150219 Pg Stock Management ENG › Documents › ...Management_ENG.pdf · = 1 presentation = 1...
Transcript of 150219 Pg Stock Management ENG › Documents › ...Management_ENG.pdf · = 1 presentation = 1...
STOCK MANAGEMENT
ITM
2014Philippe GilletHilde De Boeck
STOCK MANAGEMENT: Exercice (1)
• Timing: 5’ Introduction
40’ Exercice
40’ Restitution
40’ Conclusion
• Execution: role-play and results
"Receive and store a medical order"
STOCK MANAGEMENT: Exercice (1): order
STOCK MANAGEMENT: Exercice (1) : packing list
• Check the conformity between the order and what is received,
• Check the conformity of the packing list with the parcels received,
• Check the conformity of products + expiry date, shipment
conditions, integrity, etc.
• Prepare a report of receipt,
• Arrange storage of products received (storage conditions, stock
cards, etc.., ...).
STOCK MANAGEMENT: Exercice (1)
"Receive and store an medical order"
What should you do:
= 1 presentation
= 1 expiry date
= 1 batch/lot. N°
1 card = 1 product
1 movement = 1 row
c.f. :TLM_PRO_004_V01_Use of stock cards RDTs.pdf
TLM_F_001 Version 002: STOCK CARD – FICHE DE STOCK
STOCK MANAGEMENT: Exercice (1)
Tasks Group 1
Group 2
Group 3
Group 4
items 1 - 8 9 - 15 16 - 22 23 - 29
1
2
3
4
5
STOCK MANAGEMENT: Exercice (1)
Opening packages + conformity packing list
Conformity order
Conformity product and arrange
Stock card
Report of receipt
GROUP 1 GROUP 2 GROUP 3 GROUP 4
NAING THIRI MOHAMED Ashi Abdi AUNG The TheHMUNG LYAN Freddy Sui
KAMAU Njunguru Jessee WYLIE Carol PESISCH Corina VONG-HOGETERP Stacia
AVELLANEDA Diana USENOVIC Nikola KOUM BESSON Emilie ZURGA Mohammed
ANUNIBE Joshua AMANDE Mathieu LAVREYS Thomas MARCIL Alexandra
VAN BREEVOORT Adriana WIJNANT Gert-Jan BECK Dominique NELIS Géraldine
STOCK MANAGEMENT
Introduction: Organization (Central) Stock
1. Stock manager
2. Storage Conditions
3. Tools (forms)
(Standard) product List
Stock Card
Consumption Report
Monthly Report
Registers (expired products, stock-outs, narcotic&psychotropics, …)
4. Physical inventory
5. Orders (replenishment)
6. Distribution
7. Indicators
Introduction
STOCK MANAGEMENT..
Own experiences…
What is good stock management?
Introduction
? Stock Card
Introduction
What is good stock management?
• All drugs, consumables, reagents and equipments needed
• Good storage conditions (WHO)
(Temperature [cold chain], humidity, safety, security, arrangement)
• No stock-out (few, non critical items?)
• No (few) over stock
• No (few) expired products
• A stock buffer for x months of activities
Good storage practices are part of a quality assurance system (GSP / GCLP)
Introduction
What influences your stock management?
�Structure: size and level (National procurement centre, hospital, health
center)
� Activities: routine, study, emergencies, activities load
� Policies & rules: country, organization (NGO,..),
� Supply chain: local, international, donations, ..
� HR, facilities, management tools
� Frequency of distribution
Introduction
• What influences your stock management?
Protocols/SOPStandard product list
Estimation of the needs
Introduction
How to start?
Introduction
How to start?
Analyze the situation:
� Infrastructure and management tools
� Responsibilities: Who? Stock manager?
� Needs: standard product list (procedure/SOP + activities)
� Supply chain: How? Who? Frequency? Budget?
� Donations: National Program? How to apply?
� Current situation: Inventory + activities
� Future: Introduction new tests, new protocols?
Even for a study :• Stock• Weekly distribution
For studies : (buffer) stock not included in the routine
1.Stock manager
Responsibilities (need of job description):
� Storage conditions
� Security and Safety
�Organization
�Reception
�Delivery
�Management of expiry dates/expired product
� Inventory
� Stock level follow-up
�Orders (validation of the orders needed)
�Traceability and product quality
1.Stock manager
JOB DESCRIPTION:
DAILY – WEEKLY – MONTHLY TASKS
Activity planning with chronogram
BEWARE: who validates clients orders and deliveries?
