Managing Drug Supply Training Series, Second Edition

Trainers Guide
Drug Supply Management
Information Systems

M15
Distribution
Procurement Use
Selection
Management
Support
Copyright 2000 by Management Sciences for Health, Inc.
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US
This session is derived from Chapter 36, Monitoring and Evaluation, Chapter 41, Analyzing and
Controlling Drug Expenditures, and Chapter 45, Drug Management Information Systems, in
Managing Drug Supply: The Selection, Procurement and Use of Pharmaceuticals, 2d ed., revised
and expanded, by Management Sciences for Health with the World Health Organization (West
Hartford, CT: Kumarian Press, Inc., 1997). Used with permission. ISBN 1-56549-047-9
M15
This training module is based on materials from Managing Drug Supply, second edition. The
chapters pertaining to this module are highlighted below.
Part I
Introduction
Part II
Policy and
Legal
Framework
Part III
Drug
Management
Cycle
Part IV
Management
Support Systems
Section A
Organization and
Management
Chapter 34: Managing
Drug Programs
Section B
Financing and
Sustainability
Chapter 35: Planning
for Drug Management
Chapter 36: Monitoring
and Evaluation
Chapter 37:
Community
Participation
Chapter 38: Hospital
Drug Services
Chapter 39: Security
Management
Chapter 40: Drug
Financing Strategies
Chapter 41: Analyzing
and Controlling Drug
Expenditures
Chapter 42: Financial
Planning and
Management
Chapter 43: Donor
Financing
Chapter 44: Revolving
Drug Funds
Section C
Information
Management
Chapter 45: Drug
Management
Information Systems
Section D
Human Resources
Management
Chapter 46: Computers
in Drug Management
Contents of This Session
Purpose and Content........................................................................................................................ 1
Objectives........................................................................................................................................ 1
Preparation...................................................................................................................................... 1
Session Outline................................................................................................................................ 2
Session Preparation......................................................................................................................... 3
Prerequisites............................................................................................................................... 3
Orientation to the Session.......................................................................................................... 3
Activities.................................................................................................................................... 3
A. Introduction (10 minutes).............................................................................................. 4
B. Function and Structure of a Drug Management Information System (25 minutes) ..... 4
C. Activity One: Case Study of Sage State Hospital Pharmacy (8090 minutes) ............. 6
D. Issues in the Design and Implementation of a DMIS (2530 minutes) ........................ 9
E. Activity Two: Sources of Information (30 minutes) .................................................. 10
F. Transforming Data into Action (15 minutes) .............................................................. 11
G. Activity Three: Information System Design (4060 minutes).................................... 11
H. Summary of Session (10 minutes) .............................................................................. 12
Activity One: Case Study of Sage State Hospital Pharmacy.................................................... 13
Worksheet 1: Stock Card................................................................................................. 17
Worksheet 2: Requisition Form....................................................................................... 18
Activity Two: Sources of Information..................................................................................... 19
Worksheet 3: Sources of Information Matrix................................................................... 20
Activity Three: Information System Design............................................................................ 21
Worksheet 4: Management Information System Task Matrix......................................... 22
Drug Supply Management Information Systems 1
Purpose and Content
Staff at every level use information to make decisions that affect the overall functioning of a drug
supply system. Coordinating the elements of a drug supply system requires accurate and timely
information. A good drug management information system (DMIS) alerts staff to problems and
triggers critical actions at all levels. Unfortunately, many managers find themselves making
decisions based not on information but on intuition.
This session defines a DMIS and focuses on the practical aspects of organizing, implementing,
and managing one. It will help participants identify the various information sources and
information subsystems that can be used throughout the drug supply cycle. The session also
discusses indicators that can be used to monitor and evaluate a DMIS.
Objectives
After completing this session, participants will be able to:
Describe the benefits of an effective DMIS.
Describe the functions of a DMIS.
