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Raiche, Taylor, Robert Pammett, Shelita Dattani, Lisa Dolovich, Kevin Hamilton, Natalie Kennie-Kaulbach, Lisa McCarthy, and Derek Jorgenson. "Community pharmacists’ evolving role in Canadian primary health care: a vision of harmonization in a patchwork system." Pharmacy Practice 18, no. 4 (October 18, 2020): 2171. http://dx.doi.org/10.18549/pharmpract.2020.4.2171.
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Canada’s universal public health care system provides physician, diagnostic, and hospital services at no cost to all Canadians, accounting for approximately 70% of the 264 billion CAD spent in health expenditure yearly. Pharmacy-related services, including prescription drugs, however, are not universally publicly insured. Although this system underpins the Canadian identity, primary health care reform has long been desired by Canadians wanting better access to high quality, effective, patient-centred, and safe primary care services. A nationally coordinated approach to remodel the primary health care system was incited at the turn of the 21st century yet, twenty years later, evidence of widespread meaningful improvement remains underwhelming. As a provincial/territorial responsibility, the organization and provision of primary care remains discordant across the country. Canadian pharmacists are, now more than ever, poised and primed to provide care integrated with the rest of the primary health care system. However, the self-regulation of the profession of pharmacy is also a provincial/territorial mandate, making progress toward integration of pharmacists into the primary care system incongruent across jurisdictions. Among 11,000 pharmacies, Canada’s 28,000 community pharmacists possess varying authority to prescribe, administer, and monitor drug therapies as an extension to their traditional dispensing role. Expanded professional services offered at most community pharmacies include medication reviews, minor/common ailment management, pharmacist prescribing for existing prescriptions, smoking cessation counselling, and administration of injectable drugs and vaccinations. Barriers to widely offering these services include uncertainties around remuneration, perceived skepticism from other providers about pharmacists’ skills, and slow digital modernization including limited access by pharmacists to patient health records held by other professionals. Each province/territory enables pharmacists to offer these services under specific legislation, practice standards, and remuneration models unique to their jurisdiction. There is also a small, but growing, number of pharmacists across the country working within interdisciplinary primary care teams. To achieve meaningful, consistent, and seamless integration into the interdisciplinary model of Canadian primary health care reform, pharmacy advocacy groups across the country must coordinate and collaborate on a harmonized vision for innovation in primary care integration, and move toward implementing that vision with ongoing collaboration on primary health care initiatives, strategic plans, and policies. Canadians deserve to receive timely, equitable, and safe interdisciplinary care within a coordinated primary health care system, including from their pharmacy team.
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Miller, Sarah J., William J. Docktor, and Ginnie Lee T. North. "Strategies for Effective Hospital Pharmacy Staff Development." Journal of Pharmacy Practice 7, no. 5 (October 1994): 227–35. http://dx.doi.org/10.1177/089719009400700506.
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An active staff development program (SDP) for pharmacists has been associated with provision of higher levels of pharmaceutical care within health-care institutions. Adequate support from pharmacy management, institutional administration, the medical staff, and the pharmacy staff itself is necessary for a successful, ongoing SDP. A SDP run concurrently with implementation of clinical pharmacy services allows pharmacists to immediately apply new skills and knowledge. Such a SDP should emphasize not only information necessary for performance of the clinical service, but also should develop drug information retrieval, problem solving, and organizational skills. A SDP should use a variety of media and methods, with an emphasis on interactive and active learning formats. The staff pharmacists should occasionally make some of the presentations themselves. Continuing education credit should be provided through the SDP. Feedback regarding the success of the newly implemented clinical services should be supplied to the pharmacists as a motivator for continued learning; feedback to administration is necessary for continued justification of both the SDP and clinical services. The hospital pharmacy literature is replete with accounts of successful staff development programs. At Saint Patrick Hospital, a SDP initiated concomitantly with implementation of new clinical services has enjoyed both success and longevity.
