DECISION-MAKING PROCESS

USE OF THE SAPEVO-M METHOD WITH

PARAMETERS OF THE SCOR 12.0 MODEL FOR
RANKING OF SUPPLIERS IN A SUPPLY CHAIN OF
HOSPITAL MATERIAL OF THE BRAZILIAN NAVY
Utilização do método SAPEVO-M com parâmetros do modelo
SCOR 12.0 para ranqueamento dos fornecedores em uma cadeia de
suprimentos de material hospitalar da Marinha do Brasil

Luiz Frederico Horácio de Souza de Barros Teixeira1,

Priscilla Cristina Cabral Ribeiro2, Carlos Francisco Simões Gomes3, Marcos dos Santos4

Abstract: The study of supply chain management (SCM) can Resumo: O estudo do gerenciamento da cadeia de suprimentos
yield benefits for all parties involved. A commonly used tool (GCS) pode resultar em benefícios para todas as partes envolvidas.
in supply chain (SC) analysis is the Supply Chain Operations Uma ferramenta comumente utilizada nas análises das cadeias de
Reference (SCOR), which is a reference diagnostic model for all suprimento (CS) é o Supply Chain Operations Reference (SCOR),
steps in a chain. A hospital SC, in turn, has particularities that set um modelo de diagnóstico de referência para todas as etapas de
it apart from other areas of industry and commerce. This paper uma cadeia. Uma CS de material hospitalar, por sua vez, pos-
proposes an evaluation of health material suppliers of a Brazilian sui particularidades que a diferenciam de outras áreas da indús-
Navy unit through ordinal multi-criteria decision aid method tria e do comércio. Este trabalho propõe uma avaliação de for-
SAPEVO-M. This method is quite recent and little explored necedores de material hospitalar de uma unidade da Marinha do
in the literature of this research line. A search in the SCOPUS Brasil por meio do método ordinal multicritério de apoio à deci-
database has shown relative novelty in the supply chain corre- são Simple Aggregation of Preferences Expressed by Ordinal Vectors —
lation with ordinal methods such as SAPEVO-M used in this Multi  Decision Makers (SAPEVO-M). O método é bastante
paper. Supplier evaluation was carried out by two experts through recente e pouco explorado na literatura desta linha de pesquisa.
the SAPEVO-M online application platform called SapevoWeb. Pesquisa na base Scopus demonstrou relativo ineditismo na cor-
The results achieved allow an analysis of the quality of service relação da cadeia de suprimento com métodos ordinais, como o
provided by these companies, as there are no major differences SAPEVO-M utilizado neste artigo. A avaliação de fornecedores

1. Master in Production Engineering by Universidade Federal Fluminense. Project Manager of the Naval Systems Analysis Center – Rio de Janeiro, RJ – Brazil.
E-mail: [email protected]
2. PhD in Production Engineering by Universidade Federal de São Carlos. Associate Professor in the Department of Production Engineering at Universidade
Federal Fluminense (UFF) and Professsor of the Graduate Program in Production Engineering at Universidade Federal Fluminense (TPP/UFF) – Niterói, RJ – Brazil.
E-mail: [email protected]
3. PhD in Production Engineering by Universidade Federal do Rio de Janeiro. Associate Professor in the Department of Production Engineering at Universidade
Federal Fluminense (UFF) and Professor of the Graduate Program in Production Engineering at Universidade Federal Fluminense (TPP/UFF) – Niterói, RJ – Brazil.
E-mail: [email protected]
4. PhD in Production Engineering by Universidade Federal Fluminense. Project Manager of the Naval System Analysis Center and Professor at the Military Engineering
Institute – Rio de Janeiro, RJ – Brazil. E-mail: [email protected]

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 Luiz Frederico Horácio de Souza de Barros Teixeira, Priscilla Cristina Cabral Ribeiro, Carlos Francisco Simões Gomes, Marcos dos Santos

between one alternative and the next. However, this difference is foi realizada por dois especialistas, por meio de plataforma
evident as they move apart in the ranking. on-line de aplicação do método SAPEVO-M, denominada de
Keywords: Supply chain. Supply Chain Operations Reference. SapevoWeb. Os resultados alcançados permitem análise da qua-
Multi-criteria decision analysis. Ordinal method SAPEVO-M. lidade do serviço prestado por aquelas empresas, na medida em
Brazilian navy. que não há grandes diferenças entre uma alternativa e a seguinte.
Contudo, tal diferença se evidencia à medida que as mesmas se
distanciam no ranking.
Palavras-chave: Cadeia de suprimento. Supply Chain Operations
Reference. Métodos multicritérios de apoio à decisão. Método
ordinal SAPEVO-M. Marinha do Brasil.

