Hospitals patient tracking

Hospital and commercial diagnostic testing laboratories rely on monoclonal antibody tests to measure the amounts of specific proteins, hormones, or drugs in blood. Monoclonal antibodies tagged to fluorescent dyes are also used with lasers to determine the kind of tumor a patient has, to track the number of tumor cells, and to monitor the level of immune system cells. The CD4 count test, important to patients with HIV infection, uses monoclonal antibodies and a laser-driven device that checks cell by cell for the CD4 protein, the marker for the critical immune system cell. The same technology and a set of antibodies to immune system cell proteins are used to diagnose children suspected of having inherited an immune system deficiency. 

Hospital-Based Outpatient Clinics The Outpatient Prospective Payment System (OPPS) is the method for compensation for hospital-based outpatient facilities (DHHS, 2000a). With this system, there is a professional component (e.g., for physician providers) and a technical component (e.g., for nonphysician health care professionals) to billing that describes the various contributions of the health care team during the specific patient encounter. Ambulatory Payment Classification (APC) codes are used within this system to describe the type and complexity of the patient visit to the insurance company. When pharmacists provide services within a hospital-based clinic, the compensation for the service goes to the hospital facility instead of directly to the provider. The revenue generated should be able to be tracked internally as to which department or health care professional was involved in the care of the patient (Snella and Sachdev,... 

Figure 26.2 is a flowchart of appropriate, safe, effective, and efficient use of medications in the hospital setting (12). It incorporates the role of the prescriber, nurse, pharmacist, and patient in a typical inpatient environment. It also depicts the role of the organization s pharmacy and therapeutics committee and quality improvement functions, which will be discussed later in this chapter. The decision to treat a patient in a hospital or extended-care facility typically adds a nurse or other healthcare provider (respiratory therapist, etc.) to the trio described in the ambulatory care setting. Every time that individual has to read, interpret, decide, or act is yet another opportunity for a mistake to occur. Each of the steps in the medication use process provides an opportunity for correct or incorrect interpretation and implementation of the tactics that support the therapeutic plan. With this many opportunities for medication misadventures to occur, it is easy to understand why tracking and improving quality are important aspects of medication use. 

When he w-as examined at the hospital the patient alternated between superficial, chatty warmth and apprehension. He went back and forth from recognizing the doctor to thinking he was the patient s brother. Twice during the interview the patient called the doctor by his brother s name and asked him when he had arrived, apparently losing track... 

Most of the bone marrow transplant pharmacist positions with research emphasis are tenure-tracked or tenured with a teaching hospital. These pharmacists have minimal to no direct patient care duties assigned to them. Pharmacists are responsible for the following ... 

The OSHA standard requires employers to provide initial and annual training to all anployees exposed to an airborne concentration of lead of 30 pg/m averaged over an 8 h period. In some old facilities, exposure can come from lead-based paint or lead-soldered pipe connections. Construction and renovation projects can release lead particles into the air. Hospital departments of nuclear medicine use lead molds in patient treatment. Organizations must confine lead to a specific area. Decontamination and shower facilities should be provided to keep lead from being tracked to other areas. Provide respiratory protection and protective clothing wherever there is known exposure potential. 

The Hospital Survey on Patient Safety Culture examines patient safety culture from a hospital staff perspective and allows hospitals to assess their safety culture and track changes over time. Hospitals that administer the patient safety culture survey can voluntarily submit their data to the Comparative Database, a resource for hospitals wishing to compare their survey results to similar types of hospitals (AHRQ Publication No. 04-0041). 

As a rule, medicines used in bigger amounts in hospitals are commercially supplied by industry, smaller amounts and ad hoc orders by wholesalers, see Chap. 36. Some tasks delegated to the hospital pharmacist may be fulfilled by centralised services for allied partners due to economic or effectiveness reasons. The frame for this duty has to be flexible enough to attain a fast track distribution within the institution and thus a fast dispensing of medicines to the patient. Thus, not only drug supply, but also the medication process and consequently the prevention of medications errors, which are multidisciplinary processes within patient care, are to be considered as integral parts of the mandate [4]. 

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