CQI in Stores

CQI IN STORES

Introduction

• Stores management is a vital component of hospital material management, ensuring the availability of right items, in the right quantity, at the right time, at the right cost.
• Inefficient stores operations lead to stock-outs, wastage, excess inventory, pilferage, and increased operational costs.
• Continuous Quality Improvement (CQI) in stores aims to enhance efficiency, accuracy, service levels, and cost-effectiveness by applying structured quality improvement principles.

Total Quality Management (TQM) in Stores

• Definition: TQM is a management philosophy that emphasizes continuous improvement, customer satisfaction, teamwork, and quality in every process.
• Application in Stores:
• Customer focus – Internal (hospital departments, doctors, nurses) and external (patients, suppliers).
• Process approach – Streamlining procurement, storage, and distribution.
• Employee involvement – Training storekeepers, stock controllers, and purchase staff in quality practices.
• Continuous improvement – Reducing errors in documentation, improving lead time, and minimizing stock discrepancies.
• Decision-making based on data – Using inventory audits, consumption trends, and computerization.
• Supplier partnership – Working with vendors to maintain consistent quality and timely deliveries.

PDCA Cycle (Deming Cycle)

• A fundamental tool in CQI for stores management:

Plan

• Identify areas for improvement (e.g., frequent stock-outs, delays in indenting, pilferage).
• Plan corrective measures (e.g., reorder level system, barcode tracking, CCTV monitoring).

Do

• Implement small-scale changes (e.g., introduce electronic stock card system in one unit).

Check

• Monitor and evaluate outcomes (e.g., reduced errors, improved inventory accuracy).

Act

• Standardize successful improvements and implement across all stores.
• Restart cycle for next improvement.

Example in Hospital Stores:
Plan: Reduce stock-out of critical drugs → Do: Implement safety stock levels → Check: Compare last quarter’s stock-out frequency → Act: Apply policy to all critical items.

Continuous Quality Improvement (CQI)

• Definition: Ongoing efforts to improve processes, products, or services in incremental steps or through breakthrough innovations.
• In Stores Management:
• Continuous monitoring of stock accuracy and timely replenishment.
• Use of modern tools: ABC, VED, FSN, HML analysis for prioritization.
• Adoption of IT-enabled solutions (ERP, Hospital Information System).
• Regular staff training on proper documentation and handling.
• Benchmarking against best practices (e.g., JCI, NABH standards for stores).

Benefits of CQI in Stores:

• Minimizes wastage & pilferage.
• Reduces inventory carrying costs.
• Improves user satisfaction (clinical & non-clinical departments).
• Enhances compliance with statutory regulations.

Cost of Quality (COQ) in Stores

• Definition: Cost associated with ensuring quality, including prevention, appraisal, and failure costs.
• Categories:
1. Prevention Cost – Training staff in proper stores procedures, implementing ERP software, vendor evaluation.
2. Appraisal Cost – Conducting audits, stock verification, inspection of received goods.
3. Internal Failure Cost – Loss due to expired drugs, damaged medical gases, wrong indenting.
4. External Failure Cost – Complaints from wards due to non-availability of critical items, reputational loss, patient dissatisfaction.

Objective in CQI: Reduce failure costs by investing more in prevention and appraisal.

BIS Standards in Stores Management

• Bureau of Indian Standards (BIS): Provides guidelines for quality assurance in materials management and hospital supplies.
• Relevance to Stores:
• Ensuring standardized specifications for procurement.
• Compliance with storage conditions (temperature, humidity, safety norms).
• Adopting IS codes for pharmaceuticals, medical gases, rubber products, electrical equipment.
• Implementing ISO 9001 (Quality Management Systems) and ISO 13485 (Medical Devices) in hospital material management.
• BIS standards help in uniform quality, safety, and reliability across the supply chain.

Value Analysis in Stores

• Definition: A systematic approach to analyzing functions of items and services to achieve the required performance at the lowest overall cost without compromising quality.
• Application in Stores Management:
• Alternative materials: Using equally effective but less costly substitutes.
• Rationalization of items: Eliminating duplicate or obsolete items from stores.
• Standardization: Avoiding multiple brands for the same drug/device.
• Negotiation with vendors: Ensuring economic purchase and bulk discounts.
• Life-cycle costing: Considering not just purchase price but also storage, handling, and disposal costs.

Example:
Instead of stocking multiple brands of IV fluids, the store can standardize to 1–2 brands based on quality and cost-effectiveness.

Integration of CQI Tools in Stores

• TQM + PDCA + CQI + COQ + BIS + Value Analysis → Integrated framework.
• Practical Steps:
• Introduce Quality Assurance Cell in Materials/Stores Department.
• Regular audit & feedback mechanisms.
• Adopt Kaizen (small continuous improvements).
• Use Lean Stores Management to reduce waste.
• Apply Six Sigma to minimize stock errors.

Video Description

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