Describe the issues relevant to the design of a DMIS, especially the role of indicators.
Understand the issues related to various stages in the planning and implementation of
a successful DMIS.
Preparation
Read:
Managing Drug Supply, Chapter 45, Drug Management Information Systems
Review:
Managing Drug Supply, Chapter 36, Monitoring and Evaluation
Managing Drug Supply, Chapter 41, Analyzing and Controlling Drug Expenditures
Managing Drug Supply, Chapter 4, Pharmaceutical Supply System Assessment
Managing Drug Supply Training Series: Trainers Guide
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Session Outline
Time Topic Visual Aid
10 minutes A. Introduction 1 The Bad Data Cycle
2 Unit Objectives
3 Unit Outline
25 minutes
8090
minutes
B. Function and Structure of a Drug
Management Information System
C. Activity One: Case Study of Sage
State Hospital Pharmacy
4 Information Systems Pyramid
5 Worksheet 1: Stock Card
Worksheet 1: Stock Card
Worksheet 2: Requisition Form
2530
minutes
D. Issues in the Design and
Implementation of a DMIS
6 Steps in Designing or Revising a
DMIS
7 Key Issues in Designing a DMIS
8 Implementing a DMIS
30 minutes E. Activity Two: Sources of
Information
9 Worksheet 3: Sources of
Information Matrix
Worksheet 3: Sources of
Information Matrix
15 minutes F. Transforming Data into Action 10 Steps in Transforming Data into
Action
4060
minutes
G. Activity Three: Information
System Design
11 Worksheet 4: Management
Information System Task Matrix
Worksheet 4: Management
Information System Task Matrix
10 minutes H. Summary of Session 4 Information Systems Pyramid
12 Drug Supply Cycle
1 The Bad Data Cycle
Drug Supply Management Information Systems
3
Session Preparation
Prerequisites
The participants should have a solid foundation in the various components of the drug supply
system. A background in using computers is not required but is helpful.
Orientation to the Session
This session should come at the end of a longer course on drug supply management, presenting
the information system as the web that tracks the functioning of the system. The session may
be accompanied by a software demonstration, if appropriate. Useful computer applications
include prepackaged programs specifically designed for use in a drug supply system, such as
INVEC-2 for inventory management or ESTIMED for estimating quantities of medications.
Activities
The first activity is a case study intended to raise participants awareness of the complexities of
managing information in a relatively simple hospital setting. The second activity allows
participants to self-assess where and how they obtain information to make good management
decisions. The third is a small group activity. Each group specifies two decisions that are
necessary to achieve a specific management objective. Group members then assess what
information is needed, how to obtain it, and how to convey it so that a decision can be made.
Activity One: Case Study of Sage State Hospital Pharmacy
This case study allows participants to analyze the logistics system of a hospital pharmacy. The
hospital can be considered a microcosm of larger systems, sharing many of the same problems
and concerns. The activity is conducted in small groups and in plenary.
Activity Two: Sources of Information
This activity is an individual self-assessment intended to get participants thinking about the
completeness, accuracy, value, and usefulness of the data available to them.
Activity Three: Information System Design
This activity will help participants view the information system as a whole. Whereas the previous
activity focuses on sources of information from an individual point of view, this activity
examines how information can flow efficiently and effectively from the data source through the
entire supply system to the ultimate information user. The work is done in groups, with the
results presented and discussed by all participants.
Managing Drug Supply Training Series: Trainers Guide
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A. Introduction (10 minutes)
The Bad Data Cycle
Explain that each level of the drug supply system has specific and often different
information needs, depending on the decisions made and actions taken at that level. The
goal of an information system is to provide useful information when and where it is
needed. Information that is not applicable, timely, or reliable is useless.
Present visual aid 1, The Bad Data Cycle.
Review each step in the cycle, and point out that no one individual is responsible for this
situation; it is the information system that is not functioning properly. The problem may
lie in the design of the system or in its implementation. Whatever the source of the
problem, if a DMIS is unreliable or inadequate, it is likely that people are not receiving
the drugs they need.
