An analytical framework for enhancing hospital pharmacy supply chain performance using fuzzy rough set theory

Abstract

The pharmaceutical supply chain is vital to hospital operations but faces persistent challenges, including drug shortages, regulatory constraints, and inventory inefficiencies. This study explores the application of the Triple-A Supply Chain (TASC) framework agility, adaptability, and alignment to enhance hospital pharmacy performance. A novel hybrid multi-criteria decision-making (MCDM) model is proposed, integrating the Ordinal Priority Approach (OPA) and Aczel–Alsina Weighted Assessment (ALWAS), supported by fuzzy rough set (FRS) theory. This approach improves the reliability of expert judgment under uncertainty, addressing limitations of traditional deterministic models. OPA results identify “data visibility” (agility), “policy and regulatory alignment” (alignment), and “contingency planning” (adaptability) as the most influential TASC criteria. ALWAS analysis highlights “patient-centric inventory coverage,” “stockout frequency of high-priority medications,” and the “critical drug stock availability index” as the most significantly impacted performance indicators. These findings underscore the importance of transparent information flows, regulatory coherence, and resilience planning in achieving responsive and reliable pharmacy operations. Theoretically, the study bridges the resource-based view (RBV) and dynamic capabilities (DC), positioning TASC dimensions as strategic intangible assets that foster adaptability and competitive advantage in uncertain environments. Managerially, the results offer actionable insights for hospital leaders to enhance agility, embed contingency protocols, and align operations with institutional and regulatory priorities. The integration of advanced decision-making tools with strategic supply chain principles provides a comprehensive framework for performance improvement. Beyond hospital pharmacies, the proposed framework offers conceptual and practical value, with potential applications in broader healthcare contexts such as vaccine logistics, emergency preparedness, and digital health systems.