Material in Stores from Receiving Bay: The items for which the GRN has been prepared at the receiving Bay are transferred to the Main Stores along with two copies of GRNS.

The items brought in are tallied with the GRN in terms of quantity, batch no and expiry date etc.

In case the item quantity is as per the GRN, the receipt of goods is acknowledged. One copy of the GRN is signed by the receiving person in Stores, which is returned to Receiving Bay. This signed copy of the GRN is attached with the original invoice and is forwarded to Accounts department for releasing the payments.

The items are arranged in a manner, which helps dispensing according to the FIFO principle i.e. in the ascending order of expiry date. Items with short expiry are kept on the outer side and are dispensed earlier. Items with longer expiry dates are kept at the back and are dispensed after the short expiry goods only. (FIFO- First in First Out) In case any item is supplied after 6pm when the receiving bay is closed, the Main Stores receives the same.

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The Pharmacist receives the material in the Basement near Security post.

The copy of the challan is signed and Security stamp is put after physical verification of the goods. The material is kept in the Main store, which is handed over to the receiving bay next morning along with all the documents of receipt.

Receipt of consignment goods

Consignment goods are physically received in the Receiving Bay accompanied with two Copies of challan. Preferably, only one item is received against one challan.

The item received is checked for the Item name, qty mentioned, Batch no. and expiry date. If the details mentioned on the challan are found to be correct the goods are accepted. If not, the same are returned to vendor immediately for necessary correction.

In case the details are found to be correct, both the challan copies are stamped and signed at the receiving bay. The entry of the receipt of goods is made at the security post near receiving Bay. One copy of the challan is returned to the vendor and one copy is kept in Stores for records.

The details of goods received at the Receiving Bay are documented, which include Item name, qty received, Batch no., Challan no/Date, Date of receipt of goods, Name of the receiving person on a register.

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The goods are transferred to Main Stores from the receiving Bay, along with the documentation. If found correct, the goods are received in Stores. As an acknowledgement of receipt of goods, the receiving person in Stores signs the register.

The GRN (Receipt without order) of the consignment goods is prepared in Main Stores. One GRN has only one consignment item.

In the GRN, all information like Challan No., Cost Price, MRP, Batch no. is fed in. In the field of batch no., the challan number is also fed. (Batch no. / Challan no.) This will give a unique Item Identity no. to the consignment item as there may be more than one similar item of the same batch.

The print out of the GRN is taken which will be attached with the challan. The GRN No. is mentioned over the challan copy. The attached challan and GRN are filed company wise in the folders.

The challan no and GRN no. is mentioned on the box of the consignment item in the given format (Challan no. / GRN No.)

The GRN results in the addition of this item in the Consignment inventory of Main Stores, which is segregated in the report from the other stocked inventory of main Stores.

After consumption of the consignment item, copy of the Invoice, challan, GRN and patient consumption details are forwarded together to the Accounts for processing of payments.

32

Processing of Invoices of stocked material All goods are physically received in the Receiving Bay accompanied with either challan or invoice. The invoice for the goods received on challan is received on a later date.

The material is taken on HIS by making Goods Receipt Note after which it is transferred to Stores. Following documents are attached together before forwarding the invoices to the Accounts department: A copy of GRN signed by the Stores for the receipt of goods Challan copy bearing security stamp for the entry of goods Original invoice Proof of any other payments made e.g. octroi.

For the material received on challan, the GRN does not have the Invoice no. After the invoice is received, invoice no. is fed in the system as per the provision provided in HIS.

Payment request is made on HIS.

Payment request will be approved on HIS after verification with the invoice.

Invoice is stamped, verified and signed for processing of payment. Corresponding GRNs are also verified and signed.

33

The invoices are forwarded to Accounts for payment.

The list of challan nos. is prepared against which the material has been received but the invoice has not been received from the vendor. This list is sent to accounts by 1st of every month. Physical Stock Verification

Complete stock verification of the Main Stores is done every three months and that of A category (High value) items including consignment items is done at least once a month. Information about the stock verification is sent to all nursing stations and departments, as stores remain closed during the period of stock verification. No material transaction is done in this period.

Teams are made for different stores to carry out the stock verification.

All pending patient and departmental returns are accepted on HIS, against which the material has been physically received in Stores.

All issues and receipts are stopped before the process of stock verification begins. This is done so as to freeze the inventory.

Print out of the inventory valuation report is taken. The report is also saved in an excel file. The inventory valuation report is distributed to the team members and the process of physical verification is initiated.

34

The process is carried out following the category wise verification since the stocks are stacked category wise on the racks.

The physical stock is written against each item.

After verifying all the items in the list, the sheets are signed by the person who has verified the stocks. The sheets are handed over to the Stores In charge once the verification is completed.

The report of the stock verification is prepared and submitted to Accounts.

INVENTORY MANAGEMENT TECHINIQUES UEDE IN APEX HOSPITAL: A-B-C Analysis V.E.D Analysis

A-B-C Analysis:-

S.NO 1 2 3 4 5 6 7 8 9 10

NAME OF ITEMS ELECTROLYTE REAGENT HIV J MITRA 50 TEST GAUZE THAN 90X16MTR DENGUE NSI 10TEST GLUCOMETER STRIP REGISTRATION FILE HDL CHOLESTROL DILLUENT 20LTR LYSE 500ML MALERIA KIT

QTY

RS

TOTAL

% 0.070353485 0.054663163 0.03710953 0.030924609 0.030924609 0.026388999 0.025333439 0.021028734 0.01662507 0.015091209

C%

26KIT 92 BOX 1200NO 60KIT 15000NO 20000NO 12KIT 34NO 24NO 122KIT

13125 341250 2882 265144 150 180000 2500 10 6.4 10240 3000 3360 600 150000 150000 128000 122880 102000 80640 73200

CATE GARY 0.070353485 A 0.125016648 A 0.162126178 A 0.193050787 0.223975396 0.250364395 0.275697834 0.296726568 0.313351638 0.328442847 A A A A A A A

35
11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 MICROPORE 1 COTTON ROLL 500GMS BILLING RIM 90X12X3 NANOLAB CUVETT VACCUTE EDTA 1X50 INJ TROFENTYL 10ML VACCUTE PLAIN 1X50 SURG GLOVES N.S STERILE ISOTROY 250ML SBC JAR 10LTR R1 VACCUTE NEEDLE 1X100 MICROGEN -125 SONOGRAPHY ROLL LYSE H-18 PAPER RIM IPD FILE TRIVITROM GET GARD SURG GLOVES STERILE CRITICAL CARE CHART LABLE A4 ST BED SIDE LOCKERS HBS AG STRIP 50 TEST ALK PHOSPATE ACCUREX ELECTROLYTE REAGENT H-18 LETTER HEAD LAB ECG ELECTRODES URISTIX DIS MASK MEDICIAN CARD BILLURUBIN BED SIDE RAILING MRD FILE DILLUENT 20LTR H-18 UREA KINETIC AHD SPECIAL 500ML MICROPORE 3 AMYLASE 4X10ML CIDEX 5LTR RINCE 20LTR INJ TROFENTYL 2ML URINE CONTAINERS 3800NO 840ROLL 212RIM 11BOX 270PKT 700NO 264PKT 100PKT 40NO 245NO 135PKT 30NO 150ROLL 11NO 470RIM 4000NOS 5NO 70PKT 7000NO 250NO 17NO 85 BOX 35KIT 3KIT 60000NO 6600NO 100PKT 16200NO 10000NO 38KIT 60NO 4000NOS 8NO 13KIT 120NO 490NO 11KIT 36NO 9KIT 800NO 6700NO 18.9 85 336 6405 250 95 250 625 1522 247 446 2000 380 5135 118 13.5 9975 650 6 165 2302 450 1090 12390 0.6 5.25 341 2 3.2 840 525 7.75 3874 2275 236.25 57.75 2567 777 3045 34 3.94 71820 71400 71232 70455 67500 66500 66000 62500 60880 60515 60210 60000 57000 56485 55460 54000 49875 45500 42000 41250 39134 38250 38150 37170 36000 34650 34100 32400 32000 31920 31500 31000 30992 29575 28350 28298 28237 27972 27405 27200 26398 0.014806703 0.014720114 0.014685478 0.014525289 0.013916074 0.01370991 0.013606828 0.012885254 0.012551268 0.012476018 0.012413138 0.012369843 0.011751351 0.011645177 0.011433859 0.011132859 0.010282432 0.009380465 0.00865889 0.008504267 0.008068024 0.007885775 0.007865159 0.007663118 0.007421906 0.007143585 0.007030194 0.006679715 0.00659725 0.006580757 0.006494168 0.006391086 0.006389436 0.006097302 0.005844751 0.005834031 0.005821455 0.005766821 0.005649926 0.005607662 0.005442319 0.34324955 0.357969663 0.372655142 0.38718043 0.401096504 0.414806414 0.428413242 0.441298495 A A A A A A A A

