The drug logistics process: an innovation experience

Purpose - The purpose of this paper is to present the latest innovations in the drug distribution processes of hospital companies, which are currently dealing with high inventory and storage costs and fragmented organizational responsibilities. Design/methodology/approach - The literature review and the in-depth analysis of a case study support the understanding of the unit dose drug distribution system and the subsequent definition of the practical implications for hospital companies. Findings - Starting from the insights offered by the case study, the analysis shows that the unit dose system allows hospitals to improve the patient care quality and reduce costs. Research limitations/implications - The limitations of the research are those related to the theoretical and exploratory nature of the study, but from a practical point of view, the work provides important indications to the management of healthcare companies, which have to innovate their drug distribution systems. Originality/value - This paper analyzes a new and highly topical issue and provides several insights for the competitive development of a fundamental sector

Pneumocystis jirovecii pneumonia in tropical and low and middle income countries: a systematic review and meta-regression

Objective: Pneumocystis jirovecii pneumonia (PCP), the commonest opportunistic infection in HIV-infected patients in the developed world, is less commonly described in tropical and low and middle income countries (LMIC). We sought to investigate predictors of PCP in these settings. Design Systematic review and meta-regression. METHODS: Meta-regression of predictors of PCP diagnosis (33 studies). Qualitative and quantitative assessment of recorded CD4 counts, receipt of prophylaxis and antiretrovirals, sensitivity and specificity of clinical signs and symptoms for PCP, co-infection with other pathogens, and case fatality (117 studies). RESULTS: The most significant predictor of PCP was per capita Gross Domestic Product, which showed strong linear association with odds of PCP diagnosis (p30%; treatment was largely appropriate. Prophylaxis appeared to reduce the risk for development of PCP, however 24% of children with PCP were receiving prophylaxis. CD4 counts at presentation with PCP were usually <200×10 3/ ml. CONCLUSIONS: There is a positive relationship between GDP and risk of PCP diagnosis. Although failure to diagnose infection in poorer countries may contribute to this, we also hypothesise that poverty exposes at-risk patients to a wide range of infections and that the relatively non-pathogenic P. jirovecii is therefore under-represented. As LMIC develop economically they eliminate the conditions underlying transmission of virulent infection: P. jirovecii , ubiquitous in all settings, then becomes a greater relative threat

The healthcare goods logistics innovation evaluation: theoretical foundations and practical applications

The research presented in this thesis is focused on innovation in the health goods logistics process managed by hospital companies, with particular reference to the systems for the evaluation of its performance. It can be seen as an initial observation of the current knowledge in the context of healthcare goods logistics innovation within hospital companies (chapter 1); an initial deduction, from the literature, and explanation of a model for the healthcare goods logistics innovation performance measurement (chapter 2); an initial testing of the validity of this model and comparison with other systems of evaluation that emerge from the analysis of a case study (chapter 3). The thesis has the objective to offer a managerial support for the innovation performance evaluation of the healthcare goods logistics process managed by hospital companies. In particular, the purpose of the first article is to present a theoretical framework of the healthcare goods logistics process and its innovation within hospitals, that is, the process which includes all the activities from receiving healthcare goods until their delivery to patients. In contrast to other contexts, in healthcare the strategic importance of this process has only recently been recognised: it is essential for service differentiation and quality improvements, playing a central role in supporting the efficient operational functioning of hospitals. Although this is an important issue both theoretically and in practice, there has so far and to the best of our knowledge been no attempt to systematically review the literature examining hospital logistics process and its innovation. Therefore, in order to address this deficit, a Systematic Review of selected peer-reviewed articles is presented, providing a more complete understanding of the theme and focusing on concepts and definitions, process organisation, models, types of innovations and their conditions. The second paper aims to define a measurement system for the evaluation of innovations in the logistics process within hospitals. Driven by the need to contain costs and improve the quality of services provided to patients, hospitals are dealing with the complexities of business process reengineering of their critical processes, among which are the logistics of health goods. However, against the growing diffusion of these initiatives, there are still very limited attempts to propose and apply models to assess the performance of these innovations. The work differs from previous examinations of logistics performance measurement in that it uses a broader scope, following a Systematic Review of the literature, and its suggestion that a logistics innovation evaluation system must consider different performance dimensions, including costs, benefits, quality and safety. From a practical point of view, the work provides an important tool for the management of hospitals involved in logistics innovation evaluation, which are currently supported with inadequate systems of analysis. The objective of the third study is to identify any problems and inefficiencies in the logistics innovation evaluation system adopted by a hospital company and to define possible paths for improvement. The study is undertaken through combining a review of the literature and an empirical exploratory investigation, the latter conducted through qualitative methodology based on a case study. The focus of the case study is the Azienda Ospedaliero Universitaria Cagliari, a hospital affected by the experimentation of new organisational and technological solutions for the management of the healthcare goods logistics process. The results of the analysis document how the performance of the new method of management of healthcare goods logistics can be defined in terms of benefits to the economic, organisational, quality and process safety aspects. From the research conducted, and on the basis of a comparison with more complex approaches and measurement systems, it is clear that a logistics performance evaluation system which is based on only a limited set of indicators has evident criticalities. This study provides suggestions and guidelines for the design of a more articulated and complex tool to monitor the performance of the healthcare goods logistics process in order to improve the approach and the evaluation system currently adopted by the hospital management. It also contributes to the literature on hospital management through adopting a current research perspective