Ask participants to identify information problems in their drug supply systems. List these
on a flipchart. State that they should be asking themselves why these problems exist, and
by the end of the session, they may have some ideas about how to improve their systems.
The most common deficiencies in a functioning DMIS are:
< Incomplete or inaccurate data
< Obsolete or dated data
< Incomplete reporting or confusing report formats
< Errors in recording, deciphering, or tabulating
How to Break the Bad Data Cycle
Present and review visual aid 2, Unit Objectives. Point out that this session examines
how to break the bad data cycle and replace it with a more efficient and effective
information system.
Present visual aid 3, Unit Outline, and review it.
B. Function and Structure of a Drug Management Information System (25 minutes)
Function of a DMIS (15 minutes)
One of the major functions of a DMIS is to synthesize the large volume of data generated
by drug management operations.
Ask participants: What is the purpose of collecting and compiling data?
Drug Supply Management Information Systems
5
Point out that data are recorded observations that need to be analyzed and interpreted.
Data are then reduced to information for use in planning activities, estimating demand,
allocating resources, and monitoring and evaluating drug management operations.
Information can be presented in the form of a few key indicators. Explain that indicators
are processed data, or summary statistics, that tell you something about the performance
or functioning of the system. (Indicators are discussed in detail in the session on
indicator-based assessments.) Indicators should be targeted for staff at all levels.
Present visual aid 4, Information Systems Pyramid. Review the types of data and reports
typical for each level. Point out the relationships between the levels.
Explain that the information system should be designed to give managers and
policymakers feedback for system monitoring and evaluation. Ask participants what kind
of information is required to understand the following aspects (or other relevant aspects)
of a drug supply system, and where they would obtain the information:
< Provider behavior
< Consumer drug use and demand
< Budgetary and procurement policies and practices
< Pharmaceutical availability (distribution and stock status)
< Product quality and service performance
Point out that much of the recording and reporting in a DMIS is intended to create a paper
trail for products as they enter and leave the drug supply system.
Ask: Why leave a paper trail? Answer: To improve transparency and accountability.
Ask: Why are transparency and accountability important? Answer: Drugs are important
commodities for public health that represent significant economic value.
Key Components of a DMIS (10 minutes)
Present visual aid 4, Information Systems Pyramid, again and discuss the documents that
form the basis of the information system. Ask participants how these components relate
to the problems in their systems identified earlier.
< Record-keeping documents
Registers, ledgers, and filing systems to maintain data about the activities of a
specific organizational unit
Normally stored in one place, not circulated
< Data reporting forms
Managing Drug Supply Training Series: Trainers Guide
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Designed for transmission to other parts of an organization; help to trace the flow
of drugs and funds
Typically include requisition and issue vouchers to document stock transfers and
periodic status reports
< Feedback reports
Analytical reports produced from data collected by other units
Should address issues highlighted by status reports and analyze how each
reporting unit has performed relative to similar units
Should be used for feedback to improve data quality and reporting compliance
< Procedures for collecting and distributing data and reports
To govern the flow and use of information up and down the drug supply network
C. Activity One: Case Study of Sage State Hospital Pharmacy (8090 minutes)
This case study allows participants to explore some of the basic issues in a DMIS. They
will review the case, identify problems and likely causes, and make recommendations.
(This case is adapted from Case Study: Logistics for Sage State Hospital Pharmacy by
Anne Williams, Boston: Management Sciences for Health, 1998).
Introduce the case and select two participants to read the parts of Mary Passaly and
George Iver. The trainer plays the narrator, reading all the parts in italic. Read the case
aloud, each person playing his or her role (about 15 minutes).

Read the case study questions, and ask the participants to use the table provided to record
problems and causes. Allow the participants to work in small groups (four to six per
group) to answer the case questions (about 30 minutes).