0.453849763 A 0.466325781 A 0.478738919 A 0.491108763 0.502860114 0.514505291 0.525939149 0.537072009 0.547354441 0.556734906 0.565393796 0.573898063 0.581966088 0.589851863 0.597717022 A A A A A A A A A A A A

0.60538014 A 0.612802046 0.61994563 0.626975825 0.63365554 0.64025279 0.646833547 0.653327715 0.6597188 0.666108237 0.672205539 0.67805029 0.683884321 0.689705775 0.695472596 0.701122522 0.706730184 0.712172503 A A A A A A A A A A A A A A A A B

36
52 53 54 55 56 57 58 59 60 61 62 PLAIN TUBE SKREW CAP BETADINE SCARB 747 SGOT 2X150ML SGPT 2X150ML RINCE H-18 2LTR UREA 160ML BIRTH LOD DISCHARGES TICKET EDTA VIAL TUBE LETTER HEAD APEX BILLING RIM 90X12X2 MEDICIAN SLIP 175PKT 100NO 16KIT 16KIT 11KIT 20KIT 9000NO 173PKT 40000NO 52RIM 2000PAD S 150PCS 56CAINE 800LTR 35NO 175KG 17KIT 20KIT 13KIT 400PADS 2PKT 5LTR 450ROLL 20NO 20NO 6NO 80PCS 150KG 25NO 7KIT 80PKT 60LTR 4BOX 7500NO 3000LTR 2NO 70PKT 6KIT 6NO 65NO 200PADS 2400NO 150 262 1611 1611 2300 1260 2.7 140 0.6 446 11 140 375 26 577.5 115 1180 973 1491 48 9500 3623 40 892.5 892 2940 220 115 656 2313 200 260 3750 2 5 6825 190 2185 2100 190 58 4.75 26250 26200 25776 25776 25300 25200 24300 24220 24000 23192 22000 21000 21000 20800 20212 20125 20060 19460 19383 19200 19000 18115 18000 17850 17840 17640 17600 17250 16400 16191 16000 15600 15000 15000 15000 13650 13300 13110 12600 12350 11600 11400 0.005411807 0.005401498 0.005314085 0.005314085 0.005215951 0.005195334 0.005009787 0.004993293 0.004947937 0.004781357 0.004535609 0.004329445 0.004329445 0.004288212 0.004166988 0.004149052 0.004135651 0.004011953 0.003996078 0.00395835 0.003917117 0.003734662 0.003710953 0.003680028 0.003677967 0.003636734 0.003628487 0.00355633 0.003381091 0.003338002 0.003298625 0.003216159 0.003092461 0.003092461 0.003092461 0.002814139 0.002741982 0.002702811 0.002597667 0.002546126 0.002391503 0.00235027 0.71758431 0.722985808 0.728299893 0.733613978 0.738829928 0.744025263 0.749035049 0.754028343 0.75897628 0.763757637 0.768293246 0.772622691 0.776952137 0.781240349 0.785407337 0.789556389 0.79369204 0.797703992 0.80170007 0.80565842 0.809575537 0.813310199 0.817021152 0.82070118 0.824379147 0.828015881 0.831644369 0.835200699 0.838581789 0.841919791 0.845218416 0.848434576 0.851527037 0.854619497 0.857711958 0.860526098 0.86326808 0.86597089 0.868568558 0.871114684 0.873506187 0.875856457 B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B

63 DIS SHARP CONTAINERS 64 SPIRIT 4.5 LTR 65 PHYNOIAL 66 ECG PAPER TMT 67 BIO BAG 20X24 BLACK 68 CRETININE 69 ADA MTB 15 TEST TULIP 70 URIC ACID 160ML ACC 71 TREAT MENT SHEET 72 PT CUVETT 73 RENOGRAPH 1LTR 74 ECG ROLL 6108 BPL 75 OMNIPAQUE 100ML 76 OXYGEN REGULATOR 77 SODALIME PLUS 5KG 78 EEG ELECTRODES 79 BIO BAG 30X36 BLACK 80 PAPER ECG RECORDING 81 TRIGLYCIRIDES 125ML ACC 82 GLOVES EXAMINITION 83 HAND WASH 5LTR 84 CHIKUNGUNIYA 25 TEST 85 DIS CAP 86 DISTILEED WATER 87 SEVERANE 250 88 PLAIN TUBE 89 PT REAGENT 90 E Z CLEANING SOL 91 BETADINE SOL 2LTR 5% 92 PRESCRIPTION PAD 93 SOAP LIFEBOUY

