Lessons from a Surgical Center Satellite Warehouse in a Large Brazilian Public Hospital

Abstract

Brazilian public hospitals face several operational problems not only related to poor public management practices and their complex nature, but also the economic, and social contexts. Considering this scenario and the fact that efforts in supply management might affect a hospital organization’s excellence, this research aims to identify improvements in the logistic operations at the surgical center satellite warehouse of a Public Hospital located in Brazil. A case study based on an exploratory and qualitative approach was conducted by employing document analysis, semi-structured interviews, and on-site observations. Seven major problems concerning lack of surgical material, the non-definition of crucial logistic parameters, low information flow, surgical supply control, and management problems were pointed and addressed by seven independent but complementary actions that considered the Brazilian healthcare system’s particularities. Given the nature of exploratory research, the results are not exhaustive and cannot be generalized to different contexts. However, they help understand that reducing the waste of the logistics processes makes it possible to improve the attention to the local population that uses public health services.

Management and Organization of Storage in Hospitals, Health Storehouses, and Health Care Facilities

“…A core warehouse and a satellite warehouse make up the MW. The hospital's Surgical Center, which has many operating rooms, serves as the satellite warehouse (SW), which typically functions from there and obtains its supplies from the main warehouse [15]. ABC classification, where the categorization is based on the cost of the supply, is a very fundamental method of inventory control.…”

“…Due to challenges in creating more ordered procedures, it is common for personnel to keep supplies secret in medical units according to Volland et al For instance, the hospital's ambulatory has a physical area for storing and distributing goods. In order to save time and guarantee material availability, the ambulatory staff administer and maintain this "informal" warehouse and distribution facility, which is not a formal component of the hospital [15].…”

“…The primary one has to do with how frequently the rounds are made. The procedures that are planned or scheduled after that are included in the surgical map late since they only occur once a week, which might lead to organizational issues [15].…”

An Integrated Cost Model Based on Real Patient Flow: Exploring Surgical Hospitalization

“…Hospitals are complex and expensive structures [ 21 ] and the health decision maker should be supported with the best possible foundation. Economic evaluation in health has been applied to provide this basis and one of its forms, cost analysis, is considered the essential element of all evaluations [ 22 , 23 ].…”