Assessment of Pitfalls in Unbalanced Provision of Medical Supplies for Patients after Implementation of Health System Reform Project in Iranian Hospitals

Effective delivery of medicines and supplies is one of the most important determinants of quality of healthcare provided in hospitals. This study was designed: (1) to delineate the problems of management in provision, procurement, storage and distribution of supplies in hospitals after implementation of the health system reform project in Iran, (2) to explore the pitfalls in this process and (3) to provide scientific and practical solutions. In this qualitative - descriptive study, in order to identify the effective factors on irregular provision of supplies in hospitals, five brainstorming sessions attended by 20-25 head nurses (supervisors) of operating rooms of 6 university hospitals in Mashhad and relevant experts was held. At the end of 160 person-working hours during the meetings, the problems and the effective factors on them were discussed by the participants, and in addition, solutions to resolve the problems were raised. For providing suitable supplies for patients in the hospitals, the following process was proposed: 1. Visiting the patient by treating physician and requesting the necessary supplies by the physician, 2. Setting up and confirming the request for the required supplies by the department supervisor, 3. Sending the request to the technical in-charge for hospital supplies, 4. Coordinating between technical in-charge for hospital supplies and the supplier of the hospital, 5. Provision and delivery of supplies by the supplier of the hospital to the supplies warehouse together with matching the entry products with requested product by the technical in-charge for hospital supplies, 6. Charging the product to the account of the department supervisor, 7. Charging the supplies from the account of the supervisor to the account of the patient 8. Confirming the invoices of the supplies by the treating physician, the supervisor, and circular and scrub nurses, 9. Disbursement of the approved invoices, 10. Sending back the surplus supplies Preventing the wastage of financial resources and facilities as well as providing medical supplies with the best price are of the most important factors effective on the appropriate provision of supplies in hospitals. To this end, in addition to regular monitoring by hospital administrators, an optimized process which helps to systematize the provision and recharging of supplies and equipment is needed.