37
94 BLUE TIP 95 BIO BAG 18X18 BLACK 96 WIDAL KIT 97 ECG FOLDER 98 BIO BAG 20X24 RED 99 BIO BAG 20X24 BLUE 100 CFL 11WATT 101 ACETIK ACID 2.5LTR 102 PROBE CLEANER 103 BIO BAG 20X24 YELLOW 104 CHOLESTROL ACC 105 CALSIUM CHL.15ML 106 CIDEZYME 1LTR 107 DIS.GLASS 108 ETO CARTRIGE 109 GLUCOSE 1000ML 110 C,K MB 2X10ML CORAL 111 TISSUE PAPER ROLL 112 AIR FRESNERS 5LTR 113 DUSTBIN SMALL SIZE 114 ANTI ABD 115 YELLOW TIP 116 VACCUTE PT 117 SOAP HAMAM 118 VACCUTE ESR 119 REQUISITION SLIP 120 FORMALIN SOL 5LTR 121 REGISTER 300PAGE 122 CRP OMEGA 123 COVER SLIP 124 ALBUMIN 1X150ML 125 HARPIC TOILET CLEANER 126 INVESTGATION SUMMARY 127 C,K NAC 2X10ML CORAL 128 TOTAL PROTEIN 2X150ML 129 SODIUM HYPOCLORIDE 130 HISTORY SHEET 131 NURSING ASSESMENT PAD 132 MEDICIAN SLIP EMERGENCY 133 SONOGARPHY FOLDER 134 INJ MORPHITROV 65PKT 90KG 34KIT 4000NOS 85KG 85KG 12NO 14NO 15NO 80KG 6KIT 8KIT 7NO 380PKT 10BOX 8KIT 3KIT 525NO 12NO 120NO 12KIT 48PKT 24PKT 280NO 20PKT 200PADS 10NO 180NO 6KIT 11PKT 21 KIT 120NO 130PADS 6KIT 22KIT 360LTR 120PADS 120PADS 300PADS 2000NO 300NO 160 115 300 2.45 115 115 80 680 630 115 1491 1090 1240 22 832 1017 2637 15 650 65 647 160 315 26 362 35 675 37 1100 590 303 52 48 1036 273 16 48 48 18.5 2.75 18 10400 10350 10200 9800 9775 9775 9600 9520 9450 9200 8946 8720 8680 8360 8320 8136 7911 7875 7800 7800 7764 7680 7560 7280 7240 7000 6750 6660 6600 6490 6363 6240 6240 6216 6006 5760 5760 5760 5550 5500 5400 0.002144106 0.002133798 0.002102873 0.002020408 0.002015254 0.002015254 0.001979175 0.001962682 0.00194825 0.001896709 0.001844344 0.001797751 0.001789504 0.001723532 0.001715285 0.001677351 0.001630964 0.001623542 0.00160808 0.00160808 0.001600658 0.00158334 0.0015586 0.001500874 0.001492628 0.001443148 0.001391607 0.001373053 0.001360683 0.001338005 0.001311822 0.001286464 0.001286464 0.001281516 0.001238221 0.001187505 0.001187505 0.001187505 0.001144211 0.001133902 0.001113286 0.878000563 0.880134361 0.882237235 0.884257642 0.886272896 0.88828815 0.890267325 0.892230007 0.894178257 0.896074966 0.89791931 0.89971706 0.901506564 0.903230096 0.904945381 0.906622732 0.908253696 0.909877238 0.911485317 0.913093397 0.914694055 0.916277395 0.917835995 0.919336869 0.920829497 0.922272645 0.923664253 0.925037305 0.926397988 0.927735993 0.929047815 0.930334279 B B B B B B B B B B B B B B B B B B C C C C C C C C C C C C C C

0.931620742 C 0.932902258 C 0.934140479 C 0.935327984 C 0.936515489 C 0.937702994 C 0.938847205 C 0.939981107 C 0.941094393 C

38
15MG JHALAK POWDER 2.5KG GATE PASS YELLOW MICRO PROTEIN ID BAND WHITE VACCUTE GLUCOSE CFL 18WATT AUTOCLAVE TAP MICROSHIELD 500ML 636 COUNSELLING PAD NURSING REASSESMENT REGISTER 180PAGE BIO BAG 18X18 YELLOW BIO BAG 18X18 RED BIO BEG 18X18 BLUE SPONG 11X11 ECG GLOSSY PAPER AMBO BAG SURGERY REPORTS FILE INDEX CHARGES SHEET RING FILE PEN DRIVE 4GB SOAP ROSE MINI STEPLER PIN BIG R FACTOR DIS SYRINGE 5ML DISPO BANDAGE 6 SODIUM HYPO 5LTR RANBAXY DIS SYRINGE 2ML DISPO ID BAND PINK GLASS SLIDE OT BULB 12V50W CBC MACHINE ROLL SONOGRPAHY JELLY 250ML ECG JELLY 250ML SWICH 16AM HCV J MITRA 50TEST BANDAGE 4 CARBOLIC ACID PEN

135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174

180NO 12000NO 4KIT 7000NO 16PKT 45no 10NO 15NO 100PADS 4000NOS 185NO 40KG 40KG 40KG 350NO 25PKT 5NO 1000NO 136NO 60PAD 95NO 12NO 2200NO 40PKT 3KIT 2000NO 55PKT 10NO 2400NO 2000NO 85PKT 35NO 75 NO 200NO 200NO 40NO 1BOX 65PKT 28NO 1500NO

30 0.45 1330 0.75 328 115 513 320 48 1.2 25 115 115 115 13 180 890 4.4 32 72.5 45 350 1.9 10 1300 1.89 68.25 375 1.47 1.75 40 97 45 16.27 16.27 79 3097 47.25 108 2

5400 5400 5320 5250 5248 5175 5130 4800 4800 4800 4625 4600 4600 4600 4550 4500 4450 4400 4352 4350 4275 4200 4180 4000 3900 3780 3753 3750 3528 3500 3400 3395 3375 3255 3254 3160 3097 3071 3024 3000

0.001113286 0.001113286 0.001096793 0.001082361 0.001081949 0.001066899 0.001057622 0.000989587 0.000989587 0.000989587 0.000953509 0.000948355 0.000948355 0.000948355 0.000938046 0.000927738 0.00091743 0.000907122 0.000897226 0.000896814 0.000881351 0.000865889 0.000861766 0.000824656 0.00080404 0.0007793 0.000773734 0.000773115 0.000727347 0.000721574 0.000700958 0.000699927 0.000695804 0.000671064 0.000670858 0.000651478 0.00063849 0.00063313 0.00062344 0.000618492

0.942207679 0.943320965 0.944417758 0.945500119 0.946582068 0.947648967 0.948706589 0.949696176

C C C C C C C C

0.950685764 C 0.951675351 C 0.95262886 0.953577214 0.954525569 0.955473924 0.95641197 0.957339708 0.958257139 0.95916426 0.960061486 0.9609583 0.961839651 0.96270554 0.963567306 0.964391962 0.965196002 0.965975302 0.966749036 0.967522151 0.968249498 0.968971072 0.96967203 0.970371957 0.971067761 0.971738825 0.972409683 0.973061161 0.973699651 0.974332781 0.974956221 0.975574713 C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C

