An inventory policy model for intravenous fluids with reassignment



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A significant portion of medication cost is related to the intravenous fluids (IVs) waste caused by inefficient medication inventory systems in hospitals. IVs are a common and vital route of administration that can be served to patients who are not able to take drugs orally. IVs deliver instant action to patients, solve patient compliance issues, and suggest better control over medication administration rates. Although, IVs treatment obtains these advantages, their wastage cost is significantly higher than solid medication due to the short shelf-life, and complexity of their inventory management. Some hospitals consider the reassignment policy to reduce IVs wastage cost, which means returning the IVs to the pharmacy is allowed if it is not used for a prior scheduled patient. However, the reassignment policy makes IV delivery system even more complex as returned IVs have shorter expiration date than newly-made IVs. According to literature review no previous study has been conducted on IVs replenishment policy with reassignment policy. Therefore, this study strives to fill this research gap, which can significantly improve medication wastage cost for hospitals.

This dissertation proposed a replenishment policy with reassignment for IVs. Mainly, this study designed a discrete event simulation (DES) model for IVs replenishment in hospitals where returning the IVs to the pharmacy is allowed. First, the current IVs inventory process of a west Texas hospital was observed. Based on the observation and the retrieved data, the wastage sources were identified. Also, four IVs with the highest wastage cost were identified and applied to this study. Then, a baseline replenishment policy model was proposed. Finally, the impact of periodic inventory reviews, increase in IVs preparation shifts, and administration standard time on waste cost were studied. The outcomes of the study indicate that implementing an administration standard time can significantly improve the wastage cost and total replenishment cost of IVs, whereas additional preparation shifts, and periodic inventory reviews can decrease wastage cost but not necessarily lead to improvement in the total replenishment cost. The outcomes of the study are beneficial for hospitals to reduce the medication cost, and scholars in the field of medication inventory management.

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Replenishment policy, Healthcare, Lean, Supply chain, Waste, Intravenous fluids