1. INTRODUCTION The Supply Chain Operations Reference (SCOR) is a

model widely used to evaluate the performance of supply
When patients are seen in a clinic or hospital, they are chains (SC), although it is generic in nature. For Sellitto et al.
unaware of the needs to perform that procedure, however (2015), when approached in the context of decision support,
simple it may be. Meanwhile, the process of patient care in the SCOR model is commonly associated with the multi-
the hospital is supported by a series of operational activ- criteria Analytic Hierarchy Process (AHP) method. AHP
ities, including management and distribution of hospital is used primarily to solve the problem of choosing between
supplies to the care sites (MOONS; WAEYENBERGH; alternatives based on a hierarchical structure.
PINTELON, 2019). In this article, an evaluation of hospital material sup-
Although there are problems faced by public health, the pliers of an MB unit is proposed, using the multi-criteria
Armed Forces manage to maintain a quality service to serve ordinal method of decision support Simple Aggregation of
their personnel. In the Brazilian Navy (Marinha do Brazil – Preferences Expressed by Ordinal Vectors – Multi Decision
MB), this effort occurs through the Navy Health System Makers (SAPEVO-M). It is intended to answer the follow-
(NHS). According to the Norms for Medical-Hospital ing research question: how can suppliers of hospital material
Assistance of the Navy (BRASIL, 2012), the NHS is the from an MB unit be evaluated? The focus company will be
organized set of human, material, financial, technologi- the Navy Procurement Center in Rio de Janeiro (Centro de
cal, and information resources destined to provide health Obtenção da Marinha no Rio de Janeiro – COMRJ), which is
activities in the MB. This system serves the Navy’s mili- the largest material procurement agency for MB, with nation-
tary active duty and reserve personnel and their respective wide distribution (BRASIL, 2019c).
dependents. Public data from the Statistical Yearbook of the In the present work, the performance metrics of the SCOR
Brazilian Navy (Anuário Estatístico da Marinha do Brasil – model are considered as evaluation criteria of the SC suppli-
ANEMAR) (BRAZIL, 2019b) point out that the MB in ers. The selection of these suppliers and their evaluation were
2018 had more than 210,000 servants, including active and carried out by two specialists, through the SapevoWeb online
inactive civilians and military personnel. Thus, an efficient platform (www.sapevoweb.com), specific to the application of
supply chain management is required in order to provide the SAPEVO-M method. The assessment consists of paired
hospital supplies to this audience. comparisons between the different criteria for the generation
Although there are several studies in the literature attest- of weights and between the alternatives in each criterion for
ing that supply chain management (SCM) practices can the ordering of suppliers. The work is divided into five sec-
result in cost reduction and competitive advantage, health tions. After the introduction, the literature on the SCM and
organizations have been too slow to adopt these procedures SCOR model is reviewed and the SAPEVO-M method is
(ARONSSON; ABRAHAMSSON; SPENS, 2011). briefly presented in section 2. Section 3 describes the research

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 Luiz Frederico Horácio de Souza de Barros Teixeira, Priscilla Cristina Cabral Ribeiro, Carlos Francisco Simões Gomes, Marcos dos Santos