39
175 ODONIL 176 FEVI STICKS 177 C.K PREST 2X6ML 178 SOCKET 16AM 179 SODALIME DRAGER 5KG 180 DIS SYRINGE 10ML DISPO 181 SBC JAR 10LTRR2 182 EEG PASTE 183 BLOOD SUGAR PAD 184 FILE COBRA 185 INJ MORPHITROV 10MG 186 WIPER 187 CITRIC ACID 400GMS 188 COPY 180PAGE 189 SAVLONE 1LTR 190 STEPLER PIN SMALL 191 TUBE LIGHT 28WATT 192 CFL 9WATT 193 ENEVELOP WHITE SMALL 194 PHOSPORUS 195 CULTURE SWAB 196 OT BULB 24V250W 197 INFORMED CONSENT 198 CFL 26WATT 199 L-FOLDER 200 SAMPLE VIAL 201 PATIENT REG FORM 202 OT BULB 24V150W 203 ID CARD STRING 204 BUTTON FOLDER 205 BLOOD TRANSFUSION 206 HIV PARIKSHAN PAD 207 RUBBER BAND 208 ELECTROLYTE ROLL 209 GLASS CLEANER 5LTR 210 HEMOSPOT 50 TEST CORAL 211 MARKER PEN 212 HYDROGEN PEROOXIDE 400ML 213 FAX ROLL 214 ECG CLIP 215 PAPER ROLL 110MM 100NO 100NO 1KIT 50NO 5NO 800NO 10LTR 20NO 50PAD 300NO 150MG 15NO 40NO 220NO 20NO 460NO 60NO 35NO 5000NO 3KIT 4PKT 20NO 40PAD 15NO 450NO 13PKT 50PAD 20NO 800NO 300NO 30PAD 30PAD 12PKT 40ROLL 7NO 3KIT 80NO 65 NO 20NO 8NO 10NO 29 28 2750 55 515 3.15 247 120 48 8 15 150 55.5 10 105 4.5 34 57.15 0.4 665 490 97 48 125 4 136 35 82 2 5 48 48 120 35 200 460 17 20 65 157 125 2900 2800 2750 2750 2575 2520 2470 2400 2400 2400 2250 2250 2220 2200 2100 2070 2040 2000 2000 1995 1960 1940 1920 1875 1800 1768 1750 1640 1600 1500 1440 1440 1440 1400 1400 1380 1360 1300 1300 1256 1250 0.000597876 0.000577259 0.000566951 0.000566951 0.000530872 0.000519533 0.000509225 0.000494794 0.000494794 0.000494794 0.000463869 0.000463869 0.000457684 0.000453561 0.000432945 0.00042676 0.000420575 0.000412328 0.000412328 0.000411297 0.000404082 0.000399958 0.000395835 0.000386558 0.000371095 0.000364498 0.000360787 0.000338109 0.000329862 0.000309246 0.000296876 0.000296876 0.000296876 0.00028863 0.00028863 0.000284506 0.000280383 0.000268013 0.000268013 0.000258942 0.000257705 0.976172589 0.976749848 0.9773168 0.977883751 0.978414623 0.978934157 0.979443382 0.979938176 0.980432969 0.980927763 0.981391632 0.981855501 0.982313185 0.982766746 0.983199691 0.983626451 0.984047025 0.984459353 0.984871681 0.985282979 0.98568706 0.986087019 0.986482854 0.986869411 0.987240506 0.987605005 0.987965792 0.988303901 0.988633763 0.988943009 0.989239885 0.989536762 0.989833638 0.990122268 0.990410897 0.990695404 C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C

0.990975787 C 0.9912438 C 0.991511813 C 0.991770755 C 0.992028461 C

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216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 ESR TUBE WRRITING PAD CELL PENCIL PEZOR GRAM STAIN GAMA GT MC PAINT 400ML DVD BLANK DIS SYRINGE 1ML BD SWICH 6AM NIRMA POWDER ACON PREGNENCY TEST 50TEST REGISTRE BIG SIZE 450PAGE STEPLER TAP ROLL NURSE ADMISSION ID CARD ORIGINAL CFL 13WATT FORMALIN TABLETS GATE PASS OUTER CELL PENCIL ANESTHETIC EITHER LIQUID DETERGENT TUBE LIGHT 36WATT TINTURE BENZOIN PPD 5TU MANTOSE TEST SOCKET 6AM HIGHLIGHTER CFL 5WATT MARKER PEN RED SCISSOR RED MARK PENCIL PPD 10TU MANTOSE TEST METHALYNE BLUE CFL 36WATT VOUCHER YELLOW BULB 0WATT TAP DISPENSOR PENCIL STAMP PAD VOUCHER PINK GLYCERIN 400ML 30NO 120NO 140NO 6KIT 2KIT 20NO 100NO 400NO 20NO 35NO 4BOX 5NO 40NO 120NO 20PADS 320NO 10NO 20NO 90PADS 180NO 8NO 50LTR 20NO 10NO 7KIT 30NO 45NO 24NO 40NO 20NO 115NO 5KIT 6BOTTLE 6NO 40PADS 45NO 6NO 200NO 25NO 30PADS 10PKT 40 10 8.5 190 562 55 10.5 2.62 52 29 250 200 25 8 48 3 95 47 10 5 110 15 37 72 100 23 15 25 15 30 5 110 90 144 13.5 11.5 85 2.5 17 13.5 40 1200 1200 1190 1140 1124 1100 1050 1048 1040 1015 1000 1000 1000 960 960 960 950 940 900 900 880 750 740 720 700 690 675 600 600 600 575 550 540 540 540 518 510 500 425 405 400 0.000247397 0.000247397 0.000245335 0.000235027 0.000231728 0.00022678 0.000216472 0.00021606 0.000214411 0.000209257 0.000206164 0.000206164 0.000206164 0.000197917 0.000197917 0.000197917 0.000195856 0.000193794 0.000185548 0.000185548 0.000181424 0.000154623 0.000152561 0.000148438 0.000144315 0.000142253 0.000139161 0.000123698 0.000123698 0.000123698 0.000118544 0.00011339 0.000111329 0.000111329 0.000111329 0.000106793 0.000105144 0.000103082 8.76197E-05 8.34964E-05 8.24656E-05 0.992275857 0.992523254 0.99276859 0.993003617 0.993235345 0.993462125 0.993678598 0.993894658 0.994109068 0.994318325 0.994524489 C C C C C C C C C C C

0.994730653 C 0.994936817 0.995134734 0.995332652 0.995530569 0.995726425 0.995920219 0.996105767 0.996291315 0.996472739 0.996627362 0.996779924 0.996928362 0.997072677 0.99721493 0.99735409 0.997477789 0.997601487 0.997725186 0.99784373 0.99795712 0.998068449 0.998179778 0.998291106 0.998397899 0.998503043 0.998606125 0.998693745 0.998777241 0.998859707 C C C C C C C C C C C C C C C C C C C C C C C C C C C C C

41
257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 CARTRIGE RIBBEN VISITING CARD ALBUM ACON VDRL STRIP 50TEST TISSUE PAPER BOX ECG BULB BOTH SODE TAP BROWN TAP ID CARD TEMPERIAL PEN CELLO GRIEP RULE SHEET LINING BLADE SUPERMAX PUNCHING MACHINE CARBON FUSION ACETONE 500ML SCALE WHITE BORAD MARKER SKECTH PEN VEHICLE LOG BOOK PROTECT SHEET FEVI QUICK WHITENER PEN ERRSER SHAPNER INK POT 20NO 4NO 1BOX 15NO 12NO 10NO 12NO 600NO 60NO 30NO 150NO 6NO 2BOTTLE 1KIT 20NO 10NO 120NO 3NO 15NO 20NO 48NO 40NO 32NO 5NO 20 100 375 25 25 30 25 0.5 5 10 1.8 40 110 210 10 20 1.5 45 80 5 20 2 2.5 10 400 400 375 375 300 300 300 300 300 300 270 240 220 210 200 200 180 135 120 100 96 80 80 50 485050 6 8.24656E-05 8.24656E-05 7.73115E-05 7.73115E-05 6.18492E-05 6.18492E-05 6.18492E-05 6.18492E-05 6.18492E-05 6.18492E-05 5.56643E-05 4.94794E-05 4.53561E-05 4.32945E-05 4.12328E-05 4.12328E-05 3.71095E-05 2.78321E-05 2.47397E-05 2.06164E-05 1.97917E-05 1.64931E-05 1.64931E-05 1.03082E-05 0.998942172 C 0.999024638 C 0.999101949 C 0.999179261 0.99924111 0.999302959 0.999364809 0.999426658 0.999488507 0.999550356 0.99960602 0.9996555 0.999700856 0.99974415 0.999785383 0.999826616 0.999863726 0.999891558 0.999916297 0.999936914 0.999956706 0.999973199 0.999989692 1 C C C C C C C C C C C C C C C C C C C C C

