MINISTRY OF EDUCATION AND TRAINING HANOI UNIVERSITY OF BUSINESS AND TECHNOLOGY NGHIEM THANH HUY IMPROVE MANAGEMENT CAPACITY SUPPLY CHAIN IN MEDICAL EXAMINATION AND TREATMENT AT MILITARY HOSPITAL ON HANOI - HOSPITAL 108, 103, 354 EXECUTIVE SUMMARY ECONOMIC THESIS Ha Noi - 2019 MINISTRY OF EDUCATION AND TRAINING HANOI UNIVERSITY OF BUSINESS AND TECHNOLOGY _ NGHIEM THANH HUY IMPROVE MANAGEMENT CAPACITY SUPPLY CHAIN IN MEDICAL EXAMINATION AND TREATMENT AT MILITARY HOSPITAL ON HANOI - HOSPITAL 108, 103, 354 Major : BUSINESS ADMINISTRATION Code number : 62.34.01.02 EXECUTIVE SUMMARY ECONOMIC THESIS Scientific instructor: Phd.MSc LE CONG HOA 2.MSc NGUYEN TU Ha Noi - 2019 ACKNOWLEDGMENTS I have read and understand the violations of academic honesty I commit by personal honor that this study is conducted by me and does not violate the academic honesty requirement Hanoi, … 2019 Church members user guide Dissertation Author LIST OF ABBREVIATIONS From writing of Forum award f button BQP Employees CP HEA Ministry of Defense Personnel of the staff member key government Social Scientific Study of International Health International Vietnam Na m ISC Integrated Supply Chain - Chain supply to an area where JIT Just in time - yes the point ND Decree No TCVN Objective benchmark Vietnam Nam TQM Total Quality Management - Management of substance amount of the entire area TAT ToTAT Turn - around - time: time to time turned round Total turn-around-time: Total time to time turned round HEADING The urgency of the topic For healthcare organizations, improving supply chain management plays a very important role in controlling costs in the health supply chain Military hospitals, in addition to medical examination and treatment, are also the defense facilities of the army, the management of the supply chain becomes even more special: both aims to improve the quality of medical services, ensuring national defense and security, well implementing the work of people mobilization As a result, military logistics in military hospitals became increasingly important Therefore, the dissertation's research focuses on supply chain management capacity in Military Hospital in Hanoi including 108,103,354 Hospitals with the hope that there will be some research and contributions toward the logistics and the coordination between the closely linked functional departments, medical examination, and treatment and other activities at Hospitals with greater effectiveness Based on the above arguments and practices, the author chooses the topic "Solutions to improve the capacity of supply chain management in medical examination and treatment at Military Hospital in Hanoi (108, 105, 354) ” research thesis Overview of research works related to the topic and research orientation of the thesis The research works abroad 1.1 Studies on supply chain and supply chain management 1.2 World studies on supply chains and supply chain management capabilities in hospitals 2 The research works in Vietnam 2.1 Studies on supply chain and supply chain management capacity in businesses and industries 2.2 Studies on supply chain and supply chain management capacity in hospitals Research orientation of the topic From the research review, almost no research has built a complete model of the factors affecting supply chain management capacity It is all just about reasoning or surveying to find out the factors that influence the ability of chain management The theory of these factors has not been verified yet, nor has the level of influence of the identified factors affected the different supply chain management capabilities However, through the analysis and summation of the mentioned studies, the results individually, suggest that there are many criteria for measuring supply chain management capacity and the factors that influence capacity of supply chain management In addition, when studying the theoretical basis of supply chain and its management capacity, although not forming a complete research project, some experts in the supply chain management industry also mentioned There are a number of different factors that affect supply chain management capabilities Research on supply chain management capacity in hospitals is an unprecedented new field and moreover it is also considered in health activities at Military Hospital - a specific type of unit Hopefully the researcher will make new contributions from this research Research objectives and missions The research objective of the thesis is to focus on proposing solutions to improve the capacity of supply chain management in medical examination and treatment at Military Medical Hospitals in Hanoi, the case study of Hospital 108 , 103 and 354 With that meaning, the task of the thesis focuses on: - Systematize the theoretical basis of the capacity of supply chain management in enterprises and organizations , taking into account the specific characteristics in hospitals in general and military medical hospitals in particular - Analyzing the current situation of supply chain management capacity in medical examination and treatment at Military Medical Hospitals in Hanoi (108, 103 and 354 Hospitals) - Argument solutions and offer solutions to improve supply chain management in the examination and treatment at the Military Hospital in Hanoi phase 20 19 - 2025 Object and scope of the thesis Research subjects Research theories, current situation and solutions to improve the capacity of supply chain management in medical examination and treatment at military hospitals in Hanoi (Hospitals 108, 103 and 354), through doing clearly the nature, evaluation criteria, influencing factors and lessons learned to improve the capacity of supply chain management in medical examination and treatment in hospitals Research scope - Research approach: The thesis studies supply chains in organizations, businesses in general and in hospitals in particular From there, we will study the current situation of management and supply chain management capacity at Military Hospital in Hanoi (Hospitals 108, 103 and 354), in order to propose solutions to improve the capacity of chain management supply in medical examination and treatment at these hospitals - Research space: Researching the current situation of supply chain management in medical examination and treatment at 03 Military Hospital in Hanoi, including 108 Hospital, 103 Hospital and 354 Hospital under the Ministry of National defense - Research time: Secondary data used to implement the thesis was collected in the period from 2012 - 2018 Scientific and practical significance of the thesis Academically - Systematize basic issues such as: (i) general theory of supply chains, supply chain management and