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For year 2010, total value of drugs disposed was RM 8,575.50 due to expired or spoiled items returned from wards. The main reason was due to the failure of nurses to check the stock regularly. They only do the checking upon ordering of new stock from Pharmacy department. FMEA tool was selected by the Management to solve this problem. A special committee was set up to implement the FMEA in January 2011.The committee thru brainstorming session had developed seven steps in implementing the FMEA. At step three , Risk Priority Number (RPN) was determined. At step four with the highest RPN of 36, it was found that the failure mode of the system were due to failure of checking stock at ward level, not double checking of the drug received and wrong storage of drug at ward level. A new supply system was implemented at step five and monitoring of drug disposed started in July 2011. In this system ,pharmacy staff will go to the wards once a month to check stock of drugs kept at ward level. After the implementation of the new process, RPN was calculated again and it was found that the value was between 3 to 8 which was considered as low. Monitoring of compliance was done using ward check form based on storage condition, par level, labeling and packaging and non- conformances for spoilt and expired items. Compliance in term of drug storage was 100% and labeling compliance was 97.2% . However the compliance on par level was only 81.9% and in term of expiry date validity, the compliance was 96.5%. Based on FMEA , it was found that the main reason for expired/spoiled drugs is because of insufficient checking of ward stocks. Corrective actions are ongoing to improve further the process of supply by re-designing a new form of ward checking, re-modifying indenting process of ward stocks via the HITS system and conducting training and awareness. After implementing the new system, the value of drug disposed was RM 3,060.78 which was 94% lower. Therefore the study has shown remarkable results in reducing the amount of drug disposal which will help the organization to reduce the risk to patients and avoid wastage.

Reducing Drug Wastage at Ward Level: Using Failure Mode Effects Analysis (Fmea) Tool