V.E.D ANYLYSIS:S.NO 1 2 3 4 5 6 7 8 9 10 NAME OF ITEMS ELECTROLYTE REAGENT HIV J MITRA 50 TEST GAUZE THAN 90X16MTR DENGUE NSI 10TEST GLUCOMETER STRIP HDL CHOLESTROL DILLUENT 20LTR LYSE 500ML MALERIA KIT MICROPORE 1
VITAL

ESSENTIAN DESIRBLE

VITAL VITAL VITAL VITAL VITAL VITAL VITAL VITAL VITAL VITAL

42
11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 COTTON ROLL 500GMS BILLING RIM 90X12X3 NANOLAB CUVETT VACCUTE EDTA 1X50 INJ TROFENTYL 10ML VACCUTE PLAIN 1X50 SURG GLOVES N.S STERILE ISOTROY 250ML SBC JAR 10LTR R1 VACCUTE NEEDLE 1X100 MICROGEN -125 SONOGRAPHY ROLL LYSE H-18 PAPER RIM IPD FILE SURG GLOVES STERILE CRITICAL CARE CHART LABLE A4 ST HBS AG STRIP 50 TEST ALK PHOSPATE ACCUREX ELECTROLYTE REAGENT H-18 LETTER HEAD LAB ECG ELECTRODES URISTIX DIS MASK MEDICIAN CARD BILLURUBIN MRD FILE DILLUENT 20LTR H-18 UREA KINETIC AHD SPECIAL 500ML MICROPORE 3 AMYLASE 4X10ML CIDEX 5LTR RINCE 20LTR INJ TROFENTYL 2ML URINE CONTAINERS PLAIN TUBE SKREW CAP BETADINE SCARB 747 SGOT 2X150ML SGPT 2X150ML RINCE H-18 2LTR UREA 160ML BIRTH LOD DISCHARGES TICKET EDTA VIAL TUBE VITAL VITAL VITAL VITAL VITAL VITAL VITAL VITAL VITAL VITAL ESSENTIAL VITAL VITAL ESSENTIAL VITAL ESSENTIAL ESSENTIAL ESSENTIAL VITAL VITAL VITAL ESSENTIAL VITAL VITAL ESSENTIAL ESSENTIAL VITAL ESSENTIAL VITAL VITAL DESIRABLE VITAL VITAL ESSENTIAL VITAL VITAL ESSENTIAL ESSENTIAL VITAL VITAL VITAL VITAL VITAL ESSENTIAL VITAL

43
56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 LETTER HEAD APEX BILLING RIM 90X12X2 MEDICIAN SLIP DIS SHARP CONTAINERS SPIRIT 4.5 LTR PHYNOIAL ECG PAPER TMT CRETININE ADA MTB 15 TEST TULIP URIC ACID 160ML ACC TREAT MENT SHEET PT CUVETT RENOGRAPH 1LTR ECG ROLL 6108 BPL OMNIPAQUE 100ML SODALIME PLUS 5KG EEG ELECTRODES PAPER ECG RECORDING TRIGLYCIRIDES 125ML ACC GLOVES EXAMINITION HAND WASH 5LTR CHIKUNGUNIYA 25 TEST DIS CAP DISTILEED WATER SEVERANE 250 PLAIN TUBE PT REAGENT E Z CLEANING SOL BETADINE SOL 2LTR 5% PRESCRIPTION PAD SOAP LIFEBOUY BLUE TIP WIDAL KIT ECG FOLDER CFL 11WATT ACETIK ACID 2.5LTR PROBE CLEANER CHOLESTROL ACC CALSIUM CHL.15ML CIDEZYME 1LTR DIS.GLASS ETO CARTRIGE GLUCOSE 1000ML C,K MB 2X10ML CORAL TISSUE PAPER ROLL ESSENTIAL VITAL ESSENTIAL DESIRABLE VITAL DESIRABLE VITAL VITAL VITAL VITAL ESSENTIAL VITAL VITAL VITAL VITAL VITAL ESSENTIAL VITAL VITAL VITAL DESIRABLE VITAL ESSENTIAL VITAL ESSENTIAL VITAL VITAL VITAL VITAL VITAL DESIRABLE VITAL VITAL ESSENTIAL DESIRABLE ESSENTIAL VITAL VITAL VITAL ESSENTIAL DESIRABLE VITAL VITAL VITAL DESIRABLE

44
101 102 103 104 105 106 107 108 109 110 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 AIR FRESNERS 5LTR DUSTBIN SMALL SIZE ANTI ABD YELLOW TIP VACCUTE PT SOAP HAMAM VACCUTE ESR REQUISITION SLIP FORMALIN SOL 5LTR REGISTER 300PAGE CRP OMEGA COVER SLIP ALBUMIN 1X150ML HARPIC TOILET CLEANER INVESTGATION SUMMARY C,K NAC 2X10ML CORAL TOTAL PROTEIN 2X150ML SODIUM HYPOCLORIDE HISTORY SHEET NURSING ASSESMENT PAD MEDICIAN SLIP EMERGENCY SONOGARPHY FOLDER INJ MORPHITROV 15MG JHALAK POWDER 2.5KG GATE PASS YELLOW MICRO PROTEIN ID BAND WHITE VACCUTE GLUCOSE CFL 18WATT AUTOCLAVE TAP MICROSHIELD 500ML 636 COUNSELLING PAD NURSING REASSESMENT REGISTER 180PAGE SPONG 11X11 ECG GLOSSY PAPER AMBO BAG SURGERY REPORTS FILE INDEX CHARGES SHEET RING FILE PEN DRIVE 4GB SOAP ROSE MINI STEPLER PIN BIG R FACTOR DESIRABLE DESIRABLE VITAL VITAL VITAL DESIRABLE VITAL DESIRABLE ESSENTIAL DESIRABLE VITAL ESSENTIAL VITAL DESIRABLE ESSENTIAL VITAL VITAL ESSENTIAL ESSENTIAL ESSENTIAL ESSENTIAL VITAL VITAL DESIRABLE ESSENTIAL VITAL DESIRABLE VITAL DESIRABLE ESSENTIAL ESSENTIAL ESSENTIAL ESSENTIAL DESIRABLE ESSENTIAL VITAL ESSENTIAL ESSENTIAL DESIRABLE ESSENTIAL DESIRABLE DESIRABLE DESIRABLE DESIRABLE VITAL DESIRABLE DESIRABLE DESIRABLE

45
145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 DIS SYRINGE 5ML DISPO BANDAGE 6 SODIUM HYPO 5LTR RANBAXY DIS SYRINGE 2ML DISPO ID BAND PINK GLASS SLIDE OT BULB 12V50W CBC MACHINE ROLL SONOGRPAHY JELLY 250ML ECG JELLY 250ML SWICH 16AM HCV J MITRA 50TEST BANDAGE 4 CARBOLIC ACID PEN ODONIL FEVI STICKS C.K PREST 2X6ML SOCKET 16AM SODALIME DRAGER 5KG DIS SYRINGE 10ML DISPO SBC JAR 10LTRR2 EEG PASTE BLOOD SUGAR PAD FILE COBRA INJ MORPHITROV 10MG WIPER CITRIC ACID 400GMS COPY 180PAGE SAVLONE 1LTR STEPLER PIN SMALL TUBE LIGHT 28WATT CFL 9WATT ENEVELOP WHITE SMALL PHOSPORUS CULTURE SWAB OT BULB 24V250W INFORMED CONSENT CFL 26WATT L-FOLDER SAMPLE VIAL PATIENT REG FORM OT BULB 24V150W ID CARD STRING BUTTON FOLDER ESSENTIAL VITAL ESSENTIAL ESSENTIAL ESSENTIAL VITAL ESSENTIAL VITAL VITAL VITAL DESIRABLE VITAL VITAL ESSENTIAL DESIRABLE DESIRABLE DESIRABLE VITAL DESIRABLE VITAL ESSENTIAL VITAL VITAL ESSENTIAL ESSENTIAL VITAL DESIRABLE VITAL DESIRABLE ESSENTIAL DESIRABLE DESIRABLE DESIRABLE DESIRABLE VITAL VITAL ESSENTIAL ESSENTIAL DESIRABLE ESSENTIAL VITAL ESSENTIAL ESSENTIAL DESIRABLE DESIRABLE