At the end of the small group work, ask for volunteers to identify positive aspects at the
Sage State Hospital and write them on a flipchart. Then ask each group to share a
logistics problem and the possible causes and recommendations. Ask whether any other
group identified different causes or made different recommendations. Facilitate the
discussion so that each group presents an idea that has not already been discussed (30 to
45 minutes).

Distribute copies of Worksheet 1: Stock Card and Worksheet 2: Requisition Form.
Present visual aid 5, Worksheet 1: Stock Card. Ask participants what can be done to
improve the form. Repeat this step with the requisition form. Discuss why these changes
would be important.
Drug Supply Management Information Systems
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Case Analysis
< Positive aspects:
There is a drug management manual.
Staff members are concerned.
Attempts have been made to organize the distribution system (each client is
assigned a day; Friday is for catching up).
George can explain the new system, in theory.
George recognizes that there are problems in the units.
< Problems, causes, and recommendations:
Problem Cause What Should Mary Recommend?
The pharmacy does not
quantify orders correctly.
Orders are based on
monthly consumption,
not average monthly
consumption.
Quantities are not
translated into months
of stock.
Math and reporting
errors on stock cards.
Use standard formulas for
quantifying needs.
Adapt the stock card to provide space
for recording monthly consumption
and average monthly consumption.
Separate the +/! column on the stock
card so that it is clear when quantities
should be added or subtracted.
Implement a supervisory system to
double-check math.
Add a space for a signature or initials
on the stock card (maybe people will
be more careful).
There is too much
paperwork (pharmacy
placed 300 orders last year;
units must redo orders
when the requested item is
not in stock).
There is a lack of
information about what
each level has in stock
(pharmacy does not
know what is in stock at
CMS; units do not know
what is in stock at
pharmacy).
Make information available.
Disseminate a list of products in
stock on a regular (monthly?) basis.
Managing Drug Supply Training Series: Trainers Guide
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Problem Cause What Should Mary Recommend?
The pharmacy does not
have information about the
units consumption and
current stock levels.
Units do not keep stock
cards to track
consumption and
current stock levels.
Units do not report
consumption and
current stock levels.
Units receive supplies
from sources other than
the pharmacy.
There is no structure to
allow the pharmacy to
work with, oversee, or
help the units.
Introduce stock cards at units.
Modify requisition form to include
column for previous consumption
and current stock levels.
Instruct units to include supplies
received from other sources on
requisitions.
Implement a system to enable the
pharmacy to supervise stock
management at units.
Implement a push (not pull) system.
The data from the units are bad and
not used by the pharmacy anyway.
Units do not quantify
orders correctly.
Units do not receive the
requested amounts from
the pharmacy (pharmacy
does not have sufficient
stock to satisfy the
units orders).
There is no structure to
allow the pharmacy to
work with, oversee, or
help the units.
Units are not trained in
stock management.
Provide training in quantifying
reorder amounts (using weekly
consumption and average weekly
consumption).
Implement a system to enable the
pharmacy to supervise stock
management at units.
Pharmacy cannot find a
product known to be in
stock.
There is no system for
keeping track of where
products are located.
There is insufficient
storage space.
Include space for recording location
on the stock card.
Consider reorganizing the warehouse
layout to keep all stock of the same
item together.
Drug Supply Management Information Systems
9
Improvements to Forms
< Requisition form
Include unit size.
Include columns for current stock balance, consumption during last period, and
quantity distributed.
< Stock card
Include a space for the average monthly consumption (and provide instructions to
update it monthly).
Include space for a signature (initials).
Include space to record location in warehouse.
Include unit size.
D. Issues in the Design and Implementation of a DMIS (2530 minutes)
Explain that the success of an information system can be measured by the extent of its
utilization. Even if all the components are in place, the system may not function. For
optimal utilization, careful consideration must be given to the design and implementation
of the DMIS.
