132 Chapter IV Research Results IV.1 Introduction The outcomes of this research are crucial to demonstrate the purpose of the investigation. The present study conceptualized maturity stages in Hospital Supply Chain Management (HSCM), validated the environment of conceptual model and to do a case study of the maturity model of Hospital Supply Chain Management, and had the model that show what needs to be improved and how to make improvements so that it can achieve the expected target. Despite the fact that all models are inherently inaccurate (Sterman, 2000), the results of this research are expected to contribute to maturity modelling and address the challenges in hospital supply chain management. The research results section will present the structured outcomes, starting from framework of maturity model, the case study of hospital supply chain management in Indonesia, the identification of variables related to people, process, technology, and partner of HSCM, and the simulation results, along with policy recommendations. IV.2 Framework of Maturity in Hospital Supply Chain Management This chapter aims to address research question 1, "How to model maturity for hospital supply chain management?". Based on the systematic literature review conducted in Chapter 2, and further validated through expert judgment with Albert Hendarta, a senior consultant in Healthcare Consultant Management (HCM) and former hospital director. Figure IV.1 shows the maturity model comprising four levels that has been developed. These levels range from Level 1, namely Foundational to Level 4, namely Optimized. Each level is assessed across four critical dimensions: People, Process, Technology, and Partner, which represent the key elements of hospital supply chain management at various stages of maturity. 133 Figure IV. 1 Maturity Stages of HSCM In this research, Hospital Supply Chain Management (HSCM) refers to the comprehensive management of the supply chain within a hospital environment, encompassing the procurement, storage, distribution, and control of both medical and non-medical supplies, including pharmaceuticals, medical devices, and hospital equipment. The primary objectives of HSCM are to ensure operational efficiency, reduce the risk of drug shortages, improve information transparency, and ensure item traceability to meet patient needs and enhance healthcare service quality. 134 Four major issues are identified within the context of HSCM, which can be progressively resolved through advancing supply chain maturity. The first issue is high logistic and inventory costs, as hospitals often face inefficiencies in logistics and inventory management, leading to high operational costs. The second issue is the need for improved information transparency and item traceability, which is critical to enhancing visibility and control throughout the supply chain. The third issue involves drug shortages, where the shortage of essential drugs, whether due to internal or external factors, disrupts hospital operations and impacts patient care. Finally, the challenge of technology adaptation hinders the potential for achieving a more efficient and optimized supply chain. The primary references used to establish the levels in the framework are the Capability Maturity Model Integration (CMMI) and the literature Table presented in section II.3, as well as Appendix E, which includes the maturity dimensions, Level 1, namely Foundational is characterized by minimal structure and resources. At this level, staff have minimal competencies, and training is very limited. Processes are ad-hoc and reactive, with no clear procedures in place.