46
190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 232 233 BLOOD TRANSFUSION HIV PARIKSHAN PAD RUBBER BAND ELECTROLYTE ROLL GLASS CLEANER 5LTR HEMOSPOT 50 TEST CORAL MARKER PEN HYDROGEN PEROOXIDE 400ML FAX ROLL ECG CLIP PAPER ROLL 110MM ESR TUBE WRRITING PAD CELL PENCIL PEZOR GRAM STAIN GAMA GT MC PAINT 400ML DVD BLANK DIS SYRINGE 1ML BD SWICH 6AM NIRMA POWDER ACON PREGNENCY TEST 50TEST REGISTRE BIG SIZE 450PAGE STEPLER TAP ROLL NURSE ADMISSION ID CARD ORIGINAL CFL 13WATT FORMALIN TABLETS GATE PASS OUTER CELL PENCIL ANESTHETIC EITHER LIQUID DETERGENT TUBE LIGHT 36WATT TINTURE BENZOIN PPD 5TU MANTOSE TEST SOCKET 6AM HIGHLIGHTER CFL 5WATT MARKER PEN RED SCISSOR RED MARK PENCIL PPD 10TU MANTOSE TEST METHALYNE BLUE CFL 36WATT ESSENTIAL ESSENTIAL DESIRABLE VITAL DESIRABLE VITAL DESIRABLE ESSENTIAL ESSENTIAL ESSENTIAL VITAL VITAL DESIRABLE ESSENTIAL VITAL VITAL ESSENTIAL DESIRABLE ESSENTIAL DESIRABLE DESIRABLE VITAL DESIRABLE DESIRABLE DESIRABLE ESSENTIAL ESSENTIAL DESIRABLE ESSENTIAL ESSENTIAL ESSENTIAL ESSENTIAL DESIRABLE DESIRABLE ESSENTIAL VITAL DESIRABLE DESIRABLE DESIRABLE DESIRABLE DESIRABLE DESIRABLE VITAL VITAL DESIRABLE

DESIRABLE

47
234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 VOUCHER YELLOW BULB 0WATT TAP DISPENSOR PENCIL STAMP PAD VOUCHER PINK GLYCERIN 400ML CARTRIGE RIBBEN VISITING CARD ALBUM ACON VDRL STRIP 50TEST TISSUE PAPER BOX ECG BULB BOTH SODE TAP BROWN TAP ID CARD TEMPERIAL PEN CELLO GRIEP RULE SHEET LINING BLADE SUPERMAX PUNCHING MACHINE CARBON FUSION ACETONE 500ML SCALE WHITE BORAD MARKER SKECTH PEN VEHICLE LOG BOOK PROTECT SHEET FEVI QUICK WHITENER PEN ERRSER SHAPNER INK POT BIO BAG 20X24 BLACK BIO BAG 20X24 YELLOW BIO BAG 20X24 RED BIO BAG 20X24 BLUE BIO BAG 30X36 BLACK BIO BAG 18X18 RED BIO BAG 18X18 YELLOW BIO BAG 18X18 BLUE BIO BAG 18X18 BLACK REGISTRATION FILE ESSENTIAL DESIRABLE DESIRABLE DESIRABLE DESIRABLE ESSENTIAL ESSENTIAL ESSENTIAL DESIRABLE VITAL DESIRABLE ESSENTIAL DESIRABLE DESIRABLE DESIRABLE DESIRABLE DESIRABLE DESIRABLE DESIRABLE VITAL VITAL DESIRABLE DESIRABLE DESIRABLE DESIRABLE ESSENTIAL DESIRABLE DESIRABLE DESIRABLE DESIRABLE DESIRABLE ESSENTIAL ESSENTIAL ESSENTIAL ESSENTIAL ESSENTIAL ESSENTIAL ESSENTIAL ESSENTIAL ESSENTIAL VITAL

48

LITERATURE REVIEW:Introduction
This chapter explains the theoretical and empirical evidence about inventory management. In theory, features of effective inventory management systems are explained, how the use of computers affects the organizations use of inventory management systems, the need for controls and how to much demand with supply. In practice the chapter tries to look at previous studies done on the inventory management. It also establishes the knowledge gap. Successful inventory management involves balancing the costs of inventory with the benefits of inventory. Many small business owners fail to appreciate fully the true costs of carrying inventory, which include not only direct costs of storage, insurance and taxes, but also the cost of money tied up in inventory.

Review of Theories
Inventory control is not a Science, more nearly it is a set of methods for figuring out how much stock to order, when and how to receive it (Tibur, 2008). It is one of the roles that management has to play by putting a system of keeping track of items in inventory. A powerful inventory management system is the base of the every good retail software package. An inventory management system lets you know what our important needs, with inventory management systems are, you can get minors to majors report on what you have in stock, on order transit. Retailers software with an inventory management system eliminates the guesswork from running your retail business. The system can be set up to automatically notify you when it is time to order more inventories such as when stock falls below a prearranged level. By always having your hottest items in stock, you will be sure to not sell due to out-of- stock items. Many retail software packages will even generate purchase orders, further streamlining inventory management. In addition to increasing your sales, retail software with an inventory management system drastically reduce your operating costs by reducing the time spent manually counting inventory and creating purchases. It will also track which items are selling and which are not. By identifying your less moving items you can adjust their position, pricing or other issues earlier. You can also see which items are often purchased in pairs and can group them consequently in the store. Keeping inventory cost low is vital to competitive benefits. In a hospital, materials management has become a distinct function. Depending on the size of the hospital it could be a separate department or in a smaller set up it could be under the care of the Manager. Materials in a hospital range from consumables, stationery to even equipments besides the pharmaceuticals and

49

optical goods. The first broad section inventory management which is delineated into the following parts: Purchasing, Storage, Issue, and Inventory

Need for inventory control records:A comprehensive inventory control record system is relevant in order that:a) Goods sold can be recorded and balances in both physical and monetary terms calculated. b) Checks can be implemented on regular or random basis to minimize losses due to pilferage or damage in stores. c) Goods can be recorded on a receipt in relation to both quantity and price, by use of highly effective integrated computer system besides the manual system. d) Replacement of stock can be ordered when re-order level is reached. e) Records can be examined in order to highlight slow moving inventory which may deteriorate or become obsolete. f) Inventory can be charged to the appropriate department code when issued from store. g) Returns to store can be properly recorded/ accounted for. h) Rightful quality and quantity duly signed for and recorded in Goods Received Note (GRN). i) Stock taking procedure at a given time is done efficiently. j) The valuation of stock for balance sheet and profit measurement purposes can be accurately implemented (Kagiri, 2006).

