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.
Highlights
Based on the principle of health as a right for the State’s citizen and responsibility for the State, the Brazilian Constitution of 1988 instituted the Brazilian Unified Health System, that it has intended to improve primary and emergency care [1]
Many hospital processes and subprocesses are directly and indirectly associated with the surgeries [17]. Considering this scenario, this research aims to propose improvements in the logistics operations at the surgical center satellite warehouse of a Public Hospital located in Rio de Janeiro, Brazil, in order to avoid material absence—
The demand unpredictability in the health supply chain, especially in hospitals, causes lack of stock, inefficient and expensive operational practices, as well as incomplete information flows [41]. This unpredictability is even more accentuated in public hospitals that operate with open doors and that have little government incentive to act on [49]
Summary
Based on the principle of health as a right for the State’s citizen and responsibility for the State, the Brazilian Constitution of 1988 instituted the Brazilian Unified Health System (or Sistema Único de Saúde–SUS), that it has intended to improve primary and emergency care [1]. The population share above 65 years more than doubled in size, reaching 19 million people [5] These social changes combined jeopardize local health infrastructures and generate capacity and demand imbalances, especially in elective surgeries and emergency procedures performed in hospitals [6]. Many hospital processes and subprocesses are directly and indirectly associated with the surgeries [17] Considering this scenario, this research aims to propose improvements in the logistics operations at the surgical center satellite warehouse of a Public Hospital located in Rio de Janeiro, Brazil, in order to avoid material absence—. The proposed practices seek to reduce surgical material waste and improve management They might be a foundation for future works and a framework for implementing the suggested improvement actions in public hospitals in Brazil or other similar countries [18]. As the literature on this subject is scarce, this study contributes to hospital managers and researchers interested in this area
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