its capacity in enterprises and organizations; (ii) developing criteria to assess supply chain management capacity in medical examination and treatment at hospitals; (iii) identify factors affecting supply chain management capacity in medical examination and treatment at hospitals; and (iv) point out lessons learned from supply chain management in enterprises and organizations around the world and in Vietnam - Research is a pilot work, combining academic research with applied research From a practical perspective - The results of the study give researchers and hospital managers a fuller and more comprehensive view of an approach and assessment of supply chain management capacity - Research results help researchers, hospital managers identify criteria for evaluating the capacity of supply chain management at Military Hospital in Hanoi - This research can be a reference for those who are interested in supply chains, supply chain management capacity in terms of methodology, scales and research models in the fields of commercial business , and services and production administration Research method Based on the above general methodology, the thesis uses some specific research methods as follows: - Collecting secondary data: The study used statistics through collecting available data, conducted tables and charts to easily analyze, compare and evaluate the content needed research focus - Primary data collection: Research using expert interviews and sociological surveys - Methods of aggregating, analyzing and processing data: The author uses SPSS 20 software to synthesize, analyze and process data - Test method: After in-depth interviews with experts, the author initially built criteria for evaluating supply chain management capacity, factors affecting supply chain management capacity in diseases hospitals in general and Military Medical hospitals in Hanoi in particular, the author put into experimental research at Hospital 108 The structure of the thesis In addition to the introduction, conclusion, table of contents, list of abbreviations, tables, figures, references, the thesis is organized according to the following chapters: Chapter 1: Rationale for supply chain management capacity in businesses and organizations Chapter 2: Current situation of supply chain management capabilities in medical examination and treatment at Military Hospital in Hanoi Chapter 3: Solutions to improve the capacity of supply chain management in medical examination and treatment at Military Hospital in Hanoi CHAPTER RATIONALE FOR THE CAPACITY OF SUPPLY CHAIN MANAGEMENT CHAINS IN ENTERPRISES AND ORGANIZATIONS 1.1 Supply chain and supply chain management in businesses and organizations 1.1.1 Overview of the supply chain 1.1.1.1 Some concepts of supply chain - The concept of supply and management : Supplying is a dynamic professional profession, which is the process of ensuring that raw materials, machinery, services and services for the operation of an organization or business are conducted continuously, smoothly and effectively Supply management: Is the development at a higher step of purchasing - Supply chain concept : The supply chain covers the activities of all stakeholders from purchasing raw materials, manufacturing products to supplying to end customers and being distributed to consumers to achieve two goals The key is to create a link between suppliers and customers because they have an impact on the results and efficiency of the supply chain, efficiency throughout the system - Differences between supply chains and value chains: Value Chain (Value Chain) is a series of activities to increase the value at each step in the process, including: adequate design, manufacturing & delivery of quality products to the users hand At that time, the supply chain is the connection of all activities, starting from the production of raw materials to finished products & ending when the products reach the final consumers 1.1.1.2 Components of supply chain structure First, Base production Second, Distributor City Third, Retailers Fourth , Customers Fifth, Service Provider Figure 1 Simple supply chain Company and organization Suppliers Customers , (Source: [9; p.46] Figure Wide open chain Final Suppliers ( Primary) Supplier Company , Customers Final Customers ) Final Suppliers (Source: [9; p.46] In which service providers in areas such as: Logistics; Finance; Market research; Product design; Information Technology… Figure Example of extended hardware chain Marketing Research Product designer Raw material manufacturer producer Logistics provider Supplier Retailers Retail customers Finance service supplier Company customers customer Source: [9; p.46] 1.1.1.3 Supply chain classification First: According to the criteria of connectivity between components in the supply chain - Cooperative supply chain - Interactive supply chain is divided into levels of system, including: Second: According to the performance and complexity of the chains - Production support chain - Balance chain of purchasing, managing materials and distributing - Chain of coordination - Chain according to customer requirements - Chain has market advantage - Chain of improvement - 1.1.1.4 Cooperation in supply chain Many experts believe that in reality, there are three types of cooperation That is: - Vertical cooperation - Horizontal cooperation - Internal cooperation 1.1.2 Supply chain management in businesses and organizations 1.1.2.1 The essence of supply chain management The aggregation of supply chain management is centralized management of the relationship between the components in the supply chain 1.1.2.2 Supply chain management approaches according to factors within enterprises and organizations - Production and production management - Inventory and reserve management - Location and location determination - Shipping and transport management - Information and logistics information management Figure Key elements of internal supply chains Product What, when and by what? Inventory How much is produced and how much is in stock Information The platform to make decisions Transport Place How and when to ship products Which is best place for each activity Source 10, p 21] 1.1.2.3 The role of supply chain management in businesses and organizations Supply is an important and indispensable activity in an organization by Supply Chain Management to solve the input and output of the business effectively In addition, supply chain management also provides effective support for marketing activities, especially mixed marketing (4P: Product, Price, Promotion, Place) Supply chain management will coordinate production capabilities Another effect of the application of Supply Chain