Empirical studies
Strategy for resolving maximum profit for inventory minimization:Green and MischaDick (2001) found out that just like any investment in business; inventory needs to serve the purpose of maximizing profit. However, in many cases inventory has turned into a major cash flow constraint thus making it necessary to optimize inventory using analytical and statistical methods in an integrated approach. One of the biggest challenges in optimizing inventory is the fact that it is merely an output of many inter-organizational processes, all too often organization attempt to lower inventory using non-analytical approaches which lower service levels. The study was conducted through a case study of a major US corporation, where Green and MischaDick identified two-step approach of significant value; optimizing inventory levels while viewing the existing order fulfillment process as a given constraint and changing the fundamental order fulfillment process across the entire system. The first step was used to make quick and successful cash availability. The second step was used to generate

50

breakthrough business results and provide a robust order fulfillment process that was to perform at lower inventory levels while providing extraordinary service levels. The real world constraint is taken into account prior to deciding on the appropriate changes. Simulations are conducted to verify the appropriateness of the analytical models using actual process data. Cash flow problem is identified, further analysis reveals that inventory levels are high and turns are below most major competition. This study has not focused on the systems necessary for inventory management; they have only taken into consideration inventory level as a strategy for maximizing profit. Inventory value using six- sigma:Green and MischaDick (2002) found out that old equipment are viewed as not worth understanding and improving for the operations, however, replacement cost can be staggering. Certainty purchasing new equipment is necessary at times. However, frequently it is possible to produce good product with existing equipment. Properly characterizing existing equipment using statistical methods can yield significant improvements. The research was carried out through a case study to a major US manufacturer, made the decision to stop providing critical components. The supplier made the decision because the equipment was the 3040 years old, yields had traditionally run at 60% and the margins were low, a baseline of the extrusion process was performed and a vast list of potential factors was identified during process mapping. It was also determined through measurement system studies that the measurement systems were not capable of measuring the parts. The measurement systems were improved and several screening designed experiments were conducted. Results showed a few key factors to be important. Follow-up optimization experiments were run. The process was producing 100% yield within 3 months on existing numbers. The next step was to produce parts that had not been previously produced. The first parts off of the new die met the desired specification, although slightly off target. This study has only considered the value addition or utilization of existing equipment considered outdated to produce high quality product efficiently, therefore it did not consider the systems necessary for inventory management

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CHAPTER-3
RESEARCH METHODOLOGY

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Research Methodology and design

Introduction Under this section the chapter will show the methods and techniques that will be used to collect and analyze data during research. The research to be carried out is on enhancing effective inventory management in APEX hospital. Areas to be touched on include research design, target population, types of data, sources of data, tools to be used to collect data and the sampling design to be used.

Research Methodology:A Research Methodology defines the purpose of the research, how it proceeds, how to measure progress and what constitute success with respect to the objectives determined for carrying out the research study. Research design:The research design is descriptive in nature. The design shows the analysis of the variables relevant to the subject under study because it will focus its attention on the individual study and not the whole population of apex hospital. . It is based on data collected through structured questionnaire from the respondent. Target Population:The study targets the staff of apex hospital and vendors. Primary data will be collected through questionnaires which will be the main source of data and secondary data will be used to assist the evaluation of data to be collected in the field. Data collected in the field will be tested and results will help to write a report upon completion of analysis. SAMPLING DESIGN:Sampling is the process of obtaining about an entire population by examining only a part of it. Sampling plans calls for three decisions. a) Sample unit b) Sample size c) Sampling procedure The design to be adopted for the study will be based on convenient sampling. The population for the study will consist of employees in the APEX hospital.

53

SAMPLE UNIT APEX HOSPITAL SAMPLE SIZE 20 employees SAMPLING PROCEDURE:For the study, respondent were selected on the basis of random sampling.

SOURCE OF THE DATA:The study requires both primary and secondary data. PRIMARY SOURCE: Questionnaires Interviews SECONDARY SOURCE: Indirect observation Library and research work Internet, web pages and blogs Articles Books

Secondary data will be used to analyze the primary data in light of real world situations. ANALYSIS OF THE DATA:The primary data will be analyzed with the help of statistical tools and techniques.

DATA PRESENATION TOOLS USED:Primary data was collected through the questionnaire by distributing questionnaires; questionnaires with both close ended and open ended questions

54

have been used as sample respondents. The facts are presented in the form of pie- charts and bars. LIMITATIONS OF STUDY: The study is confined to APEX hospital, jaipur only. The interpretations and recommendations applicable to this cooperative. The study was conducted on the assumptions that the information is given by respondent. Sample size is restricted to 20 respondents. Time constraints. Top management has not adequate time, due to their busy schedule.

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CHAPTER-4

DATA ANALYSIS&INTERPRETATION

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DATA ANALYSIS AND INTERPRETATION

Q.1. Do you know about inventory management? 1) Yes 2) No 3) cant say
can't say 0%

No 40%

Yes 60%

Interpretation:From above pie chart, it is clear that most of the people are aware about inventory management but 40% employees are not aware. Q.2. Do you know about production management? 1) Yes 2) No 3) cant say

can't say 15%

Yes 45%

No 40%

Interpretation:From above figure, shows that 45% employees are aware with production management but 40% employees are not aware.

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Q.3. Do you know about supply-chain management? 1) Yes 2) No 3) cant say

cant say 19% No 12% Yes 69%

Interpretation:From above pie figure , shows that only 69% employees are aware about supply-chain management, 12% employees are not aware.

Q.4. Which type of operation management you use? 1) Traditional 2) Just in time 3) Both
18 16 14 12 10 8 6 4 2 0 Traditional Just- in time Both

Interpretation:Above figure represents that traditional method of inventory management is more in use than just in time.

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Q.5. Do you know about A-B-C analysis? 1) Yes 2) No

Cant'say 11%

3) Cant say

No 26% Yes 63%

Interpretation:From above pie figure , shows that 63% employees know about A-B-C analysis and 26% dont know. Q.6. Do you know about V.E.D analysis? 1) Yes 2) No
Cant'say 0% No 40% Yes 60%

3) Somewhat

Interpretation:Pie figure shows that 60% employees are aware about V.E.D analysis, 40% employees dont know.

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Q.7. Are you agree that with the help of inventory management any organization can increase its productivity? 1) Strongly agree 2) Agree 3) Indifference 4) Disagree 5) Strongly disagree
Indifference 15% Disagree 0% Strongly disagree 0%

Agree 35%

Strongly agree 50%

Interpretation:Figure shows that 50% employees are strongly agree, 35% employees are agree and 15% employees are indifference. Q.8. Are you satisfy with the store activities? ( i.e. issuing of material, quantity, and quality etc. of the material). 1) Strongly Satisfy 2) Satisfy 3) Dissatisfy 4) Strongly dissatisfy
Strongly 10%

Dissatisfy 25%

Strongly Satisfy 40%

Satisfy 25%

Interpretation:Pie figure shows that 40% employees are strongly satisfy, 25% employees are satisfy ,25% employees are dissatisfy and 10% employees are strongly dissatisfy.

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Q.9. Are you satisfy with the purchasing procedure adopted by hospital? 1) Strongly Satisfy 2) Satisfy 3) Indifference 4) Dissatisfy 5) Strongly dissatisfy
Indifferen ce 11% Dissatisfy 5% Strongly dissatisfy 0%

Satisfy 18%

Strongly Satisfy 66%

Interpretation:Above pie figure shows that 66% employees are strongly satisfy with the purchasing procedure , 18% employees are satisfy 11% employees are indifference and 5% employees are dissatisfy. Q.10. What is the method do you use to issue the material? 1) First in, first out (FIFO) Both
12 10 8 6 4 2 0 FIFO LIFO Other Both

2) Last in, first out (LIFO)

3) Other

4)

Interpretation:Figure shows that last in, first out (LIFO) method is mostly adopted and then first in, first out (FIFO) . In few cases both methods are used for issuing the material.

