OCUMENTATION PAGE AD-A209 660

1 NZOPITY CLASSIFICATION OF THIS PAGEForm ApprovedOCUMENTATION PAGE 0 MBNo. 07041-0188lb. RESTRICTIVE MARKINGSAD-A209 660 3. DISTRIBUTION/AVAILABILITY OF REPOT ..Approved for public release;E IDistribution unlimited4. PERFORMING ORGANIZATION REPORT NUMBER(S) 5. MONITORING ORGANIZATION REPORT NUMBER(S) f (IV7-89N1ME , ORGAnIZATION 6b. OFFICE SYMBOL 7a. NAME OF MONITORING ORGAN ZATION,rmy-bay or nivers y (if applicable)Graduate Program in Health Care Admin/HSHA-IHC $' &..6c. ADDRESS (City, State, and ZIP Code) 7b. ADDRESS (City. State, and ZIP Code) -Ft. Sam Houston, TX 78234-6100Ba. NAME OF FUNDING/SPONSORING |8b. OFFICE SYMBOL 9. PROCUREMENT INSTRUMENT IDENTIFICATION NUMBERORGANIZATION (If applicable)8c. ADDRESS(City, State, and ZIP Code) 10. SOURCE OF FUNDING NUMBERSPROGRAM PROJECT TASK WORK UNITELEMENT NO. NO. NO. ACCESSION TITLE include ' fiA STUDY TO D E"111 H6 DOLOGY TO DETERMINE MANPOWER REQUIREMENTS FOR THE MATERIELDISTRIBUTION SERVICE AT THE COLONEL FLORENCE A.)

2 BLANCHFIELD ARMY COMMUNITY HOSPITAL1l. PERSONAL AUTHQR(S)AJ Duane L. JacKson13a. TYPE OF REPORT 13b. TIME COVERED 14. DATE OF REPORT (Year,Month, Day) 115. PAGE COUNTS tudy FROMJul 84 Tul 85 Jun 85 J14116. SUPPLEMENTARY NOTATION17. COSATI CODES 18. JU JECT TERMS lContinue on reverse if necessary and identify by block number)FIELD GROUP SUB-GROUP Healt Care, Manpower Management' () ,a-C 19. ABSTRACT (Continue on reverse if 7ecessary and dentify by block number)This study was conducted to develop a methodology for determining manpower requirementsbased on workload factors. Actual time for tagk-aczqoplishment and actual dailyworkload performed for customer service, stock accountihg, cost accounting sectionsof the Materiel Distribution Service were recorded. Two manpower prediction formulas,one based on time for task accomplishment and the other on workload ,were derived from the data.

3 A significant difference was found between the pedictedmanpower requirements. The author concluded the formula based on workload was a -btterpredictive tool due to its inclusion of the minor tasks accomplished that were notmeasured by the task accomplishment model. KI . DISTRIBUTION/AVAILABILITY OF ABSTRACT 21. ABSTRACT SECURITY CLASSIFICATIONXVUNCLASSIFIED/UNLIMITED 0 SAME AS RPT. 0 DTIC USERS22a. NAME OF RESPONSIBLE INDIVIDUAL 22b- TELEPHONE (include Area Code) 22c. OFFICE SYMBOLL awrence M. Leahv. MAJ. MS (512) 221-6345/2324 NA-IHCDD Form 1473, JUN 86 Previous editions are obsolete. SECURITY CLASSIFICATION OF THIS PAGE89 6 ?06A STUDY TO DEVELOPA METHODOLOGY TO DETERMINE MANPOWER REQUIREMENTSFOR THE MATERIEL DISTRIBUTION SERVICE AT THECOLONEL FLORENCE A. BLANCHFIELD ARMY COMMUNITY HOSPITALA Graduate Research ProjectSubmitted to the Faculty ofBaylor Universityin Partial Fulfillment of theRequirements for the DegreeofMaster of Health Administration -byAccession ForNTIS GRA&IDTIC TABM ajor Duane L.

4 Jackson, MSC Unnnnc'incrd ElJustif icrstionJune 1985 Availc- JIity Codes!Av, Ll. and/orDist SpecialA 1 ACKNOWLEDGEMENTSThis project could not have been accomplished without thehelp, advice and untiring assistance of many people. First, Iwish to thank my preceptor, Colonel Gerald C. Oliver, DeputyCommander for Administration at the Colonel Florence Army Community Hospital, Fort Campbell, leadership, guidance and support were invaluable throughoutthis cooperation of all the personnel working in theMateriel Distribution Service greatly enhanced the collectionof data and is deeply appreciated. Through observing theirdaily routines, I was not only able to collect data for thisproject, but also learn the practical side of operating an also have to acknowledge the young lady who had thearduous task of typing this report and her untiring efforts tocomplete the project on a timely basis.

5 More importantly,though, is Mrs. Donna Sanchez's friendly and energetic nature,enduring the many changes that occurred while typing thisproject, always looking on the bright side of , I cannot overlook my wife and two sons who haveendured so much while I was obtaining my education. Many timesmy wife had to play the dual role of "father" and mother whileI was working on various projects. Their unceasing support athome has made this project OF ..LIST OF Prompting the of the Research of the Blanchfield MDS Warehousing Accounting Accounting Research and Analysis CONCLUSIONS AND DISTRIBUTION DESIGN AND ELEVATION OF THE COLONEL FLORENCE ARMY COMMUNITY HOSPITAL ..43C. MATERIEL DISTRIBUTION SERVICE MAJOR FUNCTIONSAND SUBROUTINE PERFORMANCE TIME COLLECTION SHEETS ..47E. STATISTICAL DERIVATION FOR THE NUMBER OF OBSERVATIONSREQUIRED TO EVALUATE EACH SUBROUTINE.