Management solutions is data analysis and record keeping at a low cost 1.1.2.4 Supply chain management model in businesses and organizations Board of manager Production and business department Supply room Marketing room Organization room Prevention plan Financial Accounting Facilities in clinics and disease rooms The level of meeting At the stage of examination the performance requirements of each At the stage of storing medicines and medical examination and treatment equipment stage At the stage of patient transport From the perspective of patients and hospital staff Arranging sick rooms and clinics, administrative rooms Information system provided to patients The coordination of Activities of coordination between logistics implementation of the and medical examination and treatment stages in the hospital Only from the perspective of hospital staff Coordinated activities between research and medical examination and treatment Activities of supply, Quality of transportation for patients shipping, warehouse Convenience of the signage system logistics Quality of equipment transportation vehicles and From the perspective of patients and hospital staff The level of medicine supply (Source: Authors compiled by themselves) 1.4 Factors affecting supply chain management capacity in enterprises and organizations 1.4.1 Factors affecting supply chain management capacity 1.4.1.1 Organizational structure 1.4.1.2 Human factor 1.4.1.3 Technology factor 1.4.1.4 Effective measurement and evaluation system 1.4.1.5 Customer satisfaction 1.4.2 Factors affecting supply chain management capacity in hospitals 1.4.2.1 Organizational and operational management structure of the hospital 2 Hospital facilities 1.4.2.3 Staff working in the field of supply 1.4.2.4 Credibility of beneficiaries from the hospital's supply chain 1.4.2.5 Modern level of information systems and technology in hospitals Organizational structure Infrastructure Logistics staff Patient's credibility Supply chain management capabilities Technology Figure 1.9: Factors affecting supply chain management capacity in hospitals (Source: Authors compiled by themselves) 1.5 Experience of supply chain management in a number of domestic and foreign enterprises and organizations and lessons learned for military hospitals in Hanoi 1.5.1 Experience of supply chain management in a number of domestic and foreign enterprises and organizations [18] 1.5.1.1 Experience in supply chain management at IBM ( International Business Machines) - A multinational computer technology corporation 1.5.1.2 Experience in supply chain management in a number of businesses, organizations in the field of medicine, medical equipment in the US - Pfizer uses RFID (Radio Frequency Identification) technology: ensuring safe and efficient supply chain - McKenson works closely with suppliers: ensuring a safe and efficient supply chain - Roche Diagnostics: Product life cycle Management (PLM) product management 1.5.1.3 Experience from supply chain management at hospitals in Singapore 1.5.1.4 Experience from supply chain management in Vietnamese hospitals - Supply chain at Bach Mai hospital - Supply chain at K hospital - Supply chain at Le Loi Hospital - Vung Tau City 1.5.2 Lessons learned for military hospitals in Hanoi One is; General lessons for businesses and organizations - Application of information technology is a key factor - Strategic planning in supply chain management - Ensuring a safe and efficient supply chain The two are; Lessons for military hospitals in Hanoi - Improve the quality of medical services at hospitals - Consider choosing more than supplier - Logistics activities can be outsourced - Human element always needs to be improved CONCLUSION OF CHAPTER In Chapter of the thesis, the author has systematized the theoretical basis of supply chain management capacity in businesses and organizations, including: Firstly, an overview of supply chains and supply chain management in enterprises and organizations Secondly, analysis of supply chain management capacity in enterprises, organizations in general and supply chain management capacity in hospitals in particular Thirdly, stating the criteria for measuring the capacity of supply chain management in enterprises and organizations Fourth, analyze the factors affecting supply chain management capacity in organizational enterprises Fifthly, stating experience in supply chain management in a number of domestic and foreign enterprises and organizations from which to draw lessons for military medical hospitals in Hanoi The theoretical foundations in chapter will be a solid foundation for the study of the current situation of supply chain management capacity in medical examination and treatment at military hospitals in Hanoi in chapter CHAPTER CURRENT SITUATION OF SUPPLY CHAIN MANAGEMENT CAPACITY IN MEDICAL EXAMINATION AND TREATMENT AT MILITARY HOSPITALS IN HANOI 2.1 An overview of Military Hospital in Hanoi and supply chain management in Hospitals 2.1.1 An overview of Military Hospital in Hanoi 2.1.1.1 Functions and duties of the Military Medical branch Along with well implementing the work of military medicine, health care for soldiers, the Military Medical branch continues to make great contributions to the cause of care, protection and improvement of the people's health 2.1.1.2 History of establishment and development of Military Hospital in Hanoi Central Military Hospital 108 Yen Trach Central Hospital - 108 Military Central Hospital was born on April 1, 1951 in Nong Village, Yen Trach Commune, Phu Luong District Thai Nguyen province Hospital 103 Treatment team (precursor of Hospital 103) was established on December 20, 1950 in Trung Giap village, Anh Dung commune (now Trung Giap commune), Phu Ninh district, Phu Tho province On May 21, 1989, the General Staff Department issued Decision No 183 / QD-TM recognizing Military Hospital 103 as the first-class hospital of the Army In 1995, Military Hospital 103 was renamed Hospital 103 Hospital 354 Hospital 354, formerly known as Tran Quoc Toan Medical Clinic (also known as Central Military Hospital), was established under Decree 82 / ND, dated 27/5/1949 of the Ministry of Defense General Commander On November 30, 1974, the Ministry of Defense decided that 354 Military Hospital belonged to the Military Medical Department - the General Department of Logistics 1 Major characteristics of Military Hospital in Hanoi - Hospitals were established very early, starting in the early years of the war against the French - Carry out the contents of special political duties: serving the object of senior officials in the army, military personnel and relatives in the army - Serving special political missions; - Specific