Shaukat Khanum Memorial Trust – Gold Award Winner of the Health Services During Crisis Award 2022

Date:  17 June 2023

Cancer hospital stockpiles: strategizing for an efficient and sufficient inventory list of essential items for setups serving in low-income countries

Mathematical healthcare models rarely capture the challenges faced by many hospitals in low-income countries. After the first wave of the pandemic, various international organisations released guidelines to help hospitals cope with supply shortages during times of crisis. While these guidelines were helpful for many institutions, they were of little use for most hospitals in low or low-middleincome countries.

Seeing the need to address this crucial gap, researchers at the Shaukat Khanum Memorial Trust set out to create their own model to help hospitals in low-income countries be more prepared for future pandemics.

“We aimed to develop a framework to establish a list of essential medical equipment, drugs, and other materials that should be stockpiled for subsequent waves of the COVID-19 pandemic, or other ‘flu-like’ pandemics, by a tertiary care cancer hospital in a low or low-middle-income country. Furthermore, various strategies to help hospitals with the logistics of stockpiling were strategized.”

Dr. Khawaja Shehryar Nasir, Consultant
at the Shaukat Khanum Memorial Cancer Hospital & Research Centre

A unique mathematical approach

“Our model uses the unique consumption patterns of a single cancer institution in a low or low- middle income country, unlike prior models designed for community hospitals in high-income countries,”

Dr. Nasir explained, adding that such countries often have a centralised healthcare network with pooled purchasing, where strategic decisions concerning stockpiling may be made at a governmental level. The same is not true for many hospitals in low-income countries, where purchasing decisions must often be made on an institutional basis.

The project first focused on a stockpiling strategy for supplies of personal protective equipment, medication, oxygen, and reagents/supplies for laboratory and radiological investigations. These items were tagged as essential goods to stockpile in times of crisis. To establish the quantity of essential items to stockpile, researchers reviewed and compared consumption data for June 2020, the peak month of the first wave of the pandemic, versus consumption data during a controlled pre-COVID timeframe (June 2019). They then determined the calculated daily use (CDU) of each of the items. A margin of 20% was then added to this number to account for the pandemic’s unpredictable nature and procurement delays. This is known as anticipated daily use (ADU). The ADU was then multiplied by the lead-time to calculate the quantity of the item needed for the stockpile. A costing analysis was also performed to determine the cost difference between procuring items as needed or purchasing pre-pandemic. If a difference of ≥5% was present, an additional analysis of the cost of maintaining, rotating, and storing the stockpiles was conducted.

Through this process, the hospital was able to determine whether a particular item should be stockpiled, allowing it to be more prepared for the next waves of the pandemic.

“During the initial waves of COVID-19, our hospital, like other hospitals worldwide, encountered situations where the PPE reserves were nearly exhausted because of increased usage and delays in the procurement process and the price of available items skyrocketed. Hereafter, in the corresponding waves, through the help of this project, we did not encounter a shortage of any essential items. The project allowed the hospital to provide an uninterrupted supply of essential materials, including oxygen, during the subsequent waves of COVID-19.”

Due to its proven usefulness, the model was subsequently integrated into the hospital’s Materials and Management Department practice.

This model is adjustable and can be modified and used under individual, institutional requirements. The model can also be expanded to incorporate estimating stockpiles for other essential medical equipment, such as syringes, catheters, dressing materials, bedding, waste management supplies, body bags and shrouds needed for the handling of dead bodies. Similarly, it can also be used for calculating necessary stockpiles for food, water, and fuel reserves.

Shaukat Khanum Memorial Trust is a not-for-profit organisation that provides state-of-the-art cancer care to patients through modern therapies, irrespective of their ability to pay. Last year, the organisation provided care to more than 200,000 patients in an outpatient-setting, 63,000 chemotherapy sessions were delivered, and more than 77,000 radiation-therapy sessions occurred.

Submit entries now!

The IHF Awards 2023 is accepting entries across 7 categories until 30 June 2023

Written by:

IHF Secretariat

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