The results of the questions applicable to this practice are listed under Table 4.9 below.
Table 4.9: Participants' responses on delivery practices
Question Scales N %
Which transport system does the hospital use to deliver stock to the clinics? (no responses = 2)
Rating of responses: Acceptable
In-house 14 78 Outsourced 0 0 Both 4 22 How is transport arranged?
Rating of responses: Acceptable
Telephone 18 72 E-mail 1 4 Fax 1 4 Send someone 5 20 When do clinics place ARV orders with the hospital?
Rating of responses: Average
When stock runs out 4 19 Anytime 2 10 According to order dates 15 71 How long does it take for the stock to reach the clinics?
(no responses = 2)
Rating of responses: Average
Same day of ordering 3 15 The following day 6 30 According to delivery dates 11 55
a) Which transport system does the hospital use to deliver the stock to the clinic/s?
The majority of the staff (78%) used in-house transport to deliver the drugs to the clinics. The remaining 22% of the staff alternated between the use of the in-house and outsourced transport to deliver treatment to the clinics.
It is observable from the above results that the in-house transport is the dominant mode of transport used for clinic deliveries. However, there was no clear indication on the use of outsourced transport as the back-up transport. With reference to the literature review in Chapter two, a single and rigid transport system whereby alternative or back-up transport is not available, is considered a threat to a continuous delivery of stock to customers. The use of both the in-house and
outsourced transportation, with one being the dominant transport and the other a back-up transport system, will promote the reliability of the transport system.
The advantages of the in-house transport system as the dominant system were stated in the literature review as flexibility to changes in customer demands, consolidation of two or more orders and no obligation to place an order to fill the delivery vehicle. These advantages confirm that the selection of the in-house transport by the hospital staff as the dominant transport was ideal. Therefore, the outsourced transport should be made an alternative transport.
b) How is the transport arranged?
As shown in Table 4.9 on the previous page, 72% of the staff booked transport telephonically, while 20% sent a staff member to the transport department to make bookings. An insignificant amount of employees (4%) used the e-mail and the fax (4%) to book transport.
It was observed that the majority of the staff arranged for transport telephonically to request delivery of the drugs from the hospital to the clinics. This type of booking was considered acceptable as the main transport utilised by the staff was in-house transport. Electronic booking systems would have been preferable if the dominant transport system was outsourced. Therefore, the current use of telephones to book in-house transport is acceptable practice.
c) When do clinics place ARV orders with the hospital? How long does it take for the stock to reach the clinic/s?
For ease of reference, the results to the above two questions are displayed in Figure 4.6 below.
Figure 4.6: Clinic order placement and delivery schedules
As shown in Figure 4.6, 71% of the staff placed orders according to the order dates, and 55% of the scheduled orders were delivered according to delivery dates. The remaining 29% of the staff indicated that clinics placed orders with the hospital when the stock was depleted (19%), or when convenient (10%). Regarding the deliveries, the remaining 45% of the staff indicated that patient treatment reached the clinics the day following the order placement date (30%) or the same day of ordering (15%).
According to these responses, the most common order method namely, ordering of the stock according to order dates, was the ordering method used by the hospital when ordering the drugs from the depot (refer to section 4.3.1, page 89).
Although the stock was ordered according to order dates, this practice was not endorsed by the FSDoH Inventory Management Policy (2012:10, 13). The policy indicates that the remaining stock levels in the stores should be a pre-determinant of the next order placement. This recommendation is in agreement with the FOQ condition-certainty order model explained in Chapter two, which states that ordering should take place at a predetermined level. Therefore, stock should be ordered at a predetermined level to ensure a continuous availability of the stock to distribute to the clinics.
In summary, the in-house transport was used by the hospital staff as the dominant transport to deliver the stock to the clinics, therefore the outsourced transport should be made the back-up transport system. The staff used telephones when booking the in-house transport and this was regarded as acceptable practice. The use of e-mails or faxes would have been more suitable if the main transport system used by the staff was outsourced in order to keep records of bookings made and to use the information during performance evaluation of the contractors.
The most common ordering method practiced by the staff was the ordering of the stock according to order dates. However, the FSDoH Inventory Management Policy and the FOQ condition-certainty order model recommend that the ordering of the stock should be according to predetermined levels. This order method will reduce the level of stock shortages experienced, which is the discussed below.