Topics in hospital pharmacy management最新文献

Programs developed to advance the careers of pharmacy staff members are important tools to attract and retain qualified staff members. Integration of career development with the advancement of the department's efforts to achieve pharmaceutical care are integral for the future success of the department. Design of programs for all major positions/classifications should be considered. These programs must be developed in concert with the employees affected. In the future, these programs can demonstrate enhanced outcomes for patient care by ensuring appropriately trained and credentialed employees. This will require a commitment to advanced human resources planning.

Interviewing job candidates is a key duty of pharmacy managers. A structured, focused review of application materials, an interview planned in advance, and the use of multiple interviewers can lead to an effective interview. The planned process can lead to the selection of employees who will stand the test of the organization over time and meet the goals and needs of the employee as well.

Training new employees is an important and necessary component of the creation of a team to provide pharmacy services. A structured, focused review of application materials, a tailored training program planned in advance, and the use of multiple trainers can lead to an effective training program and a satisfied, productive new employee. The planned training program leads to a consistent approach to physician, nurse, and patient customers and sets expectations for skills, interaction, behavior, and quality that are the basis of a long-term relationship. Employees may continue this training process over the entire course of their career. A well-designed training program will also provide portable skills and meet the goals and needs of the employee as well.

The QI program is patient driven. The question "How does this monitoring affect the patient?" is central to decisions on designing indicators. Time spent on the various levels of quality assessment in the Pharmacy QI Committee is proportional to patient impact. Personnel time devoted to concurrent review of dosing and drug interaction overrides, drug information response accuracy, and therapeutic drug monitoring reflects the importance the Pharmacy Department places on maintaining a drug therapy safety net. The patient is central to the pharmacy QI program. The spirit of the Joint Commission's standards is met; acceptable documentation completes the requirements.

The intervention tracking system at Texas Children's Hospital has evolved from a simple log to a pocket book of check-off forms requiring minimal writing. Information gathered from the intervention data has progressed from merely notification that a call was made to tracking numbers and types of interventions to including the pharmacists in the information loop. Pharmacists are assured that the time spent documenting interventions provides data for medical staff QI, pharmacy QI, and feedback to themselves as well. No documentation is wasted; no separate data collection is required. Intervention categories with medical staff-approved indicators are treated as a concurrent DUE. Depending on the rate of acceptance of pharmacists' recommendations, physicians, pharmacists, or both are targeted for education. Analysis of the acceptance rate may also indicate the need for systems changes more profoundly affecting one or the other of the groups.

The hospital mainframe computer pharmacist intervention documentation system described has successfully facilitated the recording, communication, analysis, and reporting of interventions at our hospital. It has proven to be time efficient, accessible, and user-friendly from the standpoint of both the pharmacist and administrator. The advantages of this system greatly outweigh manual documentation and justify the initial time investment in its design and development. In the future, it is hoped that the system can have even broader impact. Intervention/recommendations documented can be made accessible to medical and nursing staff, and as such further increase interdepartmental communication. As pharmacists embrace the pharmaceutical care mandate, documenting interventions in patient care will continue to grow in importance. Complete documentation is essential if pharmacists are to assume responsibility for patient outcomes. With time being an ever-increasing premium, and with economic and human resources dwindling, an efficient and effective means of recording and tracking pharmacist interventions will become imperative for survival in the fiscally challenged health care arena. Documentation of pharmacist intervention using a hospital mainframe computer at UIH has proven both efficient and effective.

Our efforts have helped us demonstrate the positive impact of pharmaceutical care for patients. Our experience with the Clinical Notes section of our computer system leads us to recommend that such capabilities be sought in all pharmacy computer systems. A significant advantage to avoiding paper-based systems for documenting and collecting information relevant to clinical interventions, ADRs, DUE data, and patient outcomes has been proven in our institution. Various ways to categorize intervention data have been reported in the literature. We recommend clinical intervention categories be based on the eight categories of drug misadventuring so that data from different hospitals can be tabulated or compared. The success of our system is that it is one system rather than many systems. The importance of pharmacist documentation demands that it be simple, efficient, and painless, or it will be nonexistent.

Using the Wizard to document clinical activities has been well received by the clinical staff. What had previously been a dreaded task has become an ongoing part of daily activities. The revised Clinical Activity Log also provided the staff pharmacists with an easier method of documenting their clinical activities. The task of inputing the information from the staff pharmacists' paper logs into the computer is time consuming and is currently being done by the clinical staff. Procurement of additional Wizards for the staff pharmacists to use in the central pharmacy and satellite pharmacies is currently being considered. Using the Wizard has enabled the clinical staff to document clinical activities into the computer database in an ongoing manner throughout the day. Documentation has increased and is now more complete. Productivity is being monitored. Physician responses and patient outcomes are now being documented. Most importantly the computerized system allows for easy retrieval of the documented information for evaluation so that tracking and trending can be done and we can thereby continue to improve the quality of pharmaceutical care being provided.

In this study, the measurement of perception of pharmacists' workload did not correlate well with any workload indicators studied. Generally, census on the study date correlated well for pharmacy technicians working in various areas of the pharmacy. If it is agreed that perception of workload is the real measure of activity--that is, how busy the employees believe it is--then the indicators used in this study are not useful. Similar research using other indicators is warranted.