Present visual aid 6, Steps in Designing or Revising a DMIS, and briefly review each
step.
Some programs have the capacity to produce valid information, and some do not. For
countries with existing information systems, the challenge is to improve them so that
managers can get the data they need for decision making and monitoring.
Ask participants what needs to happen to keep their information systems functioning
optimally. List these on the flipchart or board.
Present visual aid 7, Key Issues in Designing a DMIS, and compare it with the answers
provided by participants.
< Get buy-in; involve users in the design and pilot testing
< Be selective in choosing indicators
< Aim for representativeness, not comprehensiveness
< Use appropriate data collection methods
< Integrate data collection systems
< Develop practical analysis methods
< Computerize at appropriate levels
< Ensure effective communication
Managing Drug Supply Training Series: Trainers Guide
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Present visual aid 8, Implementing a DMIS, and briefly discuss each aspect.
< Phased approach and field testing
< Flexibility
< Training
E. Activity Two: Sources of Information (30 minutes)
This activity allows participants to think individually about where to get the information
they need to make real-life decisions. Information sources may vary from formal reports
to informal telephone conversations with colleagues. Point out that not all data sources
are equal in providing accurate, complete, and relevant data.
Explain that this is a self-assessment activity. Each participant should focus on data that
need to be gathered before an informed decision can be made.
Present visual aid 9, Worksheet 3: Sources of Information Matrix, and discuss the
instructions for completing it.
Instructions
< Ask participants to circle the one function of the supply process for which they are
most responsible.
< Participants should write down two decisions they regularly make concerning the
circled function.
< Ask participants to write down the sources they use to make these decisions. They do
not need to list the types of information, just the sources.
< Ask the participants to evaluate each source. Is it:
Complete and accurate?
Incomplete but useful?
Not very useful?
In plenary, ask three or four participants who are involved in the same general function to
identify the sources they use and their evaluation of those sources. Compare and contrast
their experiences.
Drug Supply Management Information Systems
11
F. Transforming Data into Action (15 minutes)
Managers are often unsure what to do with the huge amounts of data they receive. This
section outlines the key steps in transforming data into concrete action.
Present visual aid 10, Steps in Transforming Data into Action, and review each step:
< Processing data: collecting and inputting the raw data (usually from reporting forms
to a computer program)
< Presenting information: presenting the processed, disaggregated data as meaningful
information
< Interpreting the information for use in decision making
< Taking action: using the output as a basis for decisions and monitoring
Ask participants where their systems break down most often and why they have these
problems. Some systems operate efficiently up to the last step. Once a system has history
of not taking action, the bad cycle has a chance to set in.
G. Activity Three: Information System Design (4060 minutes)
The information needed in decision making can come from many sources, often
originating in different offices at various locations. The previous activity enumerated
what these sources might be. In this activity, participants look at a specific objective. The
focus is how information can be made to flow from the data sources to the actual user of
that information.
Present visual aid 11, Worksheet 4: Management Information System Task Matrix.
Form small groups of three to five persons. Designate each group as Group A or Group B.
For example, with 20 participants, there could be two Group As and two Group Bs.
Group As objective is to make sure that the Ministry of Health gets the most drugs for its
money. Group Bs objective is to make sure that the drugs are distributed to patients as
efficiently as possible.
Each group should complete the following tasks:
< Agree on two decisions that are necessary to achieve the objective.
< Identify the person or persons (by position) who should make the decisions and
coordinate the activities to achieve the objective.
Managing Drug Supply Training Series: Trainers Guide
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< List the most important categories of information needed (e.g., stock records,
prescribing data, procurement patterns, budget documents).
< For each information category, suggest where data are available.
< Suggest in what format and how often the information should be conveyed to the
appropriate decision makerfor example, as annual reports, formal briefings, weekly
committee meetings.
Ask one person from each group to present the groups results. Allow 5 to 10 minutes for
each presentation.
