Stakeholder involvement in drug inventory policies

This paper experimentally investigates the relationships among three major stakeholders that are involved in drug inventory management at Intensive Care Units (ICUs), namely: i) nurses, who in person manage drug orders and carry out storage operations, ii) clinicians, who choose the therapy and shape demand, and iii) the hospital management, who is in charge of the economic sustainability of the hospital. As a case study, we consider the ICU ward of a major Italian public hospital and we focus on antibiotics. We exploit a previously developed Mixed Integer Linear Programming model which decides, for each drug, when and how much to order, and we improve it by adding different sets of constraints to represent each stakeholders’ point of view. By solving three generalized models, each of which ties the satisfaction of a single stakeholder to different thresholds, we explore the mutual effects of taking explicitly into account different perspectives within the inventory policy. We implemented an instance generator, built on the basis of empirical probability distributions extracted from a large set of observed historical data and representing the decision flow ruling drugs prescription. Extensive experiments have been carried out on a set of realistic instances provided by the generator. Results based on our test case not only provide computational evidence to intuitive relations among stakeholders, but also suggest possible levels of compromise. Improved stakeholder satisfaction would also benefit the patient, the passive stakeholder who is the ultimate subject of the caring process.