management mechanism: Under the management of the Ministry of Defense in terms of personnel as well as the executive mechanism under orders, subject to the strict control and management of the General Department of Logistics - Expanding service subjects to be servicemen and people 2.1.1.4 Organizational model of Military Hospital BOARD OF MANAGER Administrative units General Planning Division Department of ScienceMilitary Nursing room The Military Department The department directing the line Institute, Center The Orthopedic Hospital 2.Vascular card Clinical Institute of infectious diseases Blocks Internal block Foreign sector Subclinical block Other faculties Radiation surgery center Stroke center Office of General Staf Center accelerator Technical logistics department Endoscopic surgery center Postgraduate Department Finance Department 10 Political Division Figure General organizational model at three Hospitals (Source: Author synthesis) 2.1.1.5 Organizational model of the Logistics - Technical Department at Military Medical Hospitals in Hanoi Logistics - Technical Department Advisory Committee Military supplies Military paramedic Department of Nutrition Housing Management Board (Barracks Board) Boards of motor vehicles and petrol (including car fleets) 2.1.2 Supply chain management at Military Hospital in Hanoi 2.1.2.1 Supply chain management in Hospitals Supply of pharmaceutical products for medical examination and treatment: The hospital is a distributor and supplier of pharmaceutical products and medical equipment to end customers who are different patients, so the hospital plays an extremely important role in this assurance Supplier: For medical examination and treatment, the main source of pharmaceuticals and medical equipment of the hospitals is through domestic and foreign pharmaceutical companies Producer: Although the Hospital has a medicine production department and only produces simple drugs, mainly infusion and basic medicines only meet 10% of the patients' needs in the Hospital Therefore, the hospital must import drugs from domestic and foreign pharmaceutical manufacturing companies 2.1.2.2 Management of operations and coordination of supply chain elements in Hospitals Agency channel Foreign Live channel Supplier Producer Domestic Figure Relationship between supplier and manufacturer Transport Place Logistics information Examination and treatment Storage and treasure Figure Supply chain management within the Hospital Firstly, generalizing medical examination and treatment activities at hospitals At Military Hospital , object examination and treatment of mainly military and insurance of active military troops occupy about 14% The next subjects are Military Insurance and Personal Insurance accounting for 22% , Health Insurance reaches about 24% Object services contributed to almost % , the object of social policies, you and the children only about less than % Thus, it can be seen that the main medical examination subjects are soldiers The hospital still focuses on the service patients segment to diversify the objects of medical examination and treatment to supplement non-state budget revenues and constantly innovate to improve the quality of the hospital's health service 14% Military service insurance and military insuarance 40% Pension insurance and relative insurance 22% Health Insurance Service object 24% Figure Percentage of patients with hospital patients on the island of Hanoi in 2012-2017 (Source: [7]) Secondly, storage and storage activities at Hospitals This content analyzes the storage and storage of medical equipment, supplies and medicines at hospitals Thirdly, patient transportation and medicine supply activities in hospitals At Hospital 103, the fleet annually receives nearly 70,000 liters of petrol and oil; vehicles are regularly stored and maintained at regular intervals, exploited and used with proper features, efficiency, kept well and used sustainably; meeting requirements of transporting war invalids, officials on business trips and supplies and equipment to ensure prompt and absolute safety Fourthly, the situation of location, departments, departments in the hospitals For the smooth running of the supply chain, the most important thing is to arrange space for the departments of Technical Logistics, Department of Equipment, Department of Pharmacy and Department of Examination Fifth, about supply chain information At Central Military Hospital 108, the management of the supply chain is decentralized, from the General Planning Department, the Financial Department, the Logistics - Technical Department, the Equipment Department, the Pharmacy Department without being concentrated in one room which boards are specific 2.2 Analysis of the current situation of supply chain management capacity in medical examination and treatment at Military Hospital in Hanoi 2.2.1 Actual situation of supply chain management in medical examination and treatment at Military Hospital in Hanoi area according to the evaluation criteria 2.2.1.1 Actual situation of logistics supply decision in hospitals From May 30, 2016, when the Quality Management Board - Central Military Hospital 108 was officially established, a specialized agency was set up to consult and advise the hospital's Board of Directors For Hospital 354 Military Hospital, according to Central Resolution (Session XI), the Party Committee of the hospital has issued a specialized resolution on medical ethics Recently, Hospital 354 has effectively implemented the consultation of people and patients through the suggestion box system, conducted irregular medical surveys to each patient The fact that management capacity is weak or weak leads to a complicated and unscientific organization This will make administrative procedures cumbersome The majority of workers surveyed chose the level of dissatisfaction or anxiety about the effectiveness of decisions (mean = 2.6667) 2.2.1.2 Actual situation of meeting the main professional requirements of Hospitals Through the statistical report of the Ministry of Health, the average cure time was shortened compared to the plan: 108 Central Military Hospital was shortened by days, Military Hospital 103 shortened 2, In days, 354 Military Hospital has shortened 2.6 days The percentage of patients cured at Military Hospital are high from 80% - 91% However, regarding the ability to meet medical examination and treatment needs, the staff still think that they are not satisfied (mean = 2.6078) The number of patients seeking medical services every year is increasing (Military Central Hospital 108 in 2017 increased by 133% compared to 2016; Military Hospital 103 in 2017 increased the number of patients 