H. Summary of Session (10 minutes)
Review visual aid 4, Information Systems Pyramid. Acknowledge that each level might
have different information needs, depending on the types of decisions that must be made.
Remind participants that the function of a DMIS is to serve the needs of the decision
maker, at whatever level.
Present visual aid 12, Drug Supply Cycle.
A DMIS is essential for the optimal functioning of all parts of the drug supply
management system. Remind the group that each area (subsystem) in the cycle can
require different types of data, but some data can be relevant to all areas. The source of
the information depends on what activity needs to be done or what decisions need to be
made.
Data collection and processing in a DMIS require a strategy for evaluating, linking, and
feeding back information to all levels. A good strategy facilitates monitoring and
evaluation of the entire system, as well as the DMIS itself.
Review visual aid 1, The Bad Data Cycle. Explain that by applying a logical process for
obtaining information and for planning and implementing information strategies and
systems, the bad data cycle can be broken.
Drug Supply Management Information Systems
13
Activity One
Case Study of Sage State Hospital Pharmacy
Rationale
The hospital can be considered a microcosm of larger systems, sharing many of the same
problems and concerns. The flow, quality, and quantity of information are important aspects of a
drug management information system, which is only as strong as its weakest component.
Instructions
Read the case study, and review the stock card and requisition form that Mary copied for her files
(Worksheets 1 and 2). Then, considering what you have learned about Marys visit to the Sage
Hospital Pharmacy, answer the following questions:
1. What are some of the positive aspects of the Sage Hospital Pharmacy?
2. Using the table on the following page, list all the problems related to the logistics
information system in the left-hand column, write each problems possible causes in the
middle column, and then list the recommendations Mary should make in the last column.
Use a separate page if you need more space.
3. How can the stock card and the requisition form be improved?
Managing Drug Supply Training Series: Trainers Guide
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Problem Cause What Should Mary Recommend?
Drug Supply Management Information Systems
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Case Study: Sage State Hospital Pharmacy
Mary Passaly has been assigned to work with the Sage State Hospital Pharmacy to improve its
logistics information system. Upon arrival at Sage, she arranges a meeting with George Iver,
the chief pharmacist, to begin gathering information about the pharmacys drug management
system. Parts of Marys conversation with George are included below:
Mary: Hello, Mr. Iver. I hope youre not too busy and that we can talk about the drug
management information system here at Sage.
George: Weve been expecting you. Please, call me George. Have a seat, and lets get started.
Mary: Thank you. As you know, my assessment will cover the key elements of the logistics
cycle. Id like to review the procurement process so that I can learn how stock is resupplied. Id
also like to review the receiving process to see how often you receive supplies and how you
manage this process, as well as your stock management practices to learn how you track
transactions and inventory levels. Finally, Id like to review the distribution system to learn how
you work with the hospital units to resupply their stock. Perhaps you could begin by giving me an
overview of your system.
George: We are responsible for providing drugs and medical supplies to the hospital units and to
the pharmacy dispensary. We arrange it so that each of the 20 units places its order on a specific
day of the week. We get 5 orders a day, Monday through Thursday. If we do not have an item in
stock, we have to return the requisition to the unit so that it can correct the order. On Fridays we
try to catch up on all these corrected requisitions and other paperwork.
Mary: How do the units quantify their orders for resupply?
George: Well, they make an estimate based on what they used the previous week.
Mary: Do they keep stock cards?
George: Oh no. Some units dont even have a place to keep the stock. They just put it on the
nurses desk. They dont manage their supplies, and we dont know how much they really use,
because if they run out of a product and it isnt their day to receive stock, they borrow from
another unit. Sometimes they receive supplies from donations or private pharmacies as well.
Mary: How do you know that the quantities they request are appropriate?
George: I know that the quantities are not appropriate! They dont understand that we dont have
enough items in stock to supply every unit, so they always exaggerate the amount they request.
