Hospital pharmacy departments

A STATE PRACTICE ACT/BOARD OF PHARMACY PROVISION Trudy Hamilton, Pharm.D., is a licensed pharmacist and is currently the manager of a hospital pharmacy department. In the state where Dr. Hamilton is licensed, nonpharmacist personnel are prohibited by both statute (the state pharmacy practice act) and state board of pharmacy regulation from engaging in activities defined as the practice of pharmacy. The specific activities that fall within the definition of the practice of pharmacy are limited to being personally performed by licensed pharmacists only. Such activities include counseling patients about their medications and responding to drug information requests from other health care professionals (e.g., physicians and nurses). 

Describe budgetary issues confronting a hospitals pharmacy department. Identify strategies undertaken by the departments director and staff pharmacists to reduce operating costs without compromising patient care. 

What sorts of skills, knowledge sets, and experiences are necessary to become the manager of a hospital pharmacy department Is this something you can see yourself doing, someday ... 

Institute of Hospital Pharmacy Department of Dermatology University of Basel Basel, Switzerland... 

Reykjavik Hospital, Pharmacy Department, Fossvogi, 108 Reykjavik, Iceland Ms. FI. Stenberg-Nilson... 

In hospital pharmacy departments with limited resources or incomplete antimicrobial management programs, phar-... 

The functions which comprise clinical services are difficult to identify, partly because there is no common agreement among practitioners as to the definition of a clinical service, partly because there are clinical components associated with most, if not all, of the service functions of the hospital pharmacy department, and partly because, in current practice, no clear distinction has been made between clinical teaching activities and clinical service activities. What are frequently purported to be service activities are, more often than not, teaching (or learning) activities. For this reason, in evaluating clinical service activities, only those services... which are continuously performed even in the absence of students and trainees, are considered. 

Mehmi M, Marschall LJ, Lambert PA, Smith JC (2009) Evaluation of disinfecting procedures for aseptic transfer in hospital pharmacy departments. J Pharm Sci Tech 63 123-138... 

Pharmacy Department University Hospital Centre CHUV-BH 04 46 Rue du Bugnon 1011 Lausanne Switzerland... 

In hospital settings, the pharmacy department generally implements a therapeutic interchange program as adopted by the Pharmacy and... 

The hospital is located in a town of approximately 100,000 people, and a large portion of the population is elderly. Partly because of both the favorable payer mix (mostly Medicare) and the fiscal savvy of the chief financial officer (CFO),1 the hospital has done very well from clinical and economic perspectives. The pharmacy department has a good drug distribution system and a director of pharmacy (DOP) who, while not trained clinically understands the value of these services. 

The hospital is growing rapidly and, as such, has become increasingly reliant of pharmacy services. Because of the many opportunities that confront the pharmacy department, the DOP has decided that the department should develop a plan to guide its priorities... 

The scenario begun in Chapter 3 continues here. In brief, Ted Thompson is a clinical pharmacist at a medium-sized community hospital. Ted has just finished participating in the process of developing astrate-gic plan for the pharmacy department. Included in the 5-year plan is a goal for the department to develop successful clinical pharmacy service programs and, where possible, to generate revenue from those programs. 

About the Author Dr. Mosavin is Chair of the Department of Pharmaceutical Sciences and Associate Professor in the Department of Pharmacotherapy and Outcomes Science at Loma Linda University s School of Pharmacy. Dr. Mosavin received a B.S. in Pharmacy from the University of Kansas, a Ph.D. in Pharmaceutical Sciences from the University of Wisconsin—Madison, and an MBA from the University of Chicago. Dr. Mosavin has experience in pharmaceutical industry, hospital pharmacy, and ambulatory care pharmacy settings. His research interests encompass economic evaluation of health care delivery systems and the role of pharmacists in these systems (especially as it relates to management of chronic diseases by pharmacists). Another key area of his research is analysis of economic gains achieved by health information technology implementation in ambulatory care pharmacy practice. 

The four management principles discussed in Chapter 2 (i.e., plan, organize, lead, and control) are relevant in the financial planning of a hospital s pharmacy department. The financial stability of the department will depend on planning and implementation of financial management programs that span these four principles. 

The director of pharmacy uses an expense report prepared on a monthly or weekly basis. In this report, all pharmacy department expenses are categorized into at least five major sections. Each expense is also given a unique code so that not only the pharmacy department but also the hospitals central accounting office can access and monitor expenses. The expense report indicates the amount budgeted for each expense, the actual expense incurred, the variance between budgeted and incurred expenses, and the variance percentage. Table 15-10 shows an abbreviated, simplified expense report for the pharmacy department of a large tertiary-care hospital. 

Table 15-11 depicts the hospital s total patient revenues for fiscal year 2007. It also indicates the total expenses for the pharmacy department and the percentage of revenues consumed by the department. Although not shown in this exhibit, a revenue/expense report is generated every month so that the cost center s expenses as a percentage of total revenue can be monitored closely. 

How can the pharmacy department of a large urban hospital help to reduce the problems caused by budgetary slack ... 

At a recent continuing-education seminar, Dr. Hamilton and her staff pharmacists learned of the potential for a significant interaction between the two medications in question. She was puzzled as to why one of the pharmacists would have told a physician that there are no drug interaction problems with the new drug. Dr. Hamilton and the staff pharmacists are aware that the hospital information technology department has not yet updated the pharmacy department computer system to include this interaction. As she concludes her conversation with Dr. Brown, she promises to find out what happened and take corrective action. 

Describe a typical organizational chart, management structure, and flow of information for a hospital and a hospital s pharmacy department. 

State boards of pharmacy and departments of public health also influence hospital pharmacy practice. The state boards serve as licensing bodies for both the location of pharmacies and those individuals able to practice. The primary duty of the department of public health (DPH) is to uphold the public interest in quality pharmacy service within the laws and regulations of the state. In fulfilling these obligations through an evaluation of the pharmacy, the board of pharmacy and the DPH assure the public that minimum standards... 

Mr AP, a 56-year-old former coal miner, presents to your hospital pharmacy from the oncology outpatients department with a prescription for the following medications ... 

Senior Oncology Pharmacist, Pharmacy Department, Mount Vernon Hospital, Middlesex... 

Caird and Woodward retired simultaneously from the company in the 1950s. Woodward died on 5 September 1959. Caird then returned to her pharmacy roots, undertaking part-time work in a hospital pharmaceutical department, first at the North Middlesex Hospital and then at Highlands Hospital. Her longtime friend, Mrs. E. Bradford, commented on Caird s longevity in the hospital service When Ella Corfield finally... 

---