120% compared to 2016; Military Hospital 354 in 2017 increased the number of patients by nearly 130% compared to 2016) 2.2.1.3 Situation of satisfying patients' need for medical examination and treatment The rate of regular bed use is over 100% and ranges from 120% to 150%, even 200% at times of high epidemic disease from February to July Overactive patients appear in the area examination area and inpatient treatment area: 2-3 inpatients / bed, clinic doctor must examine 60-100 patients / day is common The statistical results of the author's survey show that both employees and patients are quite satisfied but the level of satisfaction is not high (mean in the range of 3.0 - 4.0) 2.2.1.4 Situation meets the requirements of each hospital (medical examination and treatment) in the supply chain of hospitals Survey results of staff of CNV staff said that they were not satisfied with the level of meeting the requirements of implementing tasks of each stage in the supply chain of hospitals, especially at the stage of patient transport (mean = 2,9608) and Sewing arrangement of rooms and clinics, administrative offices (mean = 2.9098) For information storage systems, and information provided to patients has not been applied information technology, so CNV staff also only gave a level of satisfaction at 3,0275 (still confused) For patients, the survey results also show that patients are only temporarily satisfied with the medical examination and treatment, however, patients also think that the arrangement of rooms and clinics have not met the needs of the medical examinations and treatments, so the statistical result of the patient satisfaction level is 2.6667 2.2.1.5 Actual situation of supply and transportation of logistics warehouse in medical examination and treatment at hospitals Survey results show that employees are also quite satisfied with the convenience and quality of the vehicles to transport patients as well as the means to transport drugs and medical equipment (mean in approx 4) However, the survey results for patients assessing the level of satisfaction with the quality and transportation of patients, medicines and medical equipment shows that the transportation and supply of drugs has not been timely (mean = 2.7412 to 3.2627) 2.2.1.6 Actual situation of coordinating the implementation of supply chain stages in hospitals Military Medical Hospital is not only responsible for providing medical examination and treatment for patients who need medical examination and treatment at the hospital, but the Military Medical Hospital has an important task of taking care of the health of the army According to the report of the Ministry of Defense, in 2017, the military medical sector has successfully completed the task of protecting and taking care of health for the army, the army's health force has always maintained firmly above 98% Through the results of the survey, the result is that the employees are quite satisfied about the coordination between medical examination and treatment and logistics with the percentage of satisfaction rating is mainly with mean = 3.9275 In this stage, the survey results show that employees are satisfied with the collaboration between research and medical examination (mean = 3.9124) 2.2.2 Analysis of factors affecting supply chain management capacity in medical examination and treatment at Military Hospital in Hanoi 2 Organizational and operational management structure of the hospital Through the survey results from subjects employees, percentage shares agreed with the influence of the factor "Structure management and operation at the hospital" to energy management supply chain in diseases The hospital is very high (with mean of 4.3529 - 4.8186) Especially in which the qualifications of managers have a great influence on the capacity of supply chain management in hospitals (mean = 4.8186) According to the survey results from patients in hospitals in Table 2.12 below, the factor "Structure of hospital operation management" also has a great influence on the capacity of supply chain management (votes ratio Survey results mean> 4.0) In particular, according to patients, the organization of the hospital management system has the greatest impact on the capacity of supply chain management (mean = 4.2902) 2 2 Facilities for medical examination and treatment of hospitals According to the results of the survey of hospital officials and employees shown in Table 2.13, most of the hospital staff said that "Facilities for medical examination and treatment of the hospital" have a great influence on supply chain management capabilities at hospitals (mean 4.2 to 4.5) According to the survey results from the patient subjects shown in Table 2.14, the same results were obtained Most patients also assessed “Hospital facilities for treatment: affecting the ability of the hospital's supply chain management (with a mean of 4.2 to 4.4) 2.2.2.3 Staff working at the hospital The factor "Staff working in hospitals" affects the ability of supply chain management in hospitals to be quite high to very high (mean range from 3.1 to 4.7) In particular, according to hospital officials and employees, the working attitude and qualification of administrative staff in the hospital affects supply chain management capacity (mean = 3.1 and 3.7) , but does not affect the high level as professional as well as professional ethics of the medical staff (mean = 4.6 and 4.7) Clearly, in the hospital, the professional and ethical element of the team of physicians directly treating people is extremely important N pleased elements of "The staff of the hospital" has the capacity to influence the supply chain management from a high to very high (mean of 3.8 to 4.6) The patient also said that the professional qualifications and ethics of physicians have a major influence on supply chain management capacity (mean 4.5 and 4.6) In addition, the organization of the medical staff and administrative staff has less impact on the supply chain management capacity in hospitals (mean = 3.8) 2.2.2.4 The level of trust of the audience benefit from the supply chain of Diseases Hospital At the end, the survey results from subjects workers and hospital officials, a majority of respondents said that the level of trust of audiences benefit from the supply chain have high impact to capacity management supply chain In which, the level of patient satisfaction with medical examination and treatment services at the hospital is the most influential with mean = 4.4235 and the satisfaction level of patients on administrative procedures is less influential but still quite good high with mean = 3.3765 The satisfaction of patients with hospital