Table A3

Interview quotation analysis for pharmacist (PH02)

ParticipantNumber-Quote number) “… variables in Phrase(s)” (word count in variables/total word count in causal statement)Phrase(s) from participant quote denoting model variablesInterpreted model variablesCausal link between model variables (→=causal link, --‖→=causal link with delay, +/−=positive or negative polarity)Comments
PH02-01) “The way we work together in specifically, pharmacy, accounts, procurement is that during tendering process, … normally we make purchases through tender. … the pharmacy department will go around to all the clinical department and collect their needs. … so the pharmacy departments initiate the quantification process for whatever is going to be procured. … the accounts department will now inform the pharmacy department of the available funds in the accounts for procuring the needed medicines. … the account is ready with the money then we can go ahead and do tender to award the medicines to the suppliers.” (99/176)- we work together
- will go around to all the clinical department
- for whatever is going to be procured
- available funds
- award the medicines to the suppliers
Internal integration
Time delay
Hospital medicine order
Available funds
Procurement
Internal integration--‖→+Hospital medicine order→+Available funds--‖→+ProcurementWorking across departments takes time which delays procurement of medicines
PH02-02)Working together means we should have a transparent policy, transparent in the sense that what goes on in pharmacy should be open to accounts at any time. … transparency can be enhanced maybe through electronic data collection. …when we digitalize or computerise the whole process, everybody will see what is happening at one point or the other. So there should be no hidden agenda. … that can only be done when all processes are computerised.” (75/185)- Working together
- when we digitalise
- everybody will see what is happening
- no hidden agenda
Internal integration
Time delay
Visibility
Internal trust
Internal integration--‖→+Visibility--‖→+Internal trustDelay in working together and lack of data openness breeds distrust
PH02-03) with patients, what we normally do is … verify the prescription. … everything that the patient needs is actually in the prescription. … a pharmacist does a thorough verification. … the accounting department are now the ones … that will collect the cash from the patient. … the prescription comes back to the pharmacist to dispense the drugs.
… the way we make medicines available through the suppliers is that when quantifications are done and when tender process is done, the pharmacy department will issue out a local purchase order
(LPO) to the supplier to make the drugs available. within a certain time, maybe one week or two weeks as stated on the LPO.” (114/276)
- everything that the patient needs
- does a thorough verification
- collect the cash from the patient
- to dispense the drugs
- will issue out a local purchase order
- to make the drugs available
- maybe one week or two weeks
Customer orders
Time delay
Cash collected
Selling
Hospital medicine order
Shipment
Supply delay
Customer orders--‖→+Cash collected→+Selling→+Hospital medicine order--‖→_ShipmentDelay in delivering supplies affect the level of medicines available to serve customers
PH02-04) “… we do what we call an emergency purchase … before tender process is ready. …to buy any out-of-stock drug. There’s another process called a standing order. A particular company is being given a standing order because we feel that the medicines that they are supplying as something that is all is available and it’s always needed in the hospital, because it’s always needed like infusion, it should be readily available in the hospital. As the medicines are about to finish… or at the reorder level, the supplier is informed to supply another batch of products and not necessarily waiting for the tender process.” (103/213)- emergency purchase
- to buy any out-of-stock drug
- it should be readily available
- not necessarily waiting
Procurement
Medicine inventory
Time delay
Time delay
Procurement--‖→+Medicine inventoryBuying medicines hurriedly leads to further delay in the procurement cycle
PH02-05) “… pharmacist can see what the physician has prescribed for the patient immediately even before the patient appear in the pharmacy department, the pharmacist can go ahead to immediately prepare for the patient. In that way, waiting time will be reduced by the time the patient … appears in the pharmacy department. … an electronic system. … the only way … teams could improve working with patients is by computerising, making everything electronic from the physician … to the pharmacist to the accounting department.” (83172)- can see
- patient waiting time
- an electronic system
- by computerising
Visibility
Patient waiting time
Information integration
Information sharing
Visibility--‖→+Information integration→+Information sharing--‖→−Patient waiting timeSharing information is facilitated digitally with electronic systems, which is affected when there’s delay in implementation
PH02-06) “After quantification and medicine selection, we ask suppliers to quote for drugs before sending it to us. we improve the process by putting the list of medications in a flash drive and sharing with suppliers. I envisage a process in which there will be an interface with the organisation and the supplier. An interface that allows suppliers to key into the system from their end automatically.All wasted time (1–2 weeks) in the current system will be saved and improve working relationship with the suppliers. Lack of immediate payment for supplies delivered to the hospital … hinders working relationship with the suppliers.” (102/142)- before sending it to us
- all wasted time
- interface with the organisation and the supplier
- improve working relationship with the suppliers
- lack of immediate payment
Time delay
Time delay
Supplier integration
Hospital-supplier relationship (trust)
Available funds
Supplier integration--‖→+Hospital-supplier relationship (trust)→+Available fundsImproving relationship with suppliers will increase trust and level of inventory making more funds available to procure medicines
PH02-07) “The only way that we can improve working relationship with all these critical stakeholders is by letting them realise what our situation is, what our needs are. … to improve services…” (31/96)- improve working relationship