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Pedersen, Craig A., Philip J. Schneider, Michael C. Ganio, and Douglas J. Scheckelhoff. "ASHP national survey of pharmacy practice in hospital settings: Dispensing and administration—2020." American Journal of Health-System Pharmacy 78, no. 12 (March 23, 2021): 1074–93. http://dx.doi.org/10.1093/ajhp/zxab120.
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Abstract Purpose Results of the 2020 ASHP national survey of pharmacy practice in hospital settings are presented. Methods Pharmacy directors at 1,437 general and children’s medical/surgical hospitals in the United States were surveyed using a mixed-mode method of contact by email and mail. Survey completion was online. IQVIA supplied data on hospital characteristics; the survey sample was drawn from the IQVIA hospital database. Results The response rate was 18.7%. Almost all hospitals (92.5%) have a method for pharmacists to review medication orders on demand. Most hospitals (74.5%) use automated dispensing cabinets (ADCs) as their primary method for drug distribution. A third of hospitals use barcodes to verify doses during dispensing in the pharmacy and to verify ingredients when intravenous medications are compounded. More than 80% scan barcodes when restocking ADCs. Sterile workflow management technology is used in 21.3% of hospitals. Almost three-quarters of hospitals outsource some sterile preparations. Pharmacists can independently prescribe in 21.1% of hospitals. Pharmacist practice in ambulatory clinics in 46.2% of health systems and provide telepharmacy services in 28.4% of health systems. Conclusion Pharmacists continue their responsibility in their traditional role in preparation and dispensing of medications. They have successfully employed technology to improve safety and efficiency in performance of these duties and have employed emerging technologies to improve the safety, timeliness, and efficiency of the administration of drugs to patients. As pharmacists continue to expand their role to all aspects of medication use, new opportunities highlighted in ASHP’s Practice Advancement Initiative 2030 have been identified.
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Gastelurrutia, Miguel A., Maria J. Faus, and Fernando Martinez-Martinez. "Primary health care policy and vision for community pharmacy and pharmacists in Spain." Pharmacy Practice 18, no. 2 (June 1, 2020): 1999. http://dx.doi.org/10.18549/pharmpract.2020.2.1999.
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From a political and governance perspective Spain is a decentralized country with 17 states [comunidades autónomas] resulting in a governmental structure similar to a federal state. The various state regional health services organizational and management structures are focused on caring for acute illnesses and are dominated by hospitals and technology. In a review by the Interstate Council, a body for intercommunication and cooperation between the state health care services and national government, there is a move to improve health care through an integrative approach between specialized care and primary care at the state level. Community pharmacy does not appear to have a major role in this review. Primary health care is becoming more important and leading the change to improve the roles of the health care teams. Primary care pharmacists as the rest of public health professionals are employed by the respective states and are considered public servants. Total health care expenditure is 9.0% of its GDP with the public health sector accounting for the 71% and the private sector 29% of this expenditure. Community pharmacy contracts with each state health administration for the supply and dispensing of medicines and a very limited number of services. There are approximately 22,000 community pharmacies and 52,000 community pharmacists for a population of 47 million people. All community pharmacies are privately owned with only pharmacists owning a single pharmacy. Pharmacy chain stores are not legally permitted. Community pharmacy practice is based on dispensing of medications and dealing with consumer minor symptoms and requests for nonprescription medications although extensive philosophical deep debates on the conceptual and practical development of new clinical services have resulted in national consensually agreed classifications, definitions and protocolized services. There are a few remunerated services in Spain and these are funded at state, provincial or municipal level. There are no health services approved or funded at a national level. Although the profession promulgates a patient orientated community pharmacy it appears to be reluctant to advocate for a change in the remuneration model. The profession as a whole should reflect on the role of community pharmacy and advocate for a change to practice that is patient orientated alongside the maintenance of its stance on being a medication supplier. The future strategic position of community pharmacy in Spain as a primary health care partner with government would then be enhanced.
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Nelsen, Greg, Heidi Pigott, Caleb Hopkinson, and Christine M. Formea. "Considerations for development of pharmacy support models for COVID-19 alternate care sites." American Journal of Health-System Pharmacy 77, no. 19 (July 23, 2020): 1592–97. http://dx.doi.org/10.1093/ajhp/zxaa214.