method employed. Then, section 4 details the particular case SCC merged with the American Production and Inventory
studied to exemplify the authors’ proposal. The last section Control Society (APICS), creating APICS SCC, a non-prof-
presents the conclusions of this work. itable organization responsible for continuously updating the
SCOR model (ASCM, 2017).
SCOR combines concepts of process reengineering, bench-
2. LITERATURE REVIEW marking, and application of best practices and allows the
organization to detect opportunities to improve its compet-
2.1 SCOR MODEL itiveness. Such a model links business processes, performance
The concept of SC transcends the definition of logistics, metrics, practices, and personal skills to a unified structure
which, in turn, appears to be inserted in each component of (VELYCHKO, 2015; PEÑA-OROZCO; RIVERA, 2017).
the chain in question. According to the Council of Supply The purpose of adopting standards, such as those provided
Chain Management Professionals (CSCMP, 2018), “logis- by the model in question, is to enable companies to develop
tics would be the part of the supply chain that basically plans, and maintain processes in their SC that meet certain perfor-
implements, and controls the flow, storage, and information mance metrics, integrating quality assurance measures into
of goods in an efficient and effective manner”. If, previously, the process (LI; SU; CHEN, 2011). The diagnosis presented
logistics was seen as a support activity, often associated only by the model is not restricted only to the evaluation of the
with transport and storage, according to Gomes and Ribeiro financial performance of the SC, but it is also a support to
(2014), it adds value to the functions of customer service, the decision and other aspects of sustainability throughout
location, administration, transport, storage, and information the SC (NTABE et al., 2015). Like the other models, SCOR
to the productive chain. has metrics for both internal company operations (internal
SCM, in turn, would be an evolution of logistics manage- logistics, warehousing, process), and others that go beyond
ment, which includes strategic value for allowing companies company boundaries, encompassing from the source to the
to achieve better results than they would obtain if they acted delivery processes (MAESTRINI et al., 2017).
individually. Such coordination effort allows for co-adminis- According to ASCM (2017), the attributes of the SCOR
tration of resources, reduction of inventories, and waste and 12.0 model are:
maximization of profits (COOPER; LAMBERT; PAGH; • reliability: ability to perform tasks as expected, which
1997). At SCM, companies would seek to reduce operating includes predictability of the outcome of a process;
costs, outsourcing some activities and focusing on their core • responsiveness: speed at which tasks are performed and/
ones, which can be differential (GOMES; RIBEIRO, 2014). or products are offered to customers;
In the study of chains, there is concern related to Supply • agility: ability to react to external influences and respond
Chain Performance Measurement Systems (SCPMS), which to changes in the market to obtain or maintain compet-
allows the adoption of performance measurement metrics that itive advantage;
affect different companies and processes (MAESTRINI et al • costs: price of operating the SC processes, including
., 2017). According to Galo et al. (2018), due to limited com- labor, material, management, and transportation, among
munication between SC links, it is possible to think that the others; and
measurements are more internal, preventing the adoption of • efficient asset management: the ability to use assets effi-
clear and complete indicators for each criterion and limiting ciently, including inventory reduction, capacity optimi-
studies and applications. Thus, looking for a more integrated zation, and outsourcing
measurement, the SCOR model emerged.
It was created by a consulting firm in 1996 and was soon Research in the Scopus database, carried out on January
endorsed by the Supply Chain Council (SCC) as an SCM 24th, 2020 with the expressions Supply Chain and Supply
standard. This tool allows users to understand the processes Chain Operations Reference obtained, for 2009 to 2020,
involved in business organizations and to identify the vital a total of 635 documents, of which 329 articles. The annual
characteristics that lead to customer satisfaction. In 2014, distribution of these articles can be seen in Figure 1.

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 Luiz Frederico Horácio de Souza de Barros Teixeira, Priscilla Cristina Cabral Ribeiro, Carlos Francisco Simões Gomes, Marcos dos Santos

Figure 1 has the characteristic sawtooth design, with a The Chinese predominance can also be seen among the
seasonality whose explanation may be associated with the institutions that published the most, with four institutions
launch of new models. For example, there was a reduction in among the 13 best placed, as shown in Figure 3.
the number of publications in 2009 and an increase from the The authors who published the largest number of articles
end of 2010, which coincides with the launch of the SCOR in the research line are highlighted in Figure 4. It was found
10.0 model in December of that year. There is another sharp that there was only one author with prominence in the period:
drop in early 2012 and a significant increase in 2013, proba- the Brazilian Luiz Cesar Ribeiro Carpinetti, with six publi-
bly because version 11.0 was launched in late 2012. In 2016, cations, which represents twice the number of publications
there is a drop, with a further increase in the number of by the eight authors who tied for second place.
publications from 2017, the year of launch of SCOR ver- Figure 5 complements this analysis with the profile of the
sion 12.0. In 2020, there is another sharp drop in the num- journals that had the most articles published in the period.
ber of publications, but most likely associated with the fact There is also a homogeneous distribution among journals. It is
that the data are incomplete because they were compiled by worth mentioning that some of them presented a “sawtooth”
January this year. Table 1 illustrates the release dates of the behavior similar to the total annual distribution of articles on
most recent SCOR models. the topic, illustrated in Figure 1. Furthermore, there is a coin-
As shown in Figure 2, China leads the publications in cidence between the “peak” periods in both graphs. That is,
that period, with 75 articles, followed by the United States,
with 36. Brazil appears in the third position in number of
Table 1. Release date of the Supply Chain Operations
publications, accounting for 24 articles in the period.
Reference (SCOR) models.
The leadership among the institutions is divided between the
Version Release
Chinese Chiang Mai University and the Brazilian University
of São Paulo (Universidade de São Paulo – USP), which con- SCOR 8.0 June / 2006

