The Gandhian model in SCM for healthcare sustainability

Healthcare administrators are under tremendous pressure to drive down costs because of the increase in the cost of providing care day by day due to many factors that includes increase in the materials costs and manpower costs. At the same time, revenues are declining due to digital business, shifting customer needs and new competition. Moreover, price fixing by NPPA on products such as drugs, stents, implants etc. has reduced our profit margins to a great extent. The management relies on supply chain professionals to provide healthcare at sustainable costs.

Mahatma Gandhi’s way of living is the best example of sustainable development for world. The adoption of Gandhian Model in supply chain will be a solution to make healthcare sustainable. The Gandhian Model of sustainable development comprising of following three pillars that are interpreted and conceptualized to an innovative novel concept, 4D MUSIC for enhanced sustainability to overcome the pressing challenges that the healthcare institutions encounter.

• Ahimsa(non-violence): This can be interpreted as environmental sustainability i.e. causing a minimal or no impact to the environment.
• Swaraj(self-control): This can be interpreted as economic sustainability i.e. price /process / consumption optimization
• Sarvodaya<(benefits to all): This can be interpreted as social sustainability i.e. patient-centric supply chain model to achieve triple aim goals (better health, better care, and lower costs).

The two major challenges faced in healthcare are the high cost of treatment/surgical procedures due to high expensive medical devices and the impact of huge medical waste generated daily. Most of medical devices are very expensive which in turn would make these complex procedures unaffordable for majority of the population particularly in developing countries like India.

An innovative, novel concept, 4D MUSIC (4 Dimensional Multi Unit Selective Inventory Control) Model has been conceptualized, developed, and introduced to achieve sustainable healthcare. This is the only approach that covers all the three elements of sustainability that constitutes the triple bottom line of any organization. (Social Sustainability (People), Economical Sustainability (Profit or Prosperity) and Environmental Sustainability (Planet)). Moreover, it is a 4-Dimensional approach that integrates the various functions of a hospital such as finance, operations, stores, purchasing and waste management.

As of today, only three dimensions are used as part of MUSIC 3D – namely, consumption volume (to account for cost of the item and the consumption of the item), criticality of the item and lead time for classifying the materials. The present methodology addresses only social and economic sustainability only to a certain extent and it doesn’t address environmental sustainability whereas the new concept, 4D MUSIC addresses all parameters of sustainability to a greater extent. In 4D MUSIC methodology, “reuse” is used as an additional dimension to achieve sustainability.

The application of the novel 4D MUSIC methodology results in huge cost savings and significant reduction in the generation of medical waste in healthcare facilities. Thus, the healthcare organization is made more affordable and sustainable – social, economic, and environmental.

The application of 4D MUSIC model results in reduced cost (economic) that leads to a significant reduction in material handling cost by 50%. The cost of procedures can be reduced by almost 60% if this method is followed by ensuring strict control on hygiene and safety. The benefits arrived out of economic, environmental, and clinical outcomes can be shared with the community to make the healthcare more affordable and accessible (Societal). The results indicate more than 50% savings in the cost of medical devices. Similarly, the amount of waste generated, and its disposal can be significantly reduced thereby contributing to the environmental friendliness. Lastly, sharing the cost savings with the patients would make the healthcare affordable and accessible for the society. Thus, a healthcare organization can be made “sustainable” by contributing to the triple bottom line.

This novel methodology, 4D MUSIC was presented in an international healthcare conference hosted by Indian Institute of Management (IIM), Kozhikode in 2019 and was much acknowledged and appreciated by the renowned academicians and healthcare leaders across the globe. This innovation was awarded the prestigious “Six Sigma Healthcare Excellence Award” by Central Minister in Six Sigma Leadership Summit conducted during March 2022 at New Delhi.

The author is Dr Vinoth Kumar C,
Head – Supply Chain Management,
Jehangir Hospital.