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Abstract Purpose Guidance on alternate care site planning based on the experience of a health-system pharmacy department in preparing for an expected surge in coronavirus disease 2019 (COVID-19) cases is provided. Summary In disaster response situations such as the COVID-19 pandemic, healthcare institutions may be compelled to transition to a contingency care model in which staffing and supply levels are no longer consistent with daily practice norms and, while usual patient care practices are maintained, establishment of alternate care sites (eg, a convention center) may be necessitated by high patient volumes. Available resources to assist hospitals and health systems in alternate care site planning include online guidance posted within the COVID-19 resources section of the US Army Corps of Engineers website, which provides recommended medication and supply lists; and the Federal Healthcare Resilience Task Force’s alternate care site toolkit, a comprehensive resource for all aspects of alternate care site planning, including pharmacy services. Important pharmacy planning issues include security and storage of drugs, state board of pharmacy and Drug Enforcement Administration licensing considerations, and staff credentialing, education, and training. Key medication management issues to be addressed in alternate site care planning include logistical challenges of supply chain maintenance, optimal workflow for compounded sterile preparations (eg, on-site preparation vs off-site preparation and delivery from a nearby hospital), and infusion pump availability and suitability to patient acuity levels. Conclusion Planning for and operation of alternate care sites in disaster response situations should include involvement of pharmacists in key decision-making processes at the earliest planning stages.
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Lilipaly, Angela Geraldine. "AN ANALYSIS THE INFLUENCE OF SUBPROCESS IN PATIENT DISCHARGE TO A TIMELY MANNER DISCHARGE PROCESS IN XYZ HOSPITAL." Emerging Markets : Business and Management Studies Journal 5, no. 2 (February 2, 2019): 23–34. http://dx.doi.org/10.33555/ijembm.v5i2.93.
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Health care services everywhere have many process in their system. Discharge process is a last process during the patient stay in the hospital. In this process there are many division involve which would impact the time needed for each patient discharge to be completed. And this would also impact the waiting time of admiting other patient. Waiting time issues for accessing and providing healthcare services is also an issue in many hospital and is also identify by the leaders of one of the hospital in South Tangerang area (XYZ Hospital). At the time a patient is plan to be discharge, they expect a timely and quality discharge from their care provider. Hospital might have limitation on human resources, or be lack of standardization, preparation, communication, which create a bottleneck in the system. There are several process that patient have to go through when doctor concluded that the patient could be discharge: Nursing Discharge (X1): the time from patient has been prepare for discharge by physician to the time of nursing dicharge. Pharmacy Discharge (X)2: the time from excepting discharge prescribtion untill pharmacy discharge. Financial Discharge (X3): the process of patient administration and payment. Discharge Education (X4) : time of education prior discharge given by the nurse and clinical pharmacist. While the Dependent variable is Time for patient discharge process (Y). The primary objective of this research is to explore and analyze those processes, where the hospital could identify which process is significant to improve, so the management of the hospital would focus the effort and support on those process/s; which then would make patient discharge moresufficient and will then also resulting the improvement of patient admission waiting time.The Statistic Model use for this research is Multiple Regression to examine the linear relationship between 1 dependent (Y) and 4 independent variable (X1, X2, X3, X4 ). Sample of inpatient patients which are discharge from the hospital. The sample of this research is by collecting secundary data; from December data which would be 248 patient discharge a month. By having this kind of measurement and analysis, it is expected that the hospital could identify which process is significant to improve, and the managment of the hospital would focus the effort and support on those process/s; which then would make patient discharge more sufficient and will then also resulting the improvement of patient admission waiting time. This research resulted that 3 out of 4 subprocesses influence patient discharge. The 3 subprocesses which impact significantly to patient discharge are: nursing, financial and education discharge processes.