But it doesnt work this way. We have to make decisions based on what we think they really need
and which units have the greatest need for the drugs requested.
Mary: How many items do you carry?
George: Oh, Id say about 400, including medical supplies.
Managing Drug Supply Training Series: Trainers Guide
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Mary: Tell me a bit about how you order supplies. How frequently do you place orders? How
many suppliers do you have?
George: At the end of every month, we conduct a complete inventory. A pharmacist works with
one of the assistants to make a list of all the items that should be ordered. I review the list and
place the order with the Central Medical Store (CMS), but it is often out of stock, so I have to
place the order again with a commercial supplier. I also have to place orders with commercial
suppliers for all the specialty items not carried by the CMS.
Mary: How do you decide how much stock to order?
George: About six months ago, the Ministry of Health produced the Drug Management Manual,
which instructs us to order when we reach our minimum stock level, which is 1.5 months worth.
Mary: But how do you know how much to order?
George: Were supposed to order enough of each product to get us to our maximum stock level,
which is 2.5 months worth. This is how it works: When we do our monthly inventory, we
calculate how much weve used. We compare that with the amount on the stock card and make
corrections if theres a difference. Then we look at our consumption for the past month and use
that to calculate how much we would use in 2.5 months. We order that amount, minus what we
already have in stock. This seems like a good system, but truthfully, we rarely have the time to
place our orders this way. I usually estimate how much to order based on what we used last
month.
After additional discussions with George and the other pharmacists, Mary reviews the
pharmacys purchasing records and discovers that the pharmacy placed 300 orders in the past
year. She also reviews the stock cards, which are kept in folders on a desk in the warehouse, and
finds that they are frequently out of date. George explains that they often wait until Friday to
update the stock cards, but sometimes they fall behind. With the help of the pharmacists, Mary
conducts an inventory of the 20 most frequently used products and compares the physical stock
counts to the balance reported on the stock records. She learns that:
< Of the 20 stock cards, only 2 correspond to the physical stock level.
< Of the 20 items counted, 4 are out of stock.
George insists that one of the out-of-stock items, hydrogen peroxide, is in stock. In fact,
according to the stock card, the pharmacy should have two full cartons. He asks the other
pharmacists and pharmacy workers if they might have stored the hydrogen peroxide somewhere
else this time, but no one can determine where the cartons are. Embarrassed, George continues
to search for the hydrogen peroxide cartons, mumbling something about never knowing where to
find anything in the warehouse.
Drug Supply Management Information Systems
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Worksheet 1
Stock Card
SAGE STATE HOSPITAL PHARMACY
ITEM
NAME:
Ibuprofen
DATE RECEIVED
FROM/DISTRIBUTED
TO
QTY (+ or ! !! !) BALANCE
April 2 97 CMS 10,000 10,000
April 3 97 Urology 500 9,500
April 7 97 Satellite Clinic 1,500 7,000
April 8 97 Dispensary 1,000 8,500
April 9 97 Emergency 500 8,000
April 14 97 Maternity 1,000 7,000
April 16 97 Dispensary 500 2,000
April 21 97 Satellite Clinic 1,500 500
April 23 97 CMS 20,000 20,500
April 24 97 Urology 500 20,000
April 28 97 Satellite Clinic 2,000 18,000
April 29 97 Maternity 1,500 15,500
April 30 97 Dispensary 1,000 14,500
April 30 97 Emergency 1,000 13,500
May 8 97 Emergency 500 14,000
Managing Drug Supply Training Series: Trainers Guide
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Worksheet 2
Requisition Form
Requisition Form
DATE: May 9 97
UNIT: Maternity
To be completed by the unit To be completed by the pharmacy
ITEM NAME
(e.g., ibuprofen 400 mg)
QUANTITY
REQ.
