Physician performance recommendations

After performing a SWOT analysis and some baseline market research, Carol and the other pharmacists at Care-Rite Pharmacy have decided to develop a Pharmacy Check-up Service (MTM). One of Carol s pharmacists volunteered to put together a prototype patient chart that will be used by the pharmacists to document their activities. The patient chart contains several forms, including a patient history form that requests some basic demographic information (see Fig. 25-2), medical and medication histories forms (see Figs. 25-3 and 25-4), and an authorization to release medical information that is signed and dated by the patient (see Fig. 25-5). Also, a communication form was created to fax clinical information and pharmacists recommendations to the physician (Fig. 25-6). 

Step 5 is to establish thresholds for optimal use. Thresholds are the standards against which performance is measured. For example, if the criteria for dosing a medication require that all patients receive a particular dose, without variation, then the threshold will be set at 100% that is, 100% of the patients must receive that dose. It is not necessary to set absolute standards (e.g., 0% therapeutic duplication or 100% compliance with dosage recommendations), because individual variation should be taken into account. A further example of a threshold includes the percentage of patients expected to achieve a certain outcome (e.g., goal blood pressure, 75% adverse reaction, 12%). Clinical pharmacists and physician specialists should... 

Emesis is not recommended. Activated charcoal slurry with or without saline cathartic and sorbitol can be used after oral ingestion. In case of inhalation exposure, good ventilation should be maintained. Skin decontamination should be performed with repeated washing with soap. Exposed eyes should be irrigated with copious amounts of room-temperature water for at least 15 min. Liver and kidney function should be monitored. Consult a physician as soon as possible. 

Consensus Conferences on Antithrombotic Therapy sponsored by the American College of Chest Physicians. " This provides a comprehensive review and recommendations performed by international experts on antithrombotic therapy. 

I 43. A 65-year-old obese male presents with severe indigestion and chest pain after a spicy meal. A lactate dehydrogenase (LDH) level obtained to evaluate possible myocardial infarction is normal, but the laboratory recommends that LDH isozymes be performed. The managing physician knows that lactate dehydrogenase is composed of two different polypeptide chains arranged in the form of a tetramer. Assuming that all possible combinations of the different polypeptide chains occur, how many isozyme forms of lactate dehydrogenase must be measured ... 

For accreditation, the ICANL requires physicians to be board-certified in Nuclear Medicine or in Radiology with special competency in nuclear medicine, whereas special competency in nuclear medicine is not required by ACR. While both standards mandates the quality control tests to be performed daily, weekly, monthly, or annually, ACR requires the presence of a medical physicist in the facility for monitoring the tests but the ICANL only recommends for such an individual. Technologists are required to be certified by ARRT (N) or NMTCB. Continuing education of specified hours is required for each professional category for continuation of accreditation. For detailed information, refer to http //www.acr.org and http //www.icanl.org. 

Any medical conditions, including the use of any prescribed medications, that may detract from an individual s ability to perform assigned chemical surety duties must be communicated to the certifying official by oral notification and confirmed in writing. In addition, the physician must provide a recommendation as to the suitability of the worker to continue CPRP duties. Documentation of these communications should be included on the Standard Form 600. As in all healthcare, documentation is extremely important and, in this case, subject to examination during a Chemical Surety Inspection (CSI). Exhibit 17-2 lists the administrative documentation necessary to support a CSI. 

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