Capacità innovativa e struttura delle relazioni interaziendali: il caso delle aziende zootecniche del distretto di Arborea

L'innovazione è un tema di crescente interesse quel elemento fondamentale per la competizione in mercato sempre più aperti e globali. Numerosi studi individuano nella struttura delle relazioni dell'impresa con gli attori del suo contesto ambientale (Coleman, 1990; Fukuyama, 1995; Putnam, 2000) una determìinante della sua capacità innovativa (TIDD e Trewhella, 1997; Tsai e Ghoshal, 1998). Nonostante la letteratura presenti numerosi contributi che hanno indagato sulle variabili che possono influenzare le capacità innovative delle imprese industriali (Cohen, 1995), più limitati sono gli studi dedicati all'analisi del fenomeno nel caso delle imprese del settore agricolo (Avermaete et al., 2003; Coppola e Destefanis, 2007). il presente lavoro presenta uno studio volto a verificare l'impatto delle variabili strutturali del capitale sociale sulla capacità innovativa delle imprese operanti nel comparto zootecnico

An integrated drugs logistics management system: A case study in the healthcare sector

The purpose of this work is to analyse the benefits that the healthcare system may enjoy with the adoption of the latest innovations in drug logistics management. In particular the analysis concerns the adoption of the automated cabinet system, ICT solution implemented by an Italian region, and the main organisational implications connected to the use of such a system. The research questions are: Does the automated cabinet system allow the healthcare system to improve the quality of patient care and reduce costs? If so, what are the most important processes and actors in pharmaceutical logistics innovation, and what is their role? The peculiarities detected by this study confirmed that the drug distribution and consumption system solution adopted by the healthcare company has allowed for large savings in terms of cost containment and the traceability of drugs

The Drug Logistics between Efficiency and Safety for Patients: The Experience of an Italian Region

The objective of this work is to present the latest innovations in the drug distribution processes of hospital companies, which are currently dealing with high inventory and storage costs and fragmented organizational responsibilities. The literature review and the in-depth analysis of a case study support the understanding of the unit dose drug distribution system and the subsequent definition of the practical implications for hospital companies. Starting from the insights offered by the case study, the analysis shows that the unit dose system allows hospitals to improve the patient care quality and reduce costs. The limitations of the research are those related to the theoretical and exploratory nature of the study, but from a practical point of view, the work provides important indications to the management of healthcare companies, which have to innovate their drug distribution systems. This paper analyzes a new and highly topical issue and provides several insights for the competitive development of a fundamental sector

The performance measurement of changes in the logistics of health goods: a theoretical model

The aim of this paper is the definition of a measurement system for the evaluation of innovations in the hospitals logistics process. Driven by the need to contain costs and improve the quality of services provided to patients, hospitals are dealing with complex activities of business process reengineering of their critical processes, among which the logistics of health goods. The work differs from previous examinations of logistics performance measurement in that it uses a broader scope, following a Systematic Review of the literature, and it suggests that a logistics innovation evaluation system must consider different performance dimensions, including costs, benefits, quality and safety. The limitations of the research are those related to the theoretical and exploratory nature of the study. From a practical point of view, the work provides an important tool to the management of hospitals involved in logistics innovation evaluation, which are scarcely supported with adequate systems of analysis