Inventory Management of Drugs at Hospitals

Introduction: The inventory management of drugs is a key function in hospital administration in Ghana. The processes of drug management include purchasing, storing, distributing and controlling the use of drugs. These processes enable the hospital management by achieving their goal or objective of improving patient care in the various hospitals. Hospital pharmacies throughout Ghana are experiencing inventory problems that have resulted in wastage and shortage of drugs. The obvious outcome of this problem is a retrogressive effect on patient care due to delayed procedures and drug substitutions (Fox and Tyler 2003). While some drug shortages are uncontrollable (e.g. due to a natural disaster), others can be controlled. Inventory, which is a result of the purchasing process, must be well controlled. However, based on daily activities performed in the hospital pharmacy, the main concerns regarding managing inventory occur during the purchasing process. It is problematic and time-consuming to decide when and how much to order. Improper inventory management can also result from the procurement expertise of those managing the inventory (Alverson, 2003).

Although pharmacists in hospitals have expertise in the efficacy and treatment protocols of drugs that are administered to patients, they are also tasked with managing, ordering, and producing the drugs that are ultimately dispensed to patients. The pharmacists serve as the gatekeepers of drug distribution by ensuring the accuracy and appropriateness of prescribed medications. Pharmacists must make decisions regarding their inventory levels on how and when to produce or purchase drugs 2 in response to, or in anticipation of, patient demand. Frequently, these decisions are made by measuring drug utilization from historical data and devising a common inventory level (measured in days of inventory) which makes the process easy to manage but not efficient (Baumer et al. 2004). However, there is additional information available that pharmacists are currently not using to make inventory decisions. Drug demand is a function of the patient‘s condition and the prescribing protocols of the physician. The patient‘s condition provides a forecast of their drug need during their length of stay. The consumption of a particular drug on a given day is conditional on the mix of patients in the hospital that require this drug and maybe for more than one unit of a drug. Since drug usage changes over time and is not known with certainty, the daily demand is dynamic and stochastic.

Therefore patient care could be compromised if the pharmacy department of the hospital fails to execute proper inventory management practices, so that drugs when needed may be readily available. This is because there is a direct linkage between the patient-care and the efficiencies of the various units in the hospital; Gillerman and Browning (2000) found that there was an interrelationship between the patient‘s condition and his/her drug utilization which could mean that drug unavailability may result in worsening patient condition in the hospital, translating into increased patient stay at hospital. There are five hundred and thirty (530) health facilities in the Greater Accra region including one hundred and nine (109) hospitals that provide a total of four thousand, three hundred and eighteen (4,318) beds for patients (CHMI/PPME-GHS, 2007). The hospitals in the Region are from all the four different types of hospital operations currently in Ghana namely: Government Hospital, Mission Hospital, Quasi Government hospital and Private Hospital. This study therefore seeks to unravel how drug inventory management at hospitals in the Greater Accra region affect patient care.