centrated seven articles each. Another Brazilian institution SCOR 9.0 November / 2008
that stands out is the Federal Technological University of SCOR 10.0 December / 2010
Paraná (Universidade Tecnológica Federal do Paraná – UTFPR),
SCOR 11.0 December / 2012
which shares the second place with the National Kaoshiung
University of Science & Technology, in Taiwan, with six SCOR 12.0 October / 2017
publications each. Source: ASCM (2017).

50

40

30

20

10

0
2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Documents/Year

Figure 1. Publication of articles per year in the period 2009–2020.

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 Luiz Frederico Horácio de Souza de Barros Teixeira, Priscilla Cristina Cabral Ribeiro, Carlos Francisco Simões Gomes, Marcos dos Santos

China
United States
Brazil
United Kingdom
Taiwan
Germany
France
India
Malaysia
Italy
0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80
Countries/Documents

Figure 2. Distribution of articles by countries.

Chiang Mai University (China)

Universidade de São Paulo – USP (Brazil)
Universidade Tecnológica Federal do Paraná – UTFPR (Brazil)
National Kaoshiung University of Science % Technology (Taiwan)
Universiti Utara Malaysia (Malaysia)
Huazhong University of Science & Technology (China)
Hong Kong Polytechnic University (Hong Kong)
National Chiao Tung University (Taiwan)
National Yunlin University (Taiwan)
National University of Singapure (Singapore)
Tianjin University (China)
University of Tehran (Iran)
Xi’an University of Architecture and Technology (China)
0 1 2 3 4 5 6 7 8
Institution/Documents

Figure 3. Distribution of articles by institutions.

Carpinetti, L.C.R.
Chakpitak, N.
Huang, L.
Lima-Junior, F.R.
Panetto, H.
Persson, F.
Tippayawong, K.Y.
Wang, C.N.
Xiao, R.
0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5 5.5 6 6.5
Authors/Documents

Figure 4. Distribution of articles by authors.

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 Luiz Frederico Horácio de Souza de Barros Teixeira, Priscilla Cristina Cabral Ribeiro, Carlos Francisco Simões Gomes, Marcos dos Santos

after the launch of a new SCOR model, there is probably a method to multiple decision-makers, in addition to introduc-
boom in publications, so journals are more susceptible to that ing a process of normalizing the evaluation matrices, increas-
novelty and the total number of articles in the year grows. ing the consistency of the model (TEIXEIRA; SANTOS;
During the research on the Scopus database, the authors GOMES, 2019).
came across different themes related to the SCOR model. For the same authors, the SAPEVO-M method basically
Table 2 presents those most relevant to the survey, while Figure 6 consists of two processes. Firstly, in the ordinal transforma-
shows an overview of all subjects. tion of the criteria of preference, expressed by a vector that
The Decision Sciences theme is the fourth with the represents the weights of the criteria. The second process is
largest number of associated publications, with 101 articles, the ordinal transformation of preference between alterna-
which highlights the relevance between the association of tives in a given set of criteria. The preference information in
Multicriteria Decision Support (MDS) methods and SCM. SAPEVO-M is denoted by a series of paired comparisons
between the alternatives. The relationship between them is
2.2 SAPEVO-M ORDINAL METHOD AND expressed on a seven-point scale, in which the importance of
SAPEVOWEB PLATFORM each is relatively measured. Based on the evaluation between
In order to solve real problems, Operational Research alternatives, a matrix is ​​obtained with the corresponding
adopts logical-mathematical models, characterized by its
multidisciplinarity (SANTOS et al., 2015). The multicrite- Table 2. Themes related to the Supply Chain
ria approach to decision support can be characterized as a set Operations Reference (SCOR) model.
of methods that shows a problem more clearly, and in which Theme Quantity Percentage
the alternatives are evaluated by multiple criteria, which, in Business, Management &
166 21.6%
most cases, are conflicting. These are techniques for advising Accounting
the decision-making agent to make decisions about complex
Engineering 153 19.9%
problems, with evaluation, ordering or selection of alterna-
Computer Science 119 15.5%
tives through different points of view and predefined criteria
(GOMES; GOMES, 2019). Decision Sciences 101 13.2%
The SAPEVO-M method consists of a new version of Social Sciences 45 5.9%
the original SAPEVO ordinal method (GOMES; MURY;
Environmental Science 39 5.1%
GOMES, 1997), which allowed the evaluation of only one
Mathematics 28 3.7%
decision-making agent. Such an evolved version extends the

6
5
Documents

4
3
2
1
0
2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Year

International Journal of Supply Chain Management Production Planning and Control

International Journal of Production Economics International Journal of Logistics
International Journal of Production Research Research and Applications

Figure 5. Distribution of articles by journals.

