ACERCAMIENTO A LA METODOLOGÍA DEL ESTUDIO DE MARCAS DE CORTE EN RESTOS ÓSEOS Y TRABAJOS EXPERIMENTALES

Introduction

Directorate of Finance (DF) is responsible for providing comprehensive financial management services to all departments of the Ministry of Health (MOH) and man- ages the financial resources of MOH in accordance with the goals of MOH and in compliance to the laws of the Government of Bahrain, Standard Finance Manual (SFM) and generally accepted accounting and financial management principles and to enhance Value for Money to the Government in achieving those goals. The direc- torate reviews its procedures from time-to-time to see if any improvements can be made in fine-tuning the processes to achieve efficiency. One of the functions of DF is to exercise control over fixed assets of MOH, such as dealing with Purchase Requests, Requests for Disposal of Fixed Assets, Purchase and Payment for the Assets, main- taining a Fixed Assets Register and conducting physical verification of Fixed Assets to ensure their safe custody.

The Directorate of Finance opted to apply CQI to improve performance, quality and increase productivity and customer satisfaction in the area related to Fixed

Assets management.

Problem Statement

The fixed assets, which are approved for Disposal by the Fixed Assets Disposal Committee, lie around for a long time at the Ministry premises in various locations including Head Quarters, SMC and Health Centers before the Central Stores Directorate (CSD) collects these. These assets look untidy in the working area, unsafe and attract pilferage and misuse if left for a long time. The Ministry of Finance and National Economy Standard Finance Manual classified fixed assets into two categories as follows:

• New / Addition Assets: Assets required for a new Program or new employee. • Replacement Assets: Assets required to replace existing assets. This

process goes through several stages whereby the item is first checked to see if it can be repaired - if it cannot be repaired, then approval for disposal has to be sought from the appropriate directorates until it reaches CSD who takes time to come and collect the asset.

Root Cause Analysis

A team of eight members was formed, using Belbin’s team roles as a guide, from dif- ferent directorates/departments of MOH and summarized the root causes of the problem as follows:

1. New assets are ordered but not received yet because of long procedure or due to lack of budget, so the user departments keeps and uses the old asset until its replacement arrives.

2. Medical equipment is never returned to CSD as the Medical Equipment Directorate (MED) retain the old equipment for spare parts.

3. Budget approval for the new item takes too much time.

4. CSD lacks resources to handle a big volume of work, especially since it deals with all Ministries and Government entities of the Kingdom of Bahrain.

5. Lack of coordination between CSD and MOH, especially in regard to appointments for collection of old assets.

6. The user departments, especially SMC are not keeping old assets in one location, and it is very difficult for CSD to interrupt patient-related services. 7. The Headquarter buildings do not have storage locations where the old assets

The team did a survey of 100 concerned persons including DF Staff, Users and CSD employees. Based on the survey with regard to disposal of fixed assets, it was found out that in SMC 80% have problems in the disposal of assets, whereas only 20% are satisfied. In PHC 70% have problems and only 30% are satisfied and in HQ 60% have problem and 40% are satisfied.

Alternative Solutions

Through several processes including brainstorming, it was always kept in mind that changing the Government (MOFNE) Financial rules may have merit in some cases but will be difficult and time consuming to achieve. The following alternatives, which can be implemented within the existing guidelines and framework were con- sidered and studied further:

1. MOH have to arrange transportation of the assets to CSD.

2. DF to appoint 3 Fixed Assets Disposal coordinators to co-ordinate with user departments and CSD throughout the process of disposal of an asset.

3. User departments have to co-ordinate with Assets Disposal coordinator at DF as soon as they are ready to dispose the old asset.

4. The disposal of old assets will be linked to availability of budget for the new asset. 5. Users like SMC and HCD have to designate central storage locations from

where old assets should be collected.

6. CSD and DF have to agree on the schedule of collection of old assets by CSD.

Implementation

The following actions were taken during the implementation. New procedures with User Departments was agreed upon and disposal of equipment is only approved after ensuring that budget is available to buy the replacement. The disposal and pur- chase requests were to be approved simultaneously and process to buy commenced at the same time. The user departments advised DF when the old equipment was ready for collection. DF appointed 3 Fixed Assets Disposal Co-coordinators one each for: SMC, Health Centers and HQ and Periphery Hospitals. We designated nine locations (i.e. SMC main block, SMC Al-Fatah Building, Naim HC, HC Admin, Isa Town HC, Sitra HC, Muharraq HC, HQ near Tylos Building and Psychiatric Hospital) where the old assets were stored and in turn collected by CSD. DF agreed schedule with CSD, showing days and times at which these locations were visited. The user departments gave their requests to DF at least 48 hours before the desig- nated time/day, as CSD only dealt through DF co-coordinators. DF maintained a register showing all the forms approved for disposal of assets and tracked assets, which are not collected by CSD. They also issued periodical letters to users remind- ing them and giving details of assets, which had not been offered for collection.

Result

The team monitored the progress of implementation on a weekly basis, and month- ly review meetings were held. Effective communication and fine tuning the process- es overcame the initial teething problems.

As done at the time of analyzing the problem and its causes, the team again did a survey of 100 users. The results were remarkable.