Only 1 responsible (and 1 key)
+ 1 back-up (1 key)
2.Storage conditions
Organize the place
� Office
administration, document control
� Reception area
verify quantity and quality
� Delivery area
preparation for expedition
� Stock
different categories (temperature, safety, security..)
� Circulation
RESTRICTED ACCESS
ADAPTED TO ACTIVITIES
1/3 arrival-departure-office1/3 storage
1/3 circulation+ quarantine, destruction
2.Storage conditions
2.Storage conditions
Classification:
1. Storage conditions (“normal”, keep cool, dangerous, regulated products,)
1.1 Type/categories (orals, injectables, IV fluids, diagnostic tests, liquids, powders, consumables, equipments, administrative material, … )
1.1.1 Alphabetically (standard list)
General rules:
� First expired – first out !! (FEFO)
� First in - first out !! (FIFO)
� Liquids lower shelves
� Clearly identify (INN) – expiry date
� Discard expired (how?)
2. Storage conditions
According to the label
1 « normal »
� Temperature
Daily follow-up (min-max.)
Protection direct sun-light, max.30°C
� Ventilation
� Humidity
No direct contact walls and floor
Relative humidity < 65 %
� Light
Protection direct light
� Pest-control measures
Rats, insects, ...
2. Storage conditions
According to the label
2 « keep cool »
� Fridge/freezer
� Daily follow-up (min-max.)
� (Logger)
�Maintenance
Also during transport
And action if needed…
2. Storage conditions
According to the label
3. « dangerous »
� Secondary containment for liquids
� Physical separation between incompatible products (acid><base)
� Material Safety Data Sheet (MSDS)
4. « regulated products » (psychotropics, narcotic…)
� Locked cupboard
� Specific IN/OUT register
� (if rules require) keep empty vials
� Restricted list of clients
New labels
DANGEROUS
SYMBOLS
Globally Harmonized System of Classification and Labelling of Chemicals (GHS)
http://www.unece.org/trans/danger/publi/ghs/pictograms.htmlhttp://ec.europa.eu/enterprise/sectors/chemicals/classification/index_en.htm
2. Storage conditions
Deadline (Europe)For substance December 2010. For mixtures June 2015.
DANGEROUS
SYMBOLS
Globally Harmonized System of Classification and Labelling of Chemicals (GHS)
2. Storage conditions
EXAMPLE
MSDS
• Material Safety Data Sheets (MSDS)http://www.merck-chemicals.com/is-bin/INTERSHOP.enfinity/WFS/Merck-
International-Site/en_US/-/USD/ViewSearch-SearchMSDS
2. Storage conditions
���� CHEMICAL STORAGE:
http://www.lbl.gov/ehs/chsp/html/storage.shtml
Chemical Is Incompatible with:
Acetic acid
Chromic acid, nitric acid alcohols, ethylene glycol, perchloric acid, peroxides, permanganates
Chlorine
Ammonia, acetylene, butadiene, butane, methane, propane, hydrogen, benzene, powdered metals
Incompatible products : example
2. Storage conditions
2. Storage conditions
According to the labelling
3. « dangerous »
Tips :
VentilationFirst aid
3. Tools: forms
KEEPING TRACK….
How much do we need??
When do we need??
How to place an order???
���� Avoiding rupture
���� Avoiding expiration
?
???
?
3. Tools: Stock card
Priority n°1 !!
WHY ?
� Follows every stock movement
� Record physical inventory
� Basis for the order calculation
How to use ?
c.f.: 110929_BB_STOCK FICHE_V02.pdf
= 1 presentation= 1 expiry date= 1 Batch n°
1 card = 1 product
1 movement = 1 row
c.f. :TLM_PRO_004_V01_Use of stock cards RDTs.pdf
3. Tools (Standard List)
Complete list of products:
International Non-proprietary Name (INN), dosage, formulation, packing unit, reference N°.
!! For lab items > add: description, manufacturer, [distributor], brands.