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 Luiz Frederico Horácio de Souza de Barros Teixeira, Priscilla Cristina Cabral Ribeiro, Carlos Francisco Simões Gomes, Marcos dos Santos

numerical representation. The preference result is expressed and multi-decision ordinal method of decision support, the
by the vector resulting from the matrix multiplication between information transmitted to the decision-making agent is
the weight vector of criteria V and the evaluation matrix of not restricted to the provision of alternatives in an order.
the alternatives M. The alternatives are then organized in Additionally, the SapevoWeb software allows to know how
decreasing order of the numerical values ​​obtained, generat- much an alternative was better ordered in relation to another
ing the desired ranking. (TEIXEIRA; SANTOS; GOMES, 2019).
The computational platform for employing the SAPEVO-M
method is called SapevoWeb and can be accessed at: www.
sapevoweb.com. This platform is a program with a friendly 3. RESEARCH METHOD
graphic interface that presents results in reduced compu-
tational time (TEIXEIRA; SANTOS; GOMES, 2018). This research started by reviewing the literature on SC
The SapevoWeb system was developed by the Laboratory and the SCOR model, through reading and analyzing articles
of Governance, Management and Optimization Studies published in the area. The authors used the Scopus database,
(Laboratório de Estudos de Governança, Gestão e Otimização – accessed through the journals portal of the Coordination for
LEGGO), based on a partnership between the technical staff the Improvement of Higher Education Personnel (Coordenação
of the Naval Systems Analysis Center (Centro de Análises de de Aperfeiçoamento de Pessoal de Nível Superior – CAPES) on
Sistemas Navais – CASNAV), a research group of the Graduate the internet, to consult the most recent and most cited arti-
Program in Engineering of Production at the Fluminense cles to prepare the theoretical framework necessary for the
Federal University (Universidade Federal Fluminense – UFF) preparation of this article.
and a research group from the Graduate Program in Systems First, on January 24th, 2020, searches were carried out on
and Computer Engineering at the Military Institute of the Scopus website, with the keywords “Supply Chain” and
Engineering (Instituto Militar de Engenharia – IME). “Supply Chain Operations Reference”, selecting the option
This platform highlights a novelty introduced by the “All Fields” in the desired search engine field. In addition,
SAPEVO-M method when expressing numerical values the search was limited, using the database’s “Limit” tool, to arti-
associated with ordering when presenting the final result. cles published in the period between 2009 and 2020. In this
That is, although SAPEVO-M consists of a multi-criteria first stage, 329 articles were obtained, which were presented

Other (7.3%)
Agricultural an... (2.0%)
Business, Manag... (21.6%)
Economics, Econ... (2.6%)
Energy (3.3%)

Mathematics (3.7%)

Environmental S... (5.1%)

Social Sciences... (5.9%)

Engineering (19.9%)

Decision Scienc... (13.2%)

Source: adapted from Scopus (2020). Computer Scienc... (15.5%)

Figure 6. Distribution of articles by theme.

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 Luiz Frederico Horácio de Souza de Barros Teixeira, Priscilla Cristina Cabral Ribeiro, Carlos Francisco Simões Gomes, Marcos dos Santos