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Brearly, Timothy W., Courtney S. Goodman, Calandra Haynes, Katherine McDermott, and Jared A. Rowland. "Improvement of postinpatient psychiatric follow-up for veterans using telehealth." American Journal of Health-System Pharmacy 77, no. 4 (February 7, 2020): 288–94. http://dx.doi.org/10.1093/ajhp/zxz314.
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Abstract Purpose To describe the implementation and initial outcomes of a pilot interdisciplinary telehealth clinic, Allied Transitional Telehealth Encounters post-iNpatient Discharge (ATTEND), providing clinical pharmacy specialist follow-up for veterans transitioning from inpatient to outpatient mental healthcare in a Department of Veterans Affairs (DVA) hospital. Summary The ATTEND clinic’s primary intervention was providing medication management appointments through clinical video telehealth (CVT) to patient discharge locations through a DVA-provided tablet. An interdisciplinary team supported care through on-unit inpatient training, secure messaging, and self-help applications. Clinical outcomes were measured through readmission rates, wait times, self-report measures, and follow-up interview at the completion of ATTEND services. Twenty patients completed on-unit training, and 16 unique patients were seen for at least 1 outpatient appointment. Inpatient readmission rates were lower for ATTEND patients than with standard care (5% versus 19%, respectively). Wait times until first postdischarge mental health appointment were reduced by a mean of 18.6 (S.D., 8.8) days. The pharmacist made medication interventions, including dosing changes, education on incorrect administration, and medication discontinuation. Self-reported psychological symptoms decreased during ATTEND participation. Post-ATTEND interviews indicated high levels of acceptance and interest in continued tablet-based care. Primary challenges included unique technological limitations and effective care coordination. Conclusion The ATTEND telehealth clinic provided postinpatient mental health follow-up that was more prompt and convenient than conventional on-site appointments. Psychiatric self-report improved during ATTEND-facilitated transition to outpatient care, and the recidivism rate for ATTEND patients was lower than the general inpatient rate during the same time period.
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Larasanty, Luh Putu Febryana, Kadek Nadia Marta Dewi, and Made Ary Sarasmita. "PHARMACIST PROFESSION STUDENT PERCEPTION ABOUT PHARMACIST ROLE IN PHARMACY, COMMUNITY HEALTH CENTER AND HOSPITAL." Journal of Pharmaceutical Science and Application 2, no. 2 (December 1, 2020): 85. http://dx.doi.org/10.24843/jpsa.2020.v02.i02.p06.
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Background: Pharmacists play a role as a part of health services both at pharmacies, hospitals and community health centers. Pharmaceutical care was regulated in the Regulation of the Minister of Health of the Republic of Indonesia. In the internship, students of the Pharmacists program Faculty of Mathematics and Natural Sciences, Udayana University can see clearly how the implementation of the role of Pharmacists in the Pharmacy, Hospital and Community Health Center. Objective: This study aims to assess the perceptions (responses) of Pharmacist students on the role of Pharmacists in various pharmacy services. Methods: This study used a one-group posttest only design methods. The population of the study used all of the Pharmacist students who were internship at the Pharmacy, Community Health Center and Hospital. The research instrument used a closed-ended questionnaire about the perceptions of Pharmacist students on the role of Pharmacists in internship locations. Results: The results showed that the role of pharmacists in pharmacies and community health centers was greater in the field of clinical pharmacy services. While in hospitals, pharmacists have a greater role in the field of drug management. Conclusion: Students have a positive perception of the role of pharmacists. There were no significant differences in perceptions of Pharmacist students on the role of Pharmacists in the field of drug management and clinical pharmacy services (p> 0.05).
Keywords: pharmacist, pharmaceutical care, perception, role, students
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Christiansen, Nanna, Tayyaba Javid, Jasper Thomson, Heather Calvert, and Olapeju Bolarinwa. "P29 Impact of a medicines facilitation pharmacist on a paediatric ward." Archives of Disease in Childhood 103, no. 2 (January 19, 2018): e2.32-e2. http://dx.doi.org/10.1136/archdischild-2017-314585.38.