� According to the National Essential Medicines List or
(if absent) the WHO one Developed with the physician
� Dynamic (but not too much! : reviewed max twice/year)
� It impacts on the order management and on rational drug use
� Basis for other forms
Protocols/SOP
Standard list of essential medicines
Regional Hospital of Man
Central stock
Out-patient dpt.
In-patient dpt.
Operatory Ward
Delivery Room
Center for Family
Planification
Emergency Ward
Dressing Room
Maternity dpt.
Medicine dpt.
Paediatric dpt.
Surgery dpt.
Médicaments oraux x x x x x x xACICLOVIR, 800 mg, comp. x x xACETYLSALICYLIQUE ACIDE, (Aspirine) 300 mg, comp. x x xACETYLSALICYLIQUE ACIDE, (Aspirine) 500 mg, comp. x x xALBENDAZOLE, 400 mg, comp. x x x xALUMINIUM HYDR. 400 mg,+ MAGNESIUM HYDR. 400 mg, comp. x x x xAMINOPHYLLINE, 100 mg, comp. x x xAMITRIPTYLINE, 25 mg, comp. x x xAMOXICILLINE+AC.CLAVULAN.25 mg/5 ml, 100 ml s. oral x x xAMOXICILLINE+AC.CLAVULAN., 500+ 125 mg, comp. x x xAMOXYCILLINE, 125mg/ml, poudre pr 100 ml susp, oral., fl. x x xAMOXICILLINE, 250 mg. , comp. sécable x x xAMOXICILLINE, 500 mg. , comp. x x x xARTES + AMOD, 50mg + 153mg; comp.ENFANT x x x xARTES + AMOD, 50mg + 153mg; comp. ADOLESC. x x x xARTES + AMOD, 50mg + 153mg; comp. ADULTE x x x x
3. Tools: Essential Medicine List (per level)
Médicaments injectables x x x x x xAMINOPHYLLINE, 25 mg/ml, 10 ml, amp. x x x xAMOXICILLINE 1g + AC. CLAV 200 mg, poudre , IV + perf. x x xAMPICILLINE, 1 g, (IM-IV), fl. poudre x x x x xAMPICILLINE, 500 mg, (IM-IV), fl. poudre x x xARTEMETHER, 20 mg/ml, 1 ml, amp. x x xARTEMETHER, 80 mg/ml, 1 ml, amp. x x xATROPINE SULFATE, 1 mg/ml, 1 ml, amp. x x x x xBUPIVACAINE, 5 mg/ml, 20 ml. , 0,5% , flacon x x x xBUPIVACAINE rachianesthesie/hyperbare, 5 mg/ml, 4 ml, amp. x x x xCALCIUM GLUCONATE, 100 mg/ml, 10 ml, amp. x x x x xCEFAZOLINE, 1 g poudre, fl. x x xCEFTRIAXONE, 1 g, , fl. poudre x x x x
Solutés de perfusion x x x x x x x xGLUCOSE, 5%, 1 l, poche plastique, x x x xGLUCOSE, 5%, 500 ml, poche plastique x x x x xPLASMA SUBSTITUT, gélatine , 500 ml, fl. plast. x x x x x
Pansements x x x x x x x x x x x xBANDE ADHESIVE, élastique, 10 cm x 3 m x x x xBANDE CREPE (Velpeau), 10 cm x 4 m x x x x x x xBANDE DE GAZE, 8 cm x 4 m, avec lisières x x x x x x x xBANDE PLATREE, 15 cm x 3 m x x x xBANDE, JERSEY, TUBULAIRE, 10 cm x 25 m x x x xBANDE, JERSEY, TUBULAIRE, 5 cm x 25 m x x x xCOMPRESSE DE GAZE, 10 cm, 12 plis, 17 fils, non stérile x x x x x x x x x
Daily distribution of individual
prescription from the IPD pharmacy
3. Tools: Weekly/Monthly Consumption form
= Indicates monthly consumption per service per product
Interest?
� Basis for the weekly/monthly order
� Calculate average monthly consumption
� Correlation with services’ activity
� Visualize evolution (forecast)
!!! Stock rupture ���� month not included for the item !!!
3. Tools: Weekly/Monthly Consumption form
Interest?