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Q.11. Is there any purchasing committee? 1) Yes 2) No 3) Cantsay

18 16 14 12 10 8 6 4 2 0 Yes No Cantsay

Interpretation:Figure shows that most of the employees are aware about the purchasing committee of the organization. Q.12. Purchasing committee consists: 1) Managing director, Purchase manager, Store in charge and store manager. 2) MD, Purchase manager, doctor, Different departments heads. 3) MD, different department heads, purchasing manager. 4) MD, purchase manager, doctors.

3 15%

4 10% 1 50%

2 25%

Interpretation:-

Figure shows that 50% of the employees are aware about purchasing committee members, 50% employees are not aware.

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Q.13. Inventory management is used by organization for 1) To reduce uncertainty. 2) To reduce uncertainty in lead time 3) To build stock for scale of economies 4) To reduce the inventory cost 5)All above
10 9 8 7 6 5 4 3 2 1 0 reduce reduce scale of uncertainty uncertainty economies in lead time reduce the inventory cost 5)All above All above

Interpretation:Figure shows that most of the employees are aware about objective of inventory management. Q.14. Which type of order method is used by organization? 1) Lot to lot 2 )Economical order quantity 3)Fixed order quantity 4)Fixed order time
10 8 6 4 2 0 1st Qtr 2nd Qtr 3rd Qtr 4th Qtr

Interpretation:Above figure shows that economical order quantity is used by the organization for most of the items but in few cases they use other methods.

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Q.15. Which type of purchasing order is prepared? 1) Manual 2) Electronic 3) Both

16 14 12 10 8 6 4 2 0 Manual Electronic Both

Interpretation:Figure shows that organization use manual methods than electronic.

Q.16.Which type of purchasing order procedure is used by the organization? 1) Formal( Paper work) 2) Informal(Telephonic order) 3) Electronic data interchange(EDI) i.e. (though e-mail) 4) All above
Electronic data interchange 10% All above 5%

Informal 15% Formal 70%

Interpretation:Figure shows that 70% work in inventory is done through formal paper work ,15% works is done trough informal methods, 10% is done by EDI.

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Q.17. Who make the purchasing order? 1) Purchasing manager 2) Store in charge

3) Store manager

Store manager 45%

Purchasing manager 37%

Store in charge 18%

Interpretation:Figure shows that 45% respondent assume that purchasing order is prepared by store manager, 18% store- in manager and 37% purchasing manager.

Q.18. Who approved the purchasing order? 1) Purchasing manager 2) Store-in charge

3) Store manager
) Store manager 7%

Store-in charge 10%

Purchasing manager 83%

Interpretation:Figure shows that 83% respondents assume that purchasing order is approved by the purchasing manager, 10% by store-in charge and 7% by store manager.

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Q.19. Is there any specific place for receiving and inspection of material? 1) Yes 2) No

yes 25%

no 75%

Interpretation:Figure shows that 75% respondents assume that in hospital there is no specific place for reception of material.

Q.20. Purchasing and storage is handled by single department? 1) Yes 2) No

no 15%

yes 85%

Interpretation:Figure shows that 85% respondent assumes that purchasing and storage is done by a single department.

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Q.21. A.B.C and V.E.D analysis is done 1) Yearly 2) Half yearly

monthely 7%

3) Quarterly

4) Monthly

quaterly 22% half yearly 27%

yearly 44%

Interpretation:Figure shows that 44% respondents assume that A.B.C and V.E.D analysis is done in a year, 27% assume half yearly, 22% quarterly and 7% monthely. Q.22. Purchasing order is given in a month: 1) One time 2) Two times

3) More than two times

one time 31% more than two times 54% two time 15%

Interpretation:Figure shows that 54% respondents assume that purchasing order is given more than two times in a month, 31% one times and 15% two times

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Q.23. Safety stock (also called buffer stock) is a term used by logisticians to describe a level of extra stock that is maintained to mitigate risk of stockouts (shortfall in raw material or packaging) due to uncertainties in supply and demand. 2) Strongly agree 2) Agree 3) Indifference 4) Disagree 5) Strongly disagree
Strongly disagree 10% Disagree 14% Indifference 9% Agree 24%

Strongly agree 43%

Interpretation:Figure shows that 43% respondents are strongly agree with the statement, 24% are agree and 10% are strongly disagree. Q.24. Do you have safety stock for each item? 1) Yes 2 ) No

no 19%

yes 81%

Interpretation:Figure shows that 81% respondents are agree that each item has safty stock, while 19% respondents disagree.

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CHAPTER-5
FINDINGS & INTERFERENCES

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Findings & interferences:The primary data, which is collected with the help of questionnaire represent many essentials findings about the performance appraisal system of the APEX hospital. In apex hospital most of the employees are aware about inventory management, production management and supplychain management. Apex hospital is using traditional and just- in time methods of operation management. Inventory department is using A-B-C and V.E.D analysis for the management of material. Store department is using first in first out method of issuing of material in apex hospital. Apex hospital consist a purchasing committee which is composed of Managing director ,purchase manager, store-in charge and store manager. Store department is using economical order quantity method of order. Most of the purchasing order is manually prepared and it is prepared by store manager and approved by purchase manager. No order can give without approval of purchase manager. In hospital there is no specific place for receiving and inspection of consignment material from the distributor or producer. Product evaluation system in APEX hospital is not so effective.

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CHAPTER-6
CONCLUSION & RECOMMENDATIONS

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CONCLUSION:1. Inventory department of APEX hospital uses economical order quantity as the basis for stockage levels and reorder quantities. 2. There exists a moderate level of satisfaction with the current system. 3. The majority of respondents had a moderate level of experience/knowledge of inventory management.
4. The

level of efficiency/ effectiveness of the inventory

management system is moderate. 5. The coordination between different departments is low, which reduces the overall productivity hospital. 6. There is centralized system of inventory management.

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RECOMMANDATIONS: APEX Hospital should adopt accurately measure inventory level and forecast supply needs methods. There should be a clear and easy procedure that how inventory will move throughout the hospital. Responsibilities should be well defined for each employee in inventory management system. Store should have more space so that in according to need it can be extended. The employees should have skills and qualification according to the need of the place. Optimize process to eliminate operational bottleneck. Generate aware in the employees for inventory management and clearly define the objectives of inventory management to the employees of hospital. Minimize shrinkage due to theft or unnecessary use of inventory. Audit should be done by the top management at regular basis. Advance inventory management technology should use to improve performance. There should be strong coordination between different departments of hospital Hospital should use effective product evaluation system.

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BIBLIOGRAPHY: http://www.asianhhm.com/knowledge_bank/articles/materialsmanagement-healthcare.htm http://www.v2020eresource.org/newsitenews.aspx?tpath=news1 2008 http://currentnursing.com/nursing_management/material_manag ement_ABC_VED_HML_analysis.html http://www.scribd.com/doc/29335516/Inventory-ManagementProject http://www.saching.com/Articles/The-Role-of-MaterialManagement-in-the-Success-of-a-Company-2416.html http://www.publishyourarticles.net/knowledge-hub/costaccounting/what-are-the-techniques-of-store-inventorycontrol.html http://www.apexhospital.in/index_doctor.asp