- by letting them realise what our situation is
Hospital-supplier relationship (trust)
Visibility
Hospital-supplier relationship (trust)→+VisibilityIncreasing access to information will improve services
PH02-08) “we give information to patients verbally and some patients also call through our phones to get information to ask if we have a particular drug. … For suppliers, we collate list of medicines in a computer and share the list in a flash drive or on a printed paper. when critical stakeholders sometimes ask for information, especially for the donor/partner as we do in our chemotherapy access partnership. we send information through emails … and send via email. … usually, drugs availability and quantity of drugs needed.” (87/154)- to get information
- ask if we have a particular drug
- we send information through emails
Information sharing
Medicine inventory
Technology integration
Technology integration→+Information sharing→+Medicine inventorySharing information improves levels of medicine inventory
PH02-09) “The supplier, for example … I need to tell these companies the stock levels of …for them to be able to know my reorder level so that they can actually supply me more. I share this information through email, WhatsApp messages. So I give all these logistics information to my supplier for a specific drug that …have to supply. Sometimes the suppliers give information (feedback) about available medicines and expected drugs that will be available in the country.” (78/166)- I need to tell
- reorder level
- supply me more
- through email, WhatsApp messages
- to supply
- expected drugs that will be available
Information sharing
Medicine order
Medicine inventory
Technology integration
Medicine in transit
Supply delay
Technology integration→+Information sharing→+Medicine order--‖→+Medicine inventory--‖→+Medicine in transitSharing information with suppliers increase inventory levels and reduces supply delay
PH02-10) “When we digitalize and computerise every .. processes, it makes …information sharing easy for patients, suppliers and all critical stakeholders.” (20/106)- digitalize and computerise every … processes
- information sharing easy
Process integration
Information sharing
Process integration→+Information sharingSharing information Improves with digitalisation
PH02-11) “… information sharing and communications should be across all the levels. …immediately everybody will know that this drug is at reorder level and escalate the information to the supplier. … a process where suppliers are connected to the organization and can see that a particular drug is at reorder level in a particular hospital and make resupply immediately….” (57/207)- information sharing and communications
- reorder level
- suppliers are connected to the organisation
- resupply immediately
Communication
Medicine order
Supplier integration
Shipment
Communication→+Medicine order→+ Supplier integration→+ShipmentInformation sharing and communication with suppliers improves delivery of medicines
PH02-12)It is only … that I have used but I know there are … technology out there. … connected to some units that are important for now due to lack of funds.” (32/35)- it is only x, that I have used
- lack of funds
Technology integration
Available funds
Technology integration→+Available fundsTechnology improves medicine inventory and increases funds
PH02-13) “The way we measure the performance of medicine availability in my organisation … and the supplier supplies seven out of 10. …the supplier has scored 70%. It is possible that the medicine is out of stock at the time of supply. … if we’re able to make the 200 items available, then we will say our performance is 100% but if we’re not able to, we count the number of available medicines and say maybe 75% performance. … we believe we will satisfy our customers, …when prepare our list of medicines and we see that at least … we make available 75% or 80% or 90% of the stock.” (109/247)- the supplier has scored 70%
- our performance is 100%
- satisfy our customers
Supplier performance
Internal performance
Fill rate
Supplier performance→+Internal performance→+Fill rateWhen patients get all their medicine, and the suppliers and hospital are performing optimally
PH02-14) “…we can improve performance by achieving patient satisfaction by providing the drug needs of the patients. … we can improve the … by making patient drugs available at all times … and then by reducing the patient waiting time when they come to access these drugs in the pharmacy.” (49/52)- patient satisfaction
- waiting time
- access these drugs
Fill rate
Patient waiting time
Medicine inventory
Fill rate--‖→−Patient waiting time→− Medicine inventoryAvailable medicines increase fill rate and reduce wait times
PH02-15) “For the suppliers, we can improve performance by making sure that the suppliers get payment for the supply to the institution as soon as possible. Computerising and digitalising all processes makes it easier for you to inform the supplier immediately that a drug is at reorder level. …this information can be shared with the supplier to make medicines available. … we pay suppliers and … improve performance for all critical stakeholders.” (71/119)- as soon as possible
- inform the supplier
- medicines available
- we pay suppliers and … improve performance for all critical stakeholders
Time delay
Information sharing
Medicine inventory
Information sharing--‖→+Medicine inventoryNetwork partners benefit from information sharing, and the patient gets medicines
PH02-16) “With government, I think the only way we can improve is to remove … bottlenecks. …The only way to remove bottlenecks is … government … to give funds, … directly to the hospitals for certain activities. The hospitals should strictly use the funds for the intended purpose and not divert funds …, funds allocated for drugs should not be used to fund building or other capital projects in the hospital. … government can strengthen institutions through … improving communication. …through digitalization. There should be transparency and accountability in use of funds at the hospital.” (/158)- remove … bottlenecks
- not divert funds
- improving communication
- transparency and accountability
Time delays
Hospital-government relationship (trust)
Communication
Visibility
Hospital-government relationship (trust)→+Communication→+VisibilityReduced trust and communication decreases transparency

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