according to its number of citations by selecting the option In the same period, searches were made in the Scopus
“Sort on: Cited By (highest)”. In the later stage, the articles database with the keywords “SAPEVO” or “SAPEVO-M”,
were presented by release date, starting with the most recent, but no document was found related to such methods.
through the option “Sort on: Cited By (highest)”. The authors Therefore, the relative originality of the present work is proven
decided, in line with the objective of the work, to conduct a when evaluating suppliers in a SC using the SAPEVO-M
statistical survey of the 329 articles found. This survey is pre- ordinal method.
sented in section 2. The reading of the articles for the theo- In this work, the focus company is COMRJ. The authors
retical foundation was filtered through the previous reading used public data from the Transparency Portal (BRASIL, 2019)
of the titles and, in a second moment, of the abstracts. to select the eight companies with the greatest relevance in the
As explained in the previous section, the theme Decision supply of health material for that unit in 2018. To establish
Science stands out when associated with SCM, being the the importance of suppliers for this research, it was consid-
fourth with the largest number of publications related to SCM ered the total monetary value provided in that year. Figure 7
in the last 10 years. However, the authors decided to verify the represents a section of the SC of hospital material to facili-
correlation between the SCOR model and the multi-criteria tate the understanding of its operation and the scope of the
decision support methods for typically ordinal problems, whose study. On the left side of the figure are the main suppliers of
intended result is the establishment of a ranking. Research in COMRJ and, on the right side, its main customers.
the Scopus database, carried out on January 24th, 2020 with For a better understanding of the specificities of this par-
two-by-two combinations between the expressions “supply chain ticular SCM, a military doctor was interviewed (Interviewee
operations reference” and “multicriteria ranking”, or “ordinal 1 – I1) and a former businessman who has already worked as
multicriteria”, or “ordinal ranking”, obtained only two articles a supplier of hospital supplies for MB (Interviewee 2 – I2).
as a result. However, those articles did not apply any method I2 is a retired businessman with market experience in supply-
of support for multicriteria decision. Parente et al. (2008) pres- ing this type of material for 35 years, of which he worked for
ent an interdisciplinary model for research by SCM, focusing more than ten as a supplier to MB. I1 is an anesthesiologist,
on marketing in SC. Ang, Zhu and Yang (2019) integrate the post-graduated in Health Management from the Institute of
technique of Stochastic Multicriteria Acceptability Analysis Postgraduate Studies and Research in Administration of the
(SMAA) and the methodology of Data Envelopment Analysis Federal University of Rio de Janeiro (COPPEAD/UFRJ),
(DEA) to evaluate the efficiency and classification of SC in head of clinic at Hospital Naval de Brasília and medical offi-
two stages with values ​​of stochastic criteria. cer of MB for 20 years. The interviews were conducted by

• Baxter Hospitalar LTDA. Military Hospital

• Costa Camargo Com. de Organizations
Produtos Hospitalares LTDA. • Hospital Central da
• Cristalia Produtos Químicos Marinha (HCM)
Farmacêuticos LTDA. • Hospital Naval Marcílio
• Especifarma Com. de Dias (HNMD)
Medicamentos e Pro. Hospitalares LTDA.
Suppliers COMRJ Clients • Hospital Naval de
• Methabio Farmacêutica do Brasil LTDA. Brasília (HNB)
• Pró-Saúde Distribuidora • Policlínica Naval Nossa
de Medicamentos Eireli – ME Senhora da Glória (PNNSG)
• Provider Produtos Hospitalares e
• Policlínica Naval de São
Saneantes LTDA. – EPP
Pedro da Aldeia (PNSPA)
• Solumed Distribuidora de Medicamentos
• Naval outpatient clinics
e Produtos para Saúde Ltda. – EPP

ME: Individual Microenterprise; EPP: Small Business.

Figure 7. Supply chain (SC) of the Navy Procurement Center in Rio de Janeiro (COMRJ).