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AimRecruiting sufficient numbers of nurses can provide a challenge for hospitals. Pharmacists have been identified as being able to support nurses by taking on medicines management tasks alongside traditional nursing responsibilities such as medicines administration and discharge planning.1 At Barts Health NHS Trust there was increased pressure on nursing staff particularly on one of the complex medical wards during the winter pressure months. Paediatric pharmacists were identified as being able to support nurse:Safe nursing time by taking on some of nursing responsibilitiesActive discharge planning and coordinationReduce discharge prescription waiting timesImprove education and training for nurses, doctors and patients in relation to medicines management.MethodA pilot project on one paediatric medical ward was started in February 2016. The pharmacist is supernumerary to standard ward pharmacy service, reporting to the ward manager and lead pharmacist. Working hours are 9 am–5 pm Monday to Friday.Intensive training was provided over 2.5 weeks with subsequent sign off for administration of oral medication, 2nd checking for intravenous (IV) medication and IV giving.Drug listing for discharge prescription (TTA) was introduced, which involves a discussion with the doctor for medicines on discharge, transcribing these onto the TTA and using ward based dispensing where possible. Results were collected pre and post implementation.ResultsMedication administration activity:Nurse time – 60 hours/month (medication administration and 2nd checking) saved.Discharge information:Proportion of TTAs dispensed at ward level increased from 19% to 78% post implementation, avoiding delays in dispensary.Average time writing TTA to being ready for discharge reduced from 280 min to 91 min.Drug listing reduced discharge time further to 52 min.Missed and delayed doses:Random sample of 5 patients audited over 48 hour period, shown to reduce missed doses from 14% to 0%.Comments from staff:‘Because of skill mix and use of agency staff, assisting in preparing and giving IVABs has been a major help as on many days only 1 IV giver.’‘Junior staff value and support WFP and have felt has been useful to them.’‘Junior and agency staff feels better supported in understanding medicines usage’.‘Lot of complex patients with many drugs, the pharmacist has helped reducing delay in administration times’.‘TTAs for patients identified as going home have been validated sooner’.‘She helped us to reduce the number of incidents with expiry dates of medicines’.ConclusionThe role of the medicines facilitation pharmacist has been very well received by the nursing staff and the pharmacist is now an integral part of the ward team. The pharmacist was able to save a significant amount of nursing time and reduced risks of delayed and missed doses significantly and is able to provide continuous input into all aspects of medicines management. The average discharge time has reduced to substantially due to improved discharge planning, drug listing and ward based dispensing.ReferenceRobinson S. Hospital hires pharmacists for wards amid nurse shortage. Pharmaceutical Journal 23/30 May 2015;294(7863/4). [online] doi:10.1211/PJ.2015.20068544
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PAZOUR, JENNIFER A., SARAH E. ROOT, RUSSELL D. MELLER, LISA M. THOMAS, and SCOTT J. MASON. "SELECTING AND ALLOCATING REPACKAGING TECHNOLOGY FOR UNIT-DOSE MEDICATIONS IN HOSPITAL PHARMACIES." International Journal of Innovation and Technology Management 10, no. 03 (June 2013): 1340011. http://dx.doi.org/10.1142/s0219877013400117.
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To increase patient safety and support bedside-point-of-care medication administration, millions of unit-dose medications are dispensed in hospitals and health systems daily. Because not all medications are available in unit-dose form directly from the manufacturer, hospitals must repackage medications in unit-dose form themselves. We develop a mathematical model that simultaneously determines which level of technology is warranted and how each medication that is not delivered to the pharmacy in unit-dose form should be repackaged subject to multiple constraints. This model has been integrated into a free Excel-based tool available to pharmacy directors. We test our model with data based on small, medium, and large hospitals and conduct sensitivity analyses to gain further insight. We illustrate how the results from our model can aid in incorporating qualitative aspects into technology selection. Our results show that a semi-automated repackaging system is the most economical technology alternative for most hospital pharmacy in-house repackaging operations. This result, however, is sensitive to the number of unit-dose medications to repackage and the available labor.