services was the most influential (mean = 4.1035), the patients' satisfaction with hospital fees was lower (mean = 3.4431) 2.2.2.5 Analysis of modern information systems and technologies in hospital In the case of hospital officials and employees, the modernity of the information system at the hospital and the modernity of the information transmission system among departments have a great influence on management capacity of supply chain management (mean = 3.6) The modernity of the device system that updates and stores patient information has less impact on supply chain management capacity but is still quite high (mean = 3.3882) In the surveyed patients, the factor "Modernity of information systems and technology in hospitals" also has a significant influence on supply chain management capacity In particular, the level of modernization of the hospital information system is the most influential with mean = 3.8, while the modernity of the information transmission system between departments has a lower influence on management capacity and supply chain with mean = 3.3 This assessment is a little different from that of hospital officials 2.3 General assessment of the current situation of supply chain management capacity in medical examination and treatment at Military Hospital in Hanoi 2.3.1 Main points - The logistics management of Hospitals has a clear division of work and close links between departments, from the General Planning Department to the Logistics - Technical Department - Supply chain management is also effective when Hospitals select reputable suppliers - Hospitals are interested in supporting all aspects and timely from the Ministry of Defense - According to the assessment of patients and staff of hospitals, the supply chain management capacity in hospitals is reflected through the evaluation criteria at a quite satisfied level 2.3.2 Limited and causes 2.3.2.1 Limitations - The supply chain management is still in its infancy and has not followed the standards of a modern supply chain - The management of the supply chain only follows the allocation mechanism, characteristics of the subsidy mechanism, and does not create autonomy for the unit - The management of the supply chain has not been highly effective, not saving costs and time due to many stages and overlapping - The relationship between the factors in the supply chain has not really played a leading role, has not been closely linked with each other and has not shown properly with the actual needs as well as the stature, worthy position and need There are of Military Hospital - Because the above-mentioned budgeting mechanism is still indicative, the service providers / products for Hospitals are limited to a number of units in the Army - The facilities and structure of the hospitals, despite being regularly upgraded, are not yet fully integrated for the operation and management of a modern supply chain - The management of reserves at the Hospitals still has many limitations 2.3.2.2 Causes of restriction First; objective reasons - The military hospital is a unit under the Ministry of Defense, so it is managed in all aspects and complies with the instructions of the Ministry of Defense - As the Central Military Hospital is a National Special Hospital, the Hospital has an important mission to carry out the nation's political duties Second; subjective reasons - Hospitals leaders have not realized the importance and not really paid attention to the supply chain management at the Hospital - Hospitals have not clearly separated between central political tasks and basic objectives in medical examination and treatment activities - Hospitals not yet have supply chain management software - a set of the most complex software applications on the software technology market - Organizational structure: Hospitals have not separated the roles, responsibilities and obligations of the logistics departments - The facilities and structure at the hospitals need to be modernized synchronously, but the funding for construction, upgrading and operation is huge - Logistics staff in Hospitals, some lack of professional skills and operational skills in the supply chain CONCLUSION OF CHAPTER Chapter of the author has clarified the following issues: Firstly, an overview of Military Hospital in Hanoi Secondly, analyzing the current situation of supply chain management capacity in medical examination and treatment Thirdly, assess the current situation of supply chain management capacity in medical examination and treatment at hospitals through the advantages, limitations and the causes of the limitations The results of the situation and data analysis are an important basis for the author to propose solutions to improve the supply chain management capacity in medical examination and treatment at the Military Hospital in the country Hanoi table in chapter CHAPTER SOLUTIONS TO IMPROVE THE SUPPLY CHAIN MANAGEMENT CAPACITY IN MEDICAL EXAMINATION AND TREATMENT AT MILITARY HOSPITALS IN HANOI 3.1 Objectives and directions for improving the supply chain management capacity in medical examination and treatment of military hospitals in Hanoi 3.1.1 Development objectives of the Military Medical Sector and Military Medical Hospitals in Hanoi The development objectives of the Military Medical Sector and Military Medical Hospitals in Hanoi are as follows: - General objective: Building a strong and strong military medical force is determined as a key content, of decisive significance, both urgent in the short run and fundamental in the long run - Detail goal: + The Military Medical Department continues to advise the Ministry of Defense and coordinate with agencies and units to step up the consolidation and consolidation of the military medical force throughout the army + The branch maintains the rotation of military officials and employees to work in difficult areas, borders and islands + Promote breakthroughs in training, training, building human resources of high quality, ensuring a balanced and synchronous medical, pharmaceutical and medical equipment; + Appropriate remuneration policies and policies for the contingent of military officials and physicians in accordance with the Party's policy, aimed at attracting, preserving and developing human resources, ensuring the industry's sustainable development, + Deploying to build and upgrade preventive medicine system in the whole army along the direction of ensuring regional, synchronous, unified, + The branch continues to build and consolidate the comprehensive system of traditional medicine at all levels (the key point is the Military Traditional Medicine Institute) according to the motto "Universal in the first and intensive