Behind the scenes: Choong Kin Hoe on hospital logistics pharmacy
While many healthcare professionals help patients in clinics and across dispensing counters, often their work is supported by lesser-known colleagues who make sure they stay well-supplied with their essentials. For its May-June 2019 issue, MIMS Pharmacist speaks to Choong Kin Hoe, former logistics pharmacist at Hospital Kuala Lumpur (HKL), about what goes on in the store pharmacy.
Tell us about your background.
I entered HKL’s store pharmacy in 2016 as part of my compulsory service following my PRP (Provisionally Registered Pharmacist) training at Klang General Hospital. When I reported for duty, I didn’t expect to be placed in logistics as most pharmacists are sent to the outpatient departments which require the most manpower. It was a very interesting experience for me, as the opportunity to work in logistics does not come very often. I was there for just over 2.5 years.
What is the job scope of a logistics pharmacist?
Our main role is to make sure the hospital is stocked; the routine depends on what we have on hand. It’s not about checking on your stock every day; after managing your items for a while, you get a hang of which items tend to move faster and which ones move slower. The faster ones are the ones I’d monitor more closely. But generally, I'd do a thorough check about once every 2 weeks.
Apart from that, most of our time is actually spent procuring items, managing stock, and dealing with our end users (HKL’s outpatient pharmacists), the suppliers, and occasionally sales representatives.
Did you work with a big team?
Including myself at the time, there were 10 pharmacists working in HKL’s store, but HKL is a bit unique. Back when I was at Klang General Hospital, we only had around three; most hospitals only have one or two.
The reason HKL’s store pharmacy team is quite big in comparison is because while most hospitals have a centralized system, HKL has multiple stores split up based on item types; tablets, injections, IV drips, etc. Each store would have a pharmacist in charge handling their own inventory. For me, I dealt with tablets and worked under a senior pharmacist.
How does procurement work?
Everything’s computerized through the Pharmacy Information System (PhIS). Each pharmacy in HKL monitors their own stock levels. When they run low on certain items, they can generate a list of those to indent (place an order for) from the main store, which is us. We receive the list through the PhIS and then tally it against our current stock to see if we can supply what’s being asked for.
At HKL, there are two groups of items for stocking; standard and non-standard. Standard items are the common ones that’s used by almost every department, like paracetamol and flu medicine, so the main store always keeps a certain amount on hand. Non-standard items are things specific to each department eg, chemo drugs for oncology, high-end diabetes drugs, more specialized cardio drugs.
The store doesn’t keep stocks of non-standard items, but we help departments order them, and send it straight to them when the items arrive. The onus is on them to make sure they have their minimum 1 months’ supply of their non-standard items; for standard items, it’s the main store’s responsibility.
As store pharmacists, we didn’t just monitor the level of items in stock, but also the usage rate. If an outpatient pharmacy usually requested 20 boxes of Drug A per month, and then suddenly there was an order for 100 boxes, it was our responsibility to query that. Did they enter the correct quantity? Did they check the numbers?
Were there abnormalities sometimes?
Every so often there would be a case. From what I understand, in the outpatient setting, the pharmacist in charge of a department occasionally rotates, or maybe the usual pharmacist goes on long leave, so someone else comes to cover for them. That person being less familiar with the usual resupply might order the wrong quantity or package size from the store.
What do you do when a product is recalled?
During a recall, we’re usually the first department notified via email blasts because we manage everything. If company A recalls drug A, we have to find out: do we have it in stock? If we do have it, who uses it? If it’s a standard item, we’d have to inform every department. If it’s a non-standard item, then we’d just inform the departments that use it.
We’re also the ones responsible for gathering all the recalled stock within the time frame that's specified by the product recall notice. We give it back to the manufacturer, who then is responsible for reimbursing us with an equivalent amount of stock of the same item. If the entire batch is affected, we have to wait for them to produce a new batch.
What parts of the work were challenging?
For a store pharmacist, the most problematic time comes when certain items run out of stock—not just within the hospital’s supply, but throughout Malaysia. There were quite a few cases of that in the past. In one recent case, an item had only two suppliers in the whole country, so when one brand ran out of stock, everyone shifted to the second brand. The second supplier couldn’t cope with the flood of orders, so they also ran out.
When something like that happens, we have to inform the outpatient pharmacists that once they run out of stock on their side, that’s it. The best we can do is tell them roughly when stock will resume, but that’s also out of our control, because it depends entirely on the manufacturer. It’s a balance between trying to find alternative brands locally or sourcing from other hospitals—we can’t bring in stock from overseas without special approval—while also managing the outpatient pharmacists’ demands.
What did you enjoy about your work?
I felt that it was a very refreshing experience. When I was training, I didn’t get to do much of procurement in inventory management. Even throughout my studies, we didn’t know that this kind of thing was needed.
In training, everything is clinical, but in store and logistics your clinical training isn’t really used so much as your management skills. Also, because as pharmacists we were put in charge of specific stores and had support staff. We had to learn to manage people. It’s a very different experience.
What lessons did the job teach you?
Definitely multitasking. When you’re in the middle of a product recall and have to get everyone to send their stock back to you, another item may be in low supplies and you have to get more of it, and another batch has a problem you need to settle urgently. When you’re doing all these things, a client comes in the door saying: “Hey, I want to collect this item, can I do it now?” You have to juggle all these requests at the same time.
What advice would you give to others for this field?
I’d say the most important trait you need is the willingness to learn, as what you experience during your studies or training might not prepare you for what happens once you get into logistics. There’s also a lot of thinking on your feet involved. Whatever happens, you should treat it as a learning experience. I was quite lucky in that I had many senior pharmacists I could refer to, and they were also very friendly and willing to teach. So just keep an open mind and handle problems as they come.