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telephone and in a free conversation format, in which the risk that institutions run when managing inventory in a SC
interviewees were asked about their perception in relation to is the imbalance between demand and supply. In a hospital’s
the academic view on SCM found in the literature. SC, in turn, such risk could be mitigated by affiliation with
The question script was made up of open and closed ques- “multi-hospital” system arrangements, mainly local. The poten-
tions. The open ones raised, as explained above, the under- tial for improvement with such integration can lead to savings
standing of the SCM. The closed ones focused on the criteria of up to 20% of the inventory cost of the integrated health
brought from the ASCM publication (2017), that is, on the system in question (ZEPEDA; NYAGA; YOUNG, 2016).
attributes of the SCOR 12.0 model: agility (Criterion 1 - C1), The management of inventory and distribution networks
responsiveness (C2), reliability (C3), efficient management for hospital supplies is among the biggest challenges in the
(C4), and cost (C5). These criteria were classified in degree of health sector. In fact, stockouts in this sector not only cause
importance by a seven-level scale used in the SAPEVO-M financial losses, but also put patients’ lives at risk. In addition,
method: absolutely worse, much worse, worse, equivalent, many hospitals transfer management practices developed in
better, much better, and absolutely better. The criteria were the industrial sector to the healthcare environment, which
evaluated in paired comparisons, as well as the suppliers is not appropriate because of the specificities of the sector
among themselves, in the light of each one, according to the (KHOUKHI; BOJJI; BENSOUDA, 2019). In this context,
scale mentioned above. The analysis of the data by the rank- MB strives to concentrate and integrate its logistical activities
ing was carried out and a reflection was made of this order for hospital supplies, serving different health units through
and how much it represents the assessment and positioning its own supply system, adapted to its context.
of suppliers. In addition, a comparison was made between According to the Norms for Supply Execution of the
the literature review and the open questions. Brazilian Navy (Brazil, 2009), COMRJ is one of the purchas-
In the present work, two military personnel (Decision ing bodies of the Navy Supply System and it is responsible
Maker 1 - D1; and Decision Maker 2 - D2) who work in for carrying out research and selection in the market, national
the administration of COMRJ were also consulted to carry or foreign, of Providers. In addition, it is also responsible for
out the assessment of the main suppliers of health material purchasing items to meet the needs of Military Hospital
for that military organization (MO) in 2018. This assessment Organizations (MHO), primarily those located in the area
does not represent the official opinion of MB, serving only for of jurisdiction of the Command of the 1st Naval District,
academic purposes, to exemplify the case study. As criteria, based in the city of Rio de Janeiro.
the attributes of the SCOR 12.0 model were used. Decision Hospital SC differ in several aspects from typical industrial
makers 1 and 2 were presented to the definitions of these SC, and management practices in sectors such as commerce
attributes present in the model. The evaluation was carried and manufacturing are likely to be a decade ahead of those
out directly on the SapevoWeb platform. D1 and D2 were in the healthcare field. With the improvement of healthcare
encouraged to answer how important they considered each organizations, the increase in operational efficiency, and the
criterion in relation to the others, through comparisons two reduction of costs, the hospital SC is more focused on per-
by two; then, similarly, they evaluated the quality of each formance attention (CHEN; PRESTON; XIA, 2013).
alternative in each criterion, in comparison to the others. In 2018, according to the Transparency Portal, the amount
of health material purchased by COMRJ to be transferred
to MHO or medical facilities it serves was more than R$ 10
4. CASE STUDY: HOSPITAL million (BRASIL, 2019a). In addition, hospitals manage large
MATERIAL SUPPLY TO THE quantities and varieties of items and the storage and distribu-
BRAZILIAN NAVY tion of all this material are essential for providing high qual-
ity services to the patient (MOONS; WAEYENBERGH;
In inventory management, it is relevant to observe actions PINTELON, 2019).
related to policies, administration, and inventory control Aronsson, Abrahamsson and Spens (2011) question why the
(GOLOBOVANTE; RIBEIRO; GOMES, 2018). The main delay in the managing practices of the SC of health material,

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 Luiz Frederico Horácio de Souza de Barros Teixeira, Priscilla Cristina Cabral Ribeiro, Carlos Francisco Simões Gomes, Marcos dos Santos

considering that 30 to 40% of hospital expenses are invested Figures 8 and 9 illustrate the use of the SapevoWeb online
in activities related to logistics. According to E2, an obstacle system for, respectively, the evaluation of criteria and alter-
for public hospitals in Brazil would be excessive bureaucracy. natives. The first step in using the SapevoWeb software is to
As in any other public administration body, all material must insert the problem data by the user. After inserting the criteria
be purchased through tenders, which are generally too slow. to be evaluated, the system generates a comparative evalua-
Volland et al. (2017) attest that hospital SC is often tion page between them, two by two, for each previously regis-
impaired, as health professionals are diverted from care tered decision-making agent. At the end of the evaluation, the
for logistical activities for which they were not prepared. SapevoWeb system generates a comparative evaluation page
I1 refutes this position, understanding that this would not between the alternatives in each criterion, similarly to the pre-
be a problem for the Navy, which is concerned with train- vious process. After comparing the alternatives, the evaluations
ing its doctors in business management, as they move up of each decision-making agent were inserted, and the system
to higher positions in their careers. The same interviewee instantly generated a new page with the results obtained from
emphasizes that excellence in service provision is sought the weight value of the criteria and the ordering of the alter-
with a focus on governance, increasingly aiming at effi- natives, based on the SAPEVO-M method.
ciency and effectiveness in processes. Therefore, for him, The SapevoWeb system itself calculates and presents the
it is important to have managers in the health field who results: weight of the criteria, which represents their relative
know the activity well, and it is increasingly common for importance to the evaluators; and the degree obtained by
medical assistants to also go to administrative functions. the alternatives, in decreasing order of score. Table 3 indi-
Thus, for I1, such professionals are able to have a global cates the value of the criteria weights calculated by the sys-
view of the subject and make better decisions for the insti- tem, while the final result of the ranking is shown in Table 4.
tution, professionals, and patients. Table 3 shows that the consulted COMRJ administrators
In the present case study, decision makers D1 and D2, favor, mainly, the reliability criterion of the SC of hospital
who work in the administration of COMRJ, were questioned material. Probably, as they are health materials, it is import-
about their perception of the relative importance of the cri- ant for those decision makers to be sure that the agreements
teria, taken from the attributes of the SCOR 12.0 model. are complied with so that care is not compromised.
Then, the same decision-makers were asked to evaluate the Table 4 shows that there were no major discrepancies
performance of the eight suppliers selected under each criterion. between the degrees obtained by a given company and that