areas at the back" + The branch continues to promote the development of military medical technology in the direction of "leapfrog " + Military Hospital in Hanoi is considered a strategic area that will focus on the development and application of high-tech, spearhead and intensive techniques to create a breakthrough in diagnosis treatment + To strive for military hospitals 103 and 354 to reach the national hospital standards; together with the 108 Central Central Hospital, to become a special-class hospital, reaching the level of technology equivalent to the end-line hospital of some developed countries in the region technically + Hospitals with the goal of building a contingent of staff, especially strategic-level officials with quality, competence, prestige and on par with the task; 3.1.2 Development directions of the Military Medical Sector and Military Medical Hospitals in Hanoi - Development directions of Military Army: + In the coming years, the Military Medical Sector shall strengthen its capacity building and further renovate scientific and technological research work , focusing on the field of military medicine + The industry attaches importance to integrating training establishments, hospitals, research centers and production units in the research and application of topics into practice; + On the other hand, the industry continues to study innovation and improve operating methods and financial management mechanisms in hospitals + Along with that, the sector promotes the implementation and improve the efficiency of emulation movements - For Hospitals: + Create a dramatic change in the quality of professional work, service quality, comprehensive care of patients, with high professional standards and national standards in hospital management and construction build a cultural environment + Promote scientific research and new technology applications + In the coming time, the hospital will continue to accelerate the implementation of three breakthroughs , creating a strong change + Improve the application of information technology in hospital management 3.1.3 Objectives and directions for improving the capacity of supply chain management in medical examination and treatment at military hospitals in Hanoi - Target: Hospitals have a common goal of improving the supply chain management capacity to achieve a safe and effective supply chain that creates the backbone in providing the best possible care for patients - Direction: Orientations for the development of hospitals in the strong development of the world health system: the role of military medicine is very important, it is necessary to expand cooperation and international integration Strengthening the leadership and direction of the party committees and commanders for military logistics To vigorously renovate the methods of ensuring physical logistics, improving the quality and efficiency of military logistics, attaching importance to ensuring the life and health of the army Transparent management of the staff's work throughout the hospital, thereby laying the foundations for a new hospital structure and new division of labor Hospital staff and physicians should raise their sense of responsibility, take initiative in overcoming difficulties, caring and attentive service attitude, and strictly observe the discipline of military-people relations 3.2 Solutions to improve supply chain management capacity in medical examination and treatment at military hospitals in Hanoi 3.2.1 Technology solutions in supply chain management Software application in management 3.2.2 Solutions to improve the supply chain management model First; Focus on supply chain management in medical examination and treatment Second; Organizing the establishment of a new Economic - Foreign Division under the Board of Directors of the Hospital to support and supplement the Hospital's limited aspects of supply chain management in medical examination and treatment 3.2.3 Solutions for strategic cooperation planning Planning an appropriate cooperation strategy to contribute to strengthening the cooperation in supply chain management in medical examination and treatment at military hospitals in Hanoi and in the Military Medical Sector 3.2.5 Solutions to improve the quality of professional work The main professional work at the hospitals is the medical examination and treatment, so hospitals need to have solutions to improve the quality of medical services With a team of nurses and hospitals, it is necessary to consolidate and perfect the organization of nursing payrolls according to regulations; Guaranteed enough in quantity, good in quality In order to improve the quality of medical examination and treatment, hospitals need to invest financially to improve the quality of medical equipment and patient transportation facilities to promptly respond to the time and create comfort for patients patient 3.2.6 Solution Logistics hospital The Military Hospital in Hanoi can enforce hospital logistics solutions to form a supply chain more closely meet the future challenges for the health care sector In particular, this solution is implemented in logistics 3.2.7 Solutions to improve logistics staff - Create conditions for logistics staff to study, improve their professional qualifications and skills, practice ethics and discipline - Promote scientific research activities of logistics staff - Regularly organize emulation programs, campaign movements for logistics staff - Assist logistics staff in harmonizing hospital and housework tasks - Regularly consolidate and further strengthen the great unity bloc among the hospital staff, close to the people - Leaders of Hospitals need to deeply manage the situation of the thought of logistics staff - Promote the roles and responsibilities of the Party committees and leaders in directing and managing the logistics staff - Enhancing education, training, overcoming the recession manifestations of political ideology, morality and lifestyle 3.3 Recommendations 3.3.1 Recommendations to the Government - Complete and stabilize socio-economic policies and the legal system - Strengthen the inspection and supervision of health activities, regularly analyze and assess the quality of operations of hospitals - To balance the State budget appropriately for the Ministry of Defense so that the Ministry can take initiative in spending in order to meet the tasks of the health sector in general and military medical hospitals in particular in medical examination and treatment and ensuring national security - The Government should research and implement a wide range of supply chain management models at all hospitals - The Government and the People's Committee of Hanoi need