Table A4

Interview quotation analysis for pharmacist (PH03)

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
PH03-01) “…pharmacy department provide data and forward to procurement unit to work on it to send order to the suppliers. pharmacy makes sales of drugs dispensed to patients and send sales to accounts departments/finance unit. the money is used to pay for suppliers after delivery of products by suppliers. we share information, when there’s need for any medicine, we work on it and send it to procurement unit to place order for the purchase of medicines. After management approval, the account s will pay for the drugs and we give the drug to patients.” (93/97)- to send order to the suppliers
- delivery of products
- share information
- pay for the drugs
Procurement
Delivery
Information sharing
Available funds
Procurement→+Delivery→+Information sharing→+Available fundsInformation sharing is only shared when there’s need for products which hamper planning on the part of the suppliers
PH03-02) “we share information with our patient’s. some patients make request through phone calls to find out about drugs that are not readily available e.g. xxx. …we display our drugs prices list publicly so that patients can know the prices of medicines. we interact with suppliers by keeping stock inventory of the patients. … purchase drugs directly from them or through contracts. for management, we periodically send them reports quarterly on all activities.” (72/82)- share information
- can know the prices
- purchase drugs directly
- periodically
Information sharing
Visibility
Procurement
Time delay
Information sharing →+Visibility--//→+ProcurementInformation sharing is not real time for all stakeholders
PH03-03) “for patients, we make sure there’s constant supply of drugs. …sustainability of medicines so that patients can have access to the drugs it’s important to reduce lead times during order to be able to meet customer needs. Make sure we prepare list of medicines that are about to be exhausted on time. .timely submission of data for procurement. there should be prompt payment of suppliers whenever they deliver medicine.” (69/79)- constant supply of drugs
- reduce lead times
- on time
- should be prompt
- customer needs
- prepare list of medicines that are about to be exhausted
- timely submission of data for procurement
Medicine inventory
Time delay
Customer order
Time to reconcile inventory
Time to average orders
Medicine inventory--//→+Customer order--//→+Time to reconcile inventory--//→+Time to average ordersDelayed payment of suppliers affects the delivery of medicines to the hospital
PH03-04) “we have friends of hospital where management reach out to people that are ready to assist the less privilege because our patients cannot take care of themselves. … hospital reach out to people that can … help financially to the treatment of some of the less privilege patients that cannot afford their medication.” (53/78)- friends of hospital
- assist the less privilege
- cannot afford their medication
Hospital-stakeholders relationship (trust)
funding
Selling price
Hospital-stakeholders relationship (trust)--//→−funding→+Selling priceExternal funding from stakeholders supports the provision of medicines to indigent patients
PH03-05) “We share information through reports. for patients, everything is done manually, we display our list of drugs pricing for patients to know how much, it costs to take their medicines. we also keep manual documentation.” (/35)- share information
- done manually
- to know how much, it costs
Information sharing
Time delay
Visibility
Information sharing--//→+VisibilityCommunication with patients is through physical display of price list
PH03-06) “…we make phone calls if there are problems or if there’s any urgent need for some drugs. …they come to the hospital for us to discuss what the problem is and how to resolve it. For CSOs and government, we document manually.” (42/58)- urgent
- there are problems
- and how to resolve it
Time delay
Stockout
Medicine inventory
Stockout--//→−Medicine inventoryEven though the suppliers can reach the staff by phone, constraints are resolved at the hospital manually
PH03 −07) “…Use of digital technology, internet, computers is faster, more reliable. The whole process will be more efficient. it can be used to analyse or reproduce any information. … we don’t have digital tools. whatever request can be done electronically. it is the best.” (43/47)- is faster
- reproduce any information
- don’t have digital tools
Time delay
Information sharing
Visibility
Information sharing--//→+VisibilityThe staff long for the use of technology to ease difficulty in information management
PH03-08) “…makes the whole process faster and it also eliminates interruption or disruption. …meet the target you set for the patients, reliable, easy to use. …can be used to analyse data or reproduce data which is not possible manually especially if you’re looking for an information that takes a length of time to reproduce, you will not finish on time. by clicking a button or two, you get all information you need.” (71/73)- makes the whole process faster
- takes a length of time
- not finish on time
- target you set for the patients
- looking for an information
Time delay
Medicine inventory
Information sharing
Information sharing--//→+Medicine inventoryThe staff experience delay in replenishment of medicines which is attributed to manual inventory management techniques
PH03-09) “… We use computers for our stock balances on monthly basis, we keep record of issuance and the stock available at the end of every month. … some places provide computerized provider order systems. we need something like that in our systems. …also learned about radio-frequency identification technology (RFID). I don't have any idea about it.” (55/94)- our stock balances
- issuance and the stock available
- computerized provider order systems
- radio-frequency identification technology
- I don’t have any idea about it
Time to reconcile inventory
Time to average orders
Information sharing
Visibility
Capacity
Information sharing→+Visibility→+Capacity→−Time to reconcile inventory→+Time to average ordersThe staff are curious to the perceived gains from the use of digital technology for inventory management
PH03-10) “…we use maximum and minimum inventory management system. we use visual method to determine stock levels. we know the drugs that are available, and we know the drugs that are about to be exhausted. the method is not effective 100%, depending on a particular period …you may not have many cases or patients … we run into problems when prescribing patterns changes which affects us. when new drugs are introduced to the system, you start seeing prescriptions on it. then all of a sudden demand decreases for the new drug.” (90/125)- to determine stock levels
- about to be exhausted
- period
- all of a sudden
- many cases
- we run into problems when prescribing patterns changes
Medicine inventory
Stockout
Time delay
Customer orders
Supply delay
Medicine inventory--//→−Stockout→−Customer orders--//→−Supply delaySudden changes in prescribing patterns and demand of customers lead to stockout of medicines and delays in supply
PH03-11) “…we keep adequate record so that when we need drugs we can order quickly. inventory accuracy improve the supplies and minimising wastages through pilferages, theft, damages and expiries increases availability of drugs. for patients, by keeping accurate records, …don’t allow drugs to finish before requesting for more keeps drugs readily available.” (/58)- adequate record
- order quickly
- inventory accuracy
- wastages through pilferages, theft, damages and expiries
- availability of drugs
- allow drugs to finish
Time to average orders
Medicine procurement
Time to correct inventory
Shrinking inventory
Medicine inventory
Stockout
Time to average orders→−Medicine procurement→+Medicine inventory→− Stockout→+Shrinking inventory→+Time to correct inventoryShrinking inventory plays a huge role in stockout of medicines by distorting the accuracy of medicine records and delaying replenishment
PH03-11) “I think supply chain knowledge is very good. …if we can encourage stakeholders to take it serious and key into the drug revolving fund. it will motivate people to work better.” (31/46)- supply chain knowledge
- motivate people to work better
Capacity
Medicine inventory
Capacity→+Medicine inventoryBuilding capacity will make the staff happy and increase productivity

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