Clinical traceability in figures: what the evidence says

Most of the loss is expiry, not theft

A tertiary hospital in Riyadh measured its inventory waste over seven years, between 2015 and 2021, against cumulative spend of SAR 7,396 million. After applying a zero-waste strategy, cumulative waste came to 0.21% of the total, equivalent to SAR 15.5 million. Before those interventions it was 0.91% of expenditure.

The most useful figure is not the magnitude but the composition. Of the value lost, 79.8% was expired product, 14.3% non-moving inventory and only 5.9% obsolete stock.

In other words: four of every five units of currency a hospital loses in inventory are lost because something expired in the storeroom unnoticed. That is not a security problem or a purchasing problem, it is a problem of visibility over dates.

How stockouts and expiry happen

Surgical inventory concentrates the risk

A literature review published in Health Systems in 2018 compiles measurements from different hospitals. Three figures from that review frame the problem.

• More than half of a hospital's inventory assets are surgical supplies and instruments (Ryan et al., 2014)
• Supplies opened and left unused during a procedure average USD 653, ranging from USD 89 to USD 3,640, and account for 13.1% of total surgical supply cost (Zygourakis et al., 2016)
• In a single neurosurgery department, that waste amounted to roughly USD 2.9 million per year (Zygourakis et al., 2016)

The three measurements come from different studies cited in the same review; they are not figures from one hospital and are not comparable with each other.

What changed when an RFID cabinet was installed

The most direct study on this category of equipment was published in Journal of Medical Systems in 2019. It evaluated an RFID cabinet installed at University Hospital Cruces in Barakaldo, Spain, a 981-bed referral centre, over six months.

250 units were tagged: 72 surgical materials and 178 implantables, with stock value estimated at EUR 369,211. Across the six months there were no stockouts and no inventory mismatches, and no incorrect assignment of product to patient was detected.

The total reduction in supervisory staff time was 58%. Product requesting was fully automated.

How RFID works in a hospital

Getting the data off paper reduces stockouts

An evaluation of Tanzania's health logistics reform, published in 2016, measured what happened after an electronic logistics management information system was implemented in the medicines supply chain.

Stockouts fell from 32% to 23% across the average of all product groups, and stockouts lasting more than seven days fell from 24% to 15%.

The context differs from a Latin American hospital: these are medicines, at national system scale, in a low-income country. What does transfer is the mechanism measured, which is the same one: what happens to availability when the record stops depending on spreadsheets.

How to read these figures

None of the four studies is a randomised controlled trial. They are evaluations of real implementations, measured before and after, and that has consequences for what they allow you to conclude.

• An improvement measured before and after does not isolate the effect of the technology from the effect of having paid attention to the process
• The four studies were conducted in different countries, health systems and product categories, so their figures cannot be added or averaged
• None was carried out in Latin America, so the magnitudes should be taken as reference orders rather than projections

What is consistent across all four: losses concentrate in expired product and in product that was never recorded, and automatic recording reduces administrative time measurably.