to have a transport infrastructure plan to facilitate the transportation of patients, pharmaceuticals and medical equipment - The insurance industry combines with the health sector to ensure compliance with the principle of state budget revenue and expenditure and patient support, improving the quality of the supply chain in hospitals - Step by step transforming health financing mechanism - Strengthening investment and creating mechanisms and policies to attract social investment - Continue to promote reforms in the field of health insurance in the direction of reducing administrative procedures on insurance , patient-centered 3.3.2 Recommendations to the Ministry of Defense - The Ministry of Defense should give more autonomy to hospitals - The Ministry of Defense and its agencies should have more effective solutions to ensure the facilities and technical equipment for hospitals - The Ministry of Defense needs to pay close attention and pay closer attention to Military Medical Hospitals in Hanoi in all aspects of its work - The Ministry of Defense should create an open mechanism for Hospitals so that Hospitals can develop local resources and maximize their strengths and strengths - The Ministry of Defense needs to plan, train, foster and use logistics staff - The Ministry of Defense has implemented policies and solutions to remove difficulties and accelerate the development of housing projects for officials and employees in the Military Medical Service, considering the personnel participating in the projects closely, correctly rule 3.3.3 Recommendations to the Ministry of Health - The Ministry of Health should have policies to support hospitals to adapt and master technology, improve the capacity of operating procedures, support technology transfer and spread - Paying attention to training human resources in hospitals in order to improve the professional qualifications and skills of the medical team and doctors - The Ministry of Health coordinates with Hospitals to organize periodic health examinations, manage the health situation of the medical staff and logistics staff in accordance with regulations - The Ministry of Health considers building a program in Hanoi in particular and the whole country in general, that is, patients can come to receive chronic medicines without going to higher levels - The Ministry of Health should offer a comprehensive renovation of attitudes and styles for health workers towards patient satisfaction 3.3.3.4 Recommendations to the Hospital - There should be a strong change in thinking and ways of doing each stage of medical examination and treatment in the direction of substance and effectiveness - Strengthen position, capacity and investment for hospital quality management - Application of mobile technology, cloud computing in patient data management - Continue to improve the morale, service attitude of nurses and other medical staff - Focusing on upgrading basic and essential facilities such as beds, blankets, sheets, pillows, cushions, toilets besides advanced medical examination and treatment equipment - Promote information on the rights of patients in medical examination and treatment, treatment costs and drug information, especially for those with health insurance CONCLUSION OF CHAPTER In chapter 3, the author has clarified the following contents: Firstly, presenting goals and directions to improve the supply chain management capacity in medical examination and treatment at Military Hospital in Hanoi Secondly, offering solutions to improve the supply chain management capacity in medical examination and treatment at Military Hospital in Hanoi: (1) Technology solutions in supply chain management (2) Solutions to improve the supply chain management model (3) Solutions for strategic cooperation planning (4) Reserve management solution (5) Solutions to improve the quality of professional work (6) Hospital logistics solutions (7) Solutions to improve logistics staff Thirdly, in order for the above solutions to be implemented quickly, the author proposes a number of recommendations to the Government, recommendations to the Ministry of Defense and the Ministry of Health as the conditions for implementing the solution CONCLUDE Improving the capacity of supply chain management in medical examination and treatment at hospitals in general and Military Medical Hospitals in Hanoi in particular is a task as well as a development objective of the health sector The study of solutions to improve the capacity of supply chain management in medical examination and treatment at Military Hospital in Hanoi helps to understand the situation, advantages and difficulties in supply chain management at the Military Hospital in Hanoi In the course of research, the thesis presented a number of contents on the current situation of supply chain management in the hospital's medical examination and treatment, thereby making comments, evaluations and recommendations for some solutions to improve the efficiency of supply chain management at Military Hospital in Hanoi Systematize theories about the supply chain, criteria to assess the supply chain management capacity of an enterprise or organization Analysis of the current situation of supply chain management capacity at Military Medical Hospitals in Hanoi with a focus on evaluation criteria and impact factor analysis Proposing a number of directions, solutions and conditions for implementation in order to improve the supply chain management capacity at Military Hospital in Hanoi LIST OF RELATED RESEARCH WORKS PUBLISHED BY AUTHOR MSc Nghiem Thanh Huy (2018), Completing the supply chain in medical examination and treatment at military hospitals in Hanoi , Journal of Industry and Trade, No 9, June 2018 MSc Nghiem Thanh Huy (2018), Completing the management of medicine supply for medical examination and treatment at military hospitals in Hanoi , Asia-Pacific Economic Review, No 531, December, 2018 MSc Nghiem Thanh Huy, Vietnam Logistics Development Solution in the context of Industrial Revolution 4.0, Science Magazine, Hanoi Open University, No 53, March 2019 ... the party committees and commanders for military logistics To vigorously renovate the methods of ensuring physical logistics, improving the quality and efficiency of military logistics, attaching... Ministry of Health, the average cure time was shortened compared to the plan: 108 Central Military Hospital was shortened by days, Military Hospital 103 shortened 2, In days, 354 Military Hospital... individually, suggest that there are many criteria for measuring supply chain management capacity and the factors that influence capacity of supply chain management In addition, when studying the