Network value analysis of the pharmaceutical assistance in Porto Alegre city: a systemic view

Abstract

The Pharmaceutical Service (PS) involves a set of drug-related processes, including all logistic movement and promotion of rational use of these products. To deliver the desired value to the users of the health system, the PS network consists of several actors interacting to perform a set of activities, classified in selection, programming, acquisition, storage, distribution and dispensing of medicines (S-P-A-S-D-D). The objective in this research was to test the application of Value Network Analysis in a complex health process. The construction of value network of the PS happened through workshops with the managers of the PS of the municipality of Porto Alegre. As a result, it was observed that the graphical representation provided by the NVA tool, at first, surprised the managers involved, when observing the complexity of the tangible and intangible flows exchanged between the actors of the network. The analysis of the network led to the restructuring of functions and reallocation of pharmaceutical professionals, increasing the number of pharmacists acting directly in the district pharmacies, and structuring a support position for the management of the logistics processes. The changes take place by improving the overall performance of the professionals without any increase in staff or additional expenses with salaries.