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The patient care processes in hospitals are supported by a range of operational activities including inventory management and distribution of supplies to point-of-care locations. Hospitals carry large amounts and a great variety of items, and the issues of storing and distributing these items throughout the hospital supply chain are of great importance to providing high-quality patient service. Healthcare logistics encompasses the process of handling physical goods (e.g. pharmaceuticals, surgical medical products, medical equipment, sterile items, linen, food, etc.) and the associated information flows, from the reception of the goods within a hospital to their delivery at patient care locations. The medical supply costs constitute the second largest expenditure in hospitals, after personnel costs. A high-performing supply chain may realize improved outcomes (e.g. safe and quality patient service) and greater efficiency. Logistics managers need to identify opportunities to improve the logistics processes in order to lower costs and to improve patient care quality. However, in order to improve the logistics processes, you must understand how the healthcare supply chain is currently performing. Measuring the performance of the supply chain is fundamental to identify and address deficiencies in the logistics activities, and it serves as a good input for managerial decision-making. The purpose of this article is to present existing research on performance measurement at the internal hospital supply chain (e.g. inventory management, distribution activities), and more specifically in the operating theatre since it is among the most critical resources for a hospital. At the operating theatre, the requested items should be available at the right time at the right place, in the right condition, at the lowest cost possible. Furthermore, we will also discuss literature on multi-criteria decision-making techniques. It enables researchers to build a performance measurement framework and to prioritize between multiple performance indicators since a diverse group of stakeholders with conflicting interests is involved in the internal operating room supply chain.

The recent trend is towards value-based healthcare, which is characterized by the relationship between quality of care and the associated costs. However, value in healthcare is a largely unmeasured and misunderstood concept. In particular, a definition of multi-stakeholder value in healthcare decision-making is missing. In this case study, we review the radical prostatectomy procedure because previous studies have shown discrepancies between what the patient’s value most and what the experts think the patient’s value most. The objective of this research is to address this gap by identifying a multi-stakeholder definition of value which will improve healthcare decision-making. Multi-criteria decision-making (MCDM) techniques, more specifically the Analytic Hierarchy Process (AHP), are applied to prioritize the quality of care indicators according to the following six pillars of quality: safety, effectiveness, efficiency, timeliness, patient-centeredness and equity. In addition, the average cost of a radical prostatectomy is estimated. A distinction is made between three treatment stages in order to calculate the overall quality score by assigning weights to criteria in each treatment stage. According to the AHP weights, the pillars of effective, patient-centered and equitable care contribute the most to value creation. Finally, some of the challenges of MCDM studies are addressed, such as conflicting preferences between stakeholder groups. In conclusion, this case study stresses the need to adapt operational research methods and knowledge to be applied in value-based healthcare. The AHP is a suitable approach to address the needs of healthcare decision-makers, to set priorities, and to identify value improvement opportunities while considering all of the stakeholders involved in the full care cycle.

Ensuring cost containment while providing high quality patient care is of paramount concern to hospitals. The operating theater in particular is a major cost driver for any hospital, and is among the most critical resources in terms of both capacity and patient care. Effective inventory and distribution systems are a prerequisite for realizing efficiency improvements in the internal operating theater supply chain. In this work, discrete-event simulation is used to model part of the internal distribution process in the operating theater at a Belgian Hospital and to identify improvements by focusing on the replenishment process. A logistics performance measurement framework based on Analytic Network Process (ANP), as a popular Multi-Criteria Decision-Making (MCDM) technique, is adopted to assess three replenishment scenarios. The best performing scenario is selected using the Internal Logistics Efficiency Performance (ILEP) index as an evaluation basis. This research indicates that industrial engineering techniques, such as simulation and MCDM, which are successfully applied in industrial sectors, can also be adopted to realize efficiency opportunities in healthcare logistics.

Manufacturing and maintenance processes significantly benefit from effective and integrated Supply Chain Management (SCM). Recently, hospitals start to recognize the importance of these logistics initiatives to improve their operational performance while also maintaining high quality of patient care. Patient care processes are supported by a range of supply chain activities including inventory management and distribution of medical supplies to point-of-care locations. At the operating room for instance, the logistics staff’s goal is managing materials and information flows to have the requested materials at the right operating room at the right time, in the most efficient way. However, poor inventory management, lack of standardization and lack of coordination between departments complicate healthcare logistics processes, and hence result in many waste. Opportunities for efficiency gains in these logistics processes can be identified by measuring the performance of the internal supply chain. This paper presents a rigorously defined logistics performance measurement framework to evaluate the efficiency of logistics processes in operating rooms. The Analytic Network Process (ANP) is utilized as a popular Multi-Criteria Decision-Making (MCDM) technique to provide effective decision-support models. The proposed ANP-based framework is a first step towards measuring the performance of operating room supply chain processes by selecting and prioritizing logistics objectives and associated Key Performance Indicators (KPIs). Further research is required to validate the ANP framework by including multiple stakeholders’ preferences, as they may have conflicting views on performance definitions. The final goal of the framework is to support hospital logistics managers in making transparent and informed decisions to improve inventory and distribution policies in the operating room while considering all stakeholders’ preferences.