6 68F. STAFFING RESULTS FROM THE MOST RECENT MANPOWERSURVEY .. 70G. AVERAGE DAILY MEDICAL CARE COMPOSITE UNITS PRODUCED BYTHE COLONEL FLORENCE A. BLANCHFIELD ARMY COMMUNITYHOSPITAL, FY 1984 AND THE FIRST SIX MONTHS OFFY 1985 .. 75H. EXCHANGE CARTS USED AT BLANCHFIELD ARMY COMMUNITYHOSPITAL: SPECIFICATIONS AND COMPONENTS .. 77I. CART REPLENISHMENT SCHEDULE .. 80J. NINETY DAY WORKLOAD DATA FOR THE MATERIELDISTRIBUTION SERVICE .. 83K. MULTIPLE REGRESSION ANALYSIS USING COLLECTED WORKLOADDATA .. 97L. ANALYSIS OF TIME MEASUREMENT STUDIES .. 110M. CONVERSION OF MEAN TIME TO PERFORM MDS TASKS TOSTANDARD FRACTIONAL MANDAY EQUIVALENTS .. 127N. PAIRED COMPARISON HYPOTHESIS TEST .. 1290. COMPARISON OF THE TWO MODELS; NUMBER OF FULL TIMEEQUIVALENTS REQUIRED TO STAFF THE MDS .. 133 BIBLIOGRAPHY .. 137ivLIST OF TABLESTABLE Page1. Summary of Comparisons of DistributionAlternatives .. 32. The Calculation and Comparison of Full TimeEquivalents on a Monthly Basis Using theMultiple Regression and the Engineered Models.

7 34vCHAPTER IINTRODUCTIONB ackgroundA valid concern of logisticians is how to get materiels tothe correct user in the right quantity and at the right1time. The accomplishment of this goal not only leads tooperational efficiency but also helps to reduce costs byminimizing the amount of stock on hand, theieby reducing thepotential for pilferage and limiting waste. To help resolvethis dilemma, the identification of internal inventory transferoperations as an operating area has been recognized bylogisticians to integrate the physical distribution and2materiels management operations within an a hospital environment the internal inventory transferdilemma translates into a problem of moving supplies from awarehouse or central storage facility to the various wards andclinics in the proper quantity to insure medical support is notinterrupted by a stockout condition. To counter this problem,many hospitals have integrated internal inventory transferoperations into the logistical functions through the use of amateriels distribution service -MDS (also commonly called asupply point distribution center -SPD).

8 Distribution ofmateriel to the wards or clinics from this central storeroom is12generally accomplished by one of three methods: (1) the"fetch-and-carry system"; (2) the Par-level stockage system; or3(3) the cart-exchange system. The processes of these threesystems are illustrated in Appendix the fetch-and-carry system, the customer plays anactive role in ordering supplies. Someone on the using unit isdelegated the responsibility of maintaining adequate levels ofsupplies, filling out appropriate requisition forms andsubmitting the request to the central storeroom. The centralstoreroom fills the request and delivers the materiel to theuser. Frequency of this process is dependent upon the actionsby the user, while the central storeroom plays a passive roleuntil activated by a supply level stockage is based on establishing user stockagelevels for each respective area. Individuals from the MDSservice go to the user's area at scheduled intervals tophysically inventory supplies remaining on the shelf.

9 Uponreturn to the central storeroom, the quantity inventoried foreach item is compared to a pre-established stockage level andreplenishment quantities computed. Each commodity on the shelfis then brought back up to the established "par" level byMDS personnel selecting the replenishment stock, returningto the area and placing it on the shelf. The customer is thencharged for the materiel issued to bring shelf levels back upto pre-determined cart exchange system is based on exchanging entiresupply carts in a functional area with identical units that3have been replenished with supplies up to pre-determinedlevels. Carts that have been removed from the areas are thenreturned to a central processing point. Each item of supply ona cart is inventoried with the quantity counted compared to amaster list containing stockage levels for that specific cartto determine re-stockage quantities.

10 These supplies are thenpulled from stock and placed on the cart. Replenished cartsare stored and become the replacement carts for the ward orclinic carts at the next scheduled exchange cycle. Thefunctional area is then charged for the supplies necessary toreplenish stockage in order to bring each item of supply up tothe pre-established provides an excellent comparative summary of thethree distribution alternatives. Table 1 provides an overviewof the 1 SUMMARY OF COMPARISONS OF DISTRIBUTION ALTERNATIVESFETCH PAR LEVEL CARTAND CARRY STOCKAGE EXCHANGEINVENTORY REDUCTION LOW HIGH HIGHPOTENTIALLABOR UTILIZATION POOR FAIR EXCELLENTCAPITAL EXPENSE LOW LOW HIGHSPACE UTILIZATION POOR LOW HIGHMANAGEMENT CONTROL POOR VERY GOOD EXCELLENTSOURCE: Jamie C. Kowalski, "Supply Distribution Options - ANew Perspective," Hospital Materiel Management Quarterly 2(November 1980): States Army hospitals are currently using all threeapproaches; however, the par exchange and cart exchangeconcepts are becoming more popular for the obvious advantagesthey offer.