UNIT
PRICE
QUANTITY
DELIVERED
UNIT PRICE
Chloramphenicol 250 mg 2,000
Sodium chloride 500 ml 100
Dextrose 50%, 50 ml 100
Acetylsalicylic acid 500 mg 3,000
Total
PHARMACIST
Drug Supply Management Information Systems
19
Activity Two
Sources of Information
Rationale
This activity allows participants to examine where they get the information they need to make
decisions. The sources may vary from inventory reports to informal telephone conversations with
colleagues. This assessment highlights how many different sources are used and how variable
those sources are in providing accurate, complete, and relevant information.
This is a self-assessment activity. Participants will not be asked to report their personal sources
of information to the group.
Instructions
1. On Worksheet 3: Sources of Information Matrix, have participants circle the one
function of the supply process for which they are most responsible.
2. Then have them write down two decisions they regularly make concerning the function
circled (e.g., decisions regarding what drugs to purchase, how much to purchase, when to
purchase, how to deliver drugs to health facilities, which facilities will receive supplies
and when).
3. Next, have them write down the sources they use to make these decisions (e.g., reports,
forms, censuses, studies, personal files).
4. Ask participants to evaluate the quality and usefulness of each of these sources. Are they:
< Complete and accurate?
< Incomplete but useful?
< Not very useful?
5. What other information would participants like to have available when making decisions?
Where might it be obtained?
Managing Drug Supply Training Series: Trainers Guide
20
Worksheet 3
Sources of Information Matrix
PART ONE: Circle the function of the supply process for which you are most responsible, or the function in which you are the most
interested in making improvements.
SELECTION PROCUREMENT DISTRIBUTION USE
PART TWO:
Describe two decisions
that you are regularly
required to make
concerning this function.
PART THREE:
List the sources by
which you obtain
information for making
each decision.
PART FOUR:
Indicate how you feel about the
information provided by each
source. Check one column for each
source.
PART FIVE:
What information do you need? Where is this
information?
Complete
and
Adequate
Incomplete
but Useful
Not
Very
Useful
FIRST DECISION: 1.
2.
3.
4.
SECOND DECISION 1.
2.
3.
4
Drug Supply Management Information Systems
21
Activity Three
Information System Design
Rationale
The information needed for decision making can come from many sources, often originating in
different offices at various locations. The focus of this activity is how information can be made to
flow from the data sources to the actual user of the information.
Instructions
1. Work with Worksheet 4: Management Information System Task Matrix.
2. Have participants form groups of three to five persons. Designate groups as Group A or
Group B. Group As objective is to make sure that the Ministry of Health gets the most
drugs for its money. Group Bs objective is to make sure that the drugs are distributed to
patients as efficiently as possible.
3. Each group should complete the following tasks:
< Agree on two decisions that are necessary to achieve the objective.
< Identify the person or persons (by position) who should make decisions and coordinate
the activities to achieve the objective.
< List the most important categories of information needed (e.g., stock records, prescribing
data, procurement patterns, budget documents).
< For each information category, suggest where data are likely to be available.
< Suggest in what format and how often the information should be conveyed to the
appropriate decision maker (e.g., annual reports, formal briefings, weekly committee
meetings).
4. One person from each group will present the groups results.
Managing Drug Supply Training Series: Trainers Guide
22
Worksheet 4
Management Information System Task Matrix
OBJECTIVE: Group A: To ensure that the Ministry of Health gets the most drugs for its money.
Group B: To ensure that drugs are distributed to patients as effectively as possible.
TASK ONE
State what decisions are
necessary to achieve this
objective.
TASK TWO
Identify the
person/position who
should make the
decision and coordinate
activities for
achievement of this
objective.
TASK THREE
List the four most
important categories of
information needed to
make these decisions.
TASK FOUR
For each category of
information, indicate
where it is available.
TASK FIVE
How should each
category of information
be conveyed to the
appropriate decision
maker?
Mode Frequency
1.
2.
3.
4.
1.
2.
3.
4.