� Summary of essential information
�Global view consumption
�Allows analysis
� Identifies problems and needs
Contains:
� Remaining stock
� Security level
� Validity of stock (expiry date)
Monthly consumption follow-up
Health center:
RMKS. Description jan feb march april may june july sept october november december tot
ORAL DRUGS
3. Tools: Weekly/Monthly Consumption form
3. Tools: Order form
3.Tools: Pharmacy dashboard
4. INVENTORY
1. Fix date (no IN or OUT )
Preprint inventory list
2. Choose responsible: if possible
> 2 persons (count and note)
double-check
3. Check organization:
FEFO or FIFO
remove expired
assure product visibility
4. Count products: number of total units
5. Correct stock card: date, inventory use different color
6. Take action if necessary !!!
7. Discuss/report results: differences, identification and resolution of problems.
INVENTORY
Hide the stock card
5. ORDER
How to place an order???
What are the needs??
How much to order???
5. ORDER
Depends on:
• Frequency: time between orders
• Delay of delivery: time between placing the order and
reception
• Means of transport (air, sea,…)
• Security Stock
• Shelf life
• What left in stock… => Inventory
• What is in the pipeline (back orders)
5. ORDER
INVENTORY:
= Manually count numbers left
� Verify what’s really left in stock
� Identify problems discrepancies
� Verify expired or deteriorated products
5. ORDER
Calculation:
Monthly consumption x Period to cover
– left over in stock - Pipeline
Period to cover (in months) :
• Frequency
+ Delay of delivery
+ Security stock
Seasonal diseasesVariation of activitiesAvaibility of products
Shelflife$
!!! Stock rupture ���� month not included for the item !!!
forecast
How much do we need??
• Microscope slides: 1 slides per smear
• Giemsa stock: 0,5 ml (1/10) per slide
1 liter=2000 slides
• Buffer: 5 ml per slide
10 tab=10 liter=2000 slides
• Methanol: 0.5 ml per slides
1 liter=2000 slides
• ….
Example: Malaria smears
Protocols/SOPStandard list
Estimation of the need
6. DISTRIBUTION: reception or order
VERIFY:
Conformity with order
� Origin
� Quantity
� Expiry date, batch n°
Integrity
ORGANISE:
� INN
� Label
� FIFO/ FEFO
� Fill in stock card
� Fill in other documents (freight manifest, …)
Open all box
Immediately
6. Distribution
Tips
Open box
For diagnostics, distribute by
« kit »
6. Distribution: unit of distribution
Primary packaging
Tertiarypackaging
Secondarypackaging
Unit of distribution:- Secondary packaging (HC, services)- Primary packaging (patient)
Secondarypackaging
Primary packaging
Primary packaging
Unit of distribution:- Secondary packaging (HC, services)- Primary packaging (patient)
6. Distribution: unit of distribution
• Label rules changes across countries
• Manufacturer and country of origin is not necessarily mentioned
• Product information not always mentioned
• Mandatory: INN, expiry date, batch no., license owner
6. Distribution: label
• Label rules changes across countries
• Manufacturer and country of origin is not necessarily mentioned
• Product information not always mentioned
• Mandatory: INN, expiry date, batch no., license owner
6. Distribution: label
7.Indicators
• Stock-out = 0
• Expired items values < 10% (?)
• Inventory discrepancies < 5% (?)
• Numbers of intermediate orders = 0
(outside or inside)
Web links and other documents
• WHO guidelines for the storage of essential medicines and other health commodities: http://apps.who.int/medicinedocs/en/d/Js4885e/
• Chemical storage:
http://www.lbl.gov/ehs/chsp/html/storage.shtml
• Material Safety Data Sheets (MSDS)http://www.merck-chemicals.com/is-bin/INTERSHOP.enfinity/WFS/Merck-International-Site/en_US/-/USD/ViewSearch-SearchMSDS
• Example of stock card
110929_BB_STOCK FICHE_V02.pdf
• Use of stock card :
TLM_PRO_004_V01_Use of stock cards RDTs.pdf
• Excel documents (in french) : 090913_ITM-JJ_Outils de gestion_Stock.xls
Example 1
Fridge…
Comments ?
Example 2 Comments ?
Example 3 Comments ?
Exemple 4 Commentaires
Exemple 4 Commentaires