Topics in hospital pharmacy management最新文献

The development of a DCP in the manner presented previously has allowed for a consistent definition of customer needs and expectations within a pharmacy service. By applying this approach it has allowed the department to address the controversies associated with the identification of key customers and has also allowed a balance to be achieved between internal and external forces. From our analysis it is clear that the pharmacy department has a critical role in establishing a customer service philosophy that is key to the overall success of the institution's quality goal. It is also clear that pharmacy services cannot truly be developed without a customer service philosophy central to their design and implementation. In an era where drug expenditures represent an ever-increasing portion of corporate budgets, the pharmacy's ability to deliver goods and services that are customer and quality focused will be critical to organizational survival. The time has come to put ego aside and critically analyze whether or not a quality service is being delivered that meets a true customer need.

Unless we are willing to take a long-term look in terms of the implementation of TQM in our health care system, TQM will not work. QI is badly needed in health care, but quality is a slippery concept and requires continuous monitoring and commitment from all of us who embrace it. However, the suggestions provided in this article may assist in adopting and implementing such programs. Furthermore, the articles that follow in this issue will show how the concepts incorporated in the implementation of the TQM process can be successfully applied to a health care setting.

Continuous QI requires our hospitals to undergo a fundamental change in values, beliefs, and ways to manage. Process improvement changes must start with senior managers, who create the environment for continuous improvement and then enable department managers and employees to improve their processes. Persistent poor quality does not respect organizational boundaries, and HQIP provides an opportunity to manage all the resources necessary to make improvements. As pharmacy managers, we must identify processes under our control that can be continuously improved based on documented customer judgments. We must stop asking employees to work harder in a flawed system and empower them to improve those processes within their control. It may be easy to become frustrated if it seems to take a long time to implement TQM. Remember, transforming our departments and hospitals will not happen overnight. We are embarking on a new style of leadership and management, one that will help pharmacies implement our pharmaceutical care vision.

An effective total quality management system is the outcome of a well-defined process for QI. The Toledo Hospital seven-step QI process provides a systematized, databased approach to problem solving. The process has been shown to work for all types of QI teams throughout the hospital.

While the barriers to TQM implementation are many and the lessons learned can be very painful, we are convinced the results are well worth the effort. TQM implementation is a long term strategic approach and while results can be fairly quick, organizational cultural change and strategic redirection take time. Progress can be very slow. By reducing waste, rework, and variation we can both improve quality and reduce cost. The ultimate goal of TQM is to have organizational members using the quality tools in their daily work life. As an increasing number of health care organizations move through the four phases of implementation, sharing lessons learned can help us understand how to evaluate our quality processes and sustain the improvement process.

With increased use of automation in pharmacy operations, traditional roles for technicians, staff pharmacists, and managers will be altered. Demands will be for higher order skills, use of information, and technical expertise. The technologies available offer the promise of accurate and reliable distribution and administration of products, enabling pharmacists to assume accountability for medication use in patients and for the outcomes of pharmaceutical care.

There are many theories and connected tools that have proven to be particularly effective in influencing paradigm shifts. This article has introduced some of each. References listed are useful sources for detailed information. What seems to be clear is that managers should be explicit about the way they characterize their organization. This influences how one measures organizational effectiveness and the selection and application of theories and tools for creating change. The attempt of this article has been to introduce this as a conceptual framework and point to some practical applications in changing organizational thinking.