Source: SapevoWeb (2020).

Figure 8. Extract from the criteria evaluation page.

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 Luiz Frederico Horácio de Souza de Barros Teixeira, Priscilla Cristina Cabral Ribeiro, Carlos Francisco Simões Gomes, Marcos dos Santos

subsequently ranked. In the case studied, the close notes may Table 3. Criteria weight.
mean that there are no significant differences between the Attribute Weight Criterion
service provided by a company and that which follows in
Agility 1.5000 C1
the 2018 supplier ranking. On the other hand, as the result is
presented on an absolute scale, one can observe that the first Responsiveness 0.7923 C2
place had a performance close to double that of the seventh Reliability 1.9231 C3
place, or that the eighth place had a performance equivalent Efficient Asset Management 0.0056 C4
to half of the second place that year. This means that, if there
Cost 0.8615 C5
are no major differences between one alternative and the
next, that difference becomes evident as they move away in
the ranking. This information can be essential for a decision
Table 4. Ranking of alternatives: suppliers.
maker, for example, to understand the gains and losses in the
Ranking Supplier Degree obtained
selection of a certain alternative over another. In a hypothet-
ical situation in which a supplier better placed in the ranking 1st CRISTALIA LTDA. 6.58253
cannot be selected for any reason outside the will of the deci- 2 nd
BAXTER LTDA. 5.46576
sion-making agent, he could have greater security to analyze
3rd COSTA LTDA. 5.36367
the selection of other alternatives in the ranking.
4th ESPECIFARMA 4.96107

5th SOLUMED 4.64744

5. CONCLUSION 6th PRO-SAUDE 3.91016

7th PROVIDER 3.38812

The SapevoWeb system emerges as an important tool
8th METHABIO 2.65502
for easily obtaining results from complex problems and for

Source: SapevoWeb (2020).

Figure 9. Extract from the alternative evaluation page for each criterion.

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 Luiz Frederico Horácio de Souza de Barros Teixeira, Priscilla Cristina Cabral Ribeiro, Carlos Francisco Simões Gomes, Marcos dos Santos

researchers to focus on other stages of the process. The free certain item, customers could accept the second place in the
online availability of this multicriteria decision aid platform ranking as a viable alternative, without significant damage
makes it possible to disseminate a new ordinal method to to the quality of service. On the other hand, if the option
the academic community. were placed at the bottom of the ranking, customers could
The present study proposed to use the MDS ordi- see a drop in the quality of the service presented, consid-
nal method from a different perspective in a SCM study, ering that this alternative scored 2.5 times lower than the
introducing a new possibility of approach to value SCM company that ranked first in the evaluation.
aspects through ordering. According to the experts con- To improve the management of hospital supplies at MB,
sulted, the company Cristalia LTDA. was the best placed it is suggested that this research be replicated with an even
in the ranking of eight hospital suppliers from COMRJ. greater number of suppliers, the employment of more spe-
However, when presenting a grade for each ordered alter- cialists from COMRJ as evaluators and extension to other
native, the SAPEVO-M method allows for subjective sectors of the NHS. Future research can carry out a literature
analysis of the difference in service quality of each com- review in other databases, use the metrics of the SCOR model
pany. Consequently, in a hypothetical situation in which as criteria to evaluate suppliers or extend the application of
that company could not compete to be selected to supply a the SAPEVO-M method to other levels of the supply chain.

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