The findings matter because hospital pharmacies are the backbone of clinical care. Any delay, error, or shortage in drug availability can lead to postponed treatments, compromised patient outcomes, and declining trust in healthcare services. By mapping risks and prioritizing mitigation strategies, the study offers a roadmap for hospitals to strengthen pharmaceutical service reliability.
Growing Pressure on Hospital Pharmacy Systems
Hospital drug supply chains are becoming increasingly complex. They must ensure that medicines are available in the right type, quantity, quality, and time for every patient. In Indonesia and many other countries, hospitals rely on interconnected systems involving budgeting, procurement, digital platforms such as e-catalogs, and coordination with distributors.
However, recurring issues such as delayed procurement, stock shortages, and limited system integration continue to disrupt operations. These challenges are not isolated. They reflect broader systemic pressures, including bureaucratic processes, workforce limitations, and technological gaps in hospital information systems.
The research conducted at a hospital pharmacy installation in Surakarta shows that these disruptions are not just logistical concerns they are clinical risks with direct consequences for patient care.
Simple Framework, Actionable Insights
The research team used a structured but practical approach to analyze the drug supply chain. Four experienced pharmacists each responsible for different stages of the supply process provided data through in-depth interviews and structured questionnaires.
The study mapped the supply chain into five main stages:
- Planning drug needs
- Sourcing or procurement
- Compounding or preparation
- Distribution to patients or wards
- Return and handling of unused or rejected medicines
To identify and prioritize risks, the researchers applied two analytical tools:
- SCOR (Supply Chain Operations Reference) to map processes
- House of Risk (HOR) to identify root causes and rank mitigation strategies
This combination allowed the researchers to move beyond listing problems and instead produce a clear hierarchy of risks and solutions that hospital managers can act on.
21 Risks Identified Across the Supply Chain
The study identified 21 risk events and 21 risk agents distributed across all stages of the supply chain. The risks were not concentrated in one area but spread throughout the system.
Key risk factors include:
- Emergency time pressure during high-demand situations
- Insufficient number of pharmacy staff
- Slow and unresponsive bureaucracy
- Frequent disruptions in the national e-catalog system
- Limited functionality of hospital information systems (SIMRS)
- Weak communication with pharmaceutical distributors
Among these, time pressure and staffing shortages were classified as the most critical risks. These factors increase the likelihood of delays in drug preparation, errors in compounding, and bottlenecks in service delivery.
The study also found that risks in the “make” (compounding) and “deliver” (distribution) stages have the most direct impact on patient safety, as these stages involve direct interaction with patient treatment processes.
Priority Solutions for Hospital Management
The research does not stop at identifying risks. It provides a ranked list of mitigation strategies based on effectiveness and ease of implementation.
Top recommended actions include:
- Routine coordination across hospital units and clear service quality standards
- Adding pharmacy staff based on workload demands
- Strengthening communication with drug distributors
- Expanding service hours and conducting regular staff training
- Reporting e-catalog issues to national authorities
- Improving hospital information systems and IT infrastructure
The highest-ranked solution focuses on improving coordination and governance. This reflects a key insight: many operational problems are not caused by a lack of resources alone, but by weak communication and slow decision-making processes.
Real-World Impact on Healthcare Systems
The implications of this research extend beyond a single hospital. It offers practical guidance for improving pharmaceutical supply chains in hospitals across Indonesia and similar healthcare systems worldwide.
Key benefits include:
- Improved patient safety through reduced medication errors
- Faster service delivery in emergency and routine care
- Better resource management in hospital pharmacies
- Stronger integration of digital health systems
- Enhanced collaboration with suppliers and distributors
For policymakers, the findings highlight the importance of strengthening national procurement systems such as the e-catalog platform. For hospital administrators, the study underscores the need to invest in human resources, system integration, and cross-unit coordination.
Academic Insight
Viktorda S. Noti of Universitas Setia Budi emphasizes that drug supply chain risks are systemic and interconnected. The research shows that disruptions cannot be solved in isolation, but require coordinated action across planning, procurement, and service delivery units.
Jason Merari Peranginangin, also from Universitas Setia Budi, highlights that strengthening coordination mechanisms and escalating operational barriers to leadership are among the most effective strategies for improving system performance.
Their findings reinforce the idea that hospital pharmacy management is not just a technical function, but a strategic component of healthcare quality and patient safety.
Author Profiles
Viktorda S. Noti, S.Farm. – Graduate researcher in pharmacy management, Master of Pharmacy Program, Universitas Setia Budi Surakarta. تخصص in pharmaceutical supply chain and risk management.
Jason Merari Peranginangin, S.Farm., M.Farm. – Lecturer and researcher at the Faculty of Pharmacy, Universitas Setia Budi Surakarta, specializing in clinical pharmacy and healthcare systems.Source
This study confirms a critical reality: hospital drug supply chains are only as strong as their coordination, workforce, and systems. Without integrated management, even small disruptions can escalate into serious risks for patient care.
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