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Amariles, Pedro, Mauricio Ceballos, and Cesar Gonzalez-Giraldo. "Primary health care policy and vision for community pharmacy and pharmacists in Colombia." Pharmacy Practice 18, no. 4 (November 23, 2020): 2159. http://dx.doi.org/10.18549/pharmpract.2020.4.2159.
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Colombia is a decentralized republic with a population of 50 million, constituted by 32 departments (territorial units) and 1,204 municipalities. The health system provides universal coverage and equal access to health care services to 95% of the population. Primary health care is seen as a practical approach that guarantees the health and well-being of whole-of-society. The National Pharmaceutical Policy (NPP, 2012) goal is "to develop strategies that enable the Colombian population equitable access to effective medicines, through quality pharmaceutical services (PS)”. There are 4,351 providers certified to deliver PS: 3,699 (85%) ambulatory and 652 (15%) hospital care. The goals for PS are: a) promoting healthy lifestyles; b) preventing risk factors arising from medication errors; c) promoting rational use of medicines; and d) implementing Pharmaceutical Care. There are a number of ways that ambulatory patients access medications: through intermediary private companies, public and private hospitals pharmacies, and retail establishments (drugstores and pharmacies). Intermediary private companies are similar to Pharmaceutical Benefits Management in the U.S. health system, and act as intermediaries between health insurers, pharmaceutical laboratories, and patients. Pharmacists are being employed by these companies and in health insurance companies managing, auditing and delivering rational use of medicines programs. In 2014 there were approximately 20,000 pharmacies and drugstores, (private establishments) where a significant number of prescription-only medicines are sold without medical prescription. Colombian laws allow personal without pharmacy education to be a “director” in these establishments, so the training and education of persons working in drugstores and pharmacies is an important challenge. There about 8,000 registered pharmaceutical chemists with 25% to 30% working in patient care. Since the 90´s, there are more favorable conditions for pharmacist’s participation and contribution to health system and patient’s health outcome. These environmental facilitators include: a) laws and regulations regarding pharmaceutical services (2005-2007), b) establishment of a NPP (2012), and c) opportunities associated with the consolidation of private health management companies providing health services with an interest in pharmaceutical services (since 1995). Finally, telepharmacy, comprehensive care routes for pharmaceutical services, and further strengthen of postgraduate training in pharmacy practice are future strategies to improve the pharmacy profession in Colombia. They provide an opportunity to influence the recognition and value of the pharmacist as the health care professional.
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Pelham, Larry D., Karin E. Bushaw, Michael R. Norwood, and Margaret O'Brien. "Operational Issues for Hospital-Based Home Infusion Pharmacies." Journal of Pharmacy Practice 3, no. 1 (February 1990): 11–18. http://dx.doi.org/10.1177/089719009000300103.
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This article focuses on a nonprofit, hospital-based comprehensive home infusion service in which all intravenous (IV) drugs or nutritional admixtures, professional services, supplies, and reimbursement services are performed solely by inpatient pharmacists, IV therapy nurses, and pharmacy assistants. By modifying an inpatient work load measurement system, additional staff are justified by total time for home infusion service work units. Twenty-four-hour back-up by cross-trained inpatient pharmacists and IV therapy nurses has contributed to the number of patients served by the home infusion service, which has grown steadily. A permanent and complete outpatient medical record is maintained for each patient (separate from inpatient records) in the infusion service and is available for 24-hour easy access for after-hour calls. All multidisciplinary team members participate in formal, weekly patient-care case conferences to review and update all patient therapies. Services covered, billing procedures, procedure codes, allowable charges, prior approval requirements, copayment arrangements, claims processing schedules, and related billing arrangements were first identified. The overall success of the program's reimbursement remains at 85% of charges when combining all patients. Structure, process, and outcome criteria unique to a comprehensive home care quality assurance program evolved from our high volume (total parenteral nutrition [TPN]), high risk (pain management, antibiotics), and problem-prone (TPN, pain management) therapies. Reimbursement remains the most troublesome aspect of initiating a successful hospital-based program. The success of our program depends heavily on the ability to attract and retain a highly motivated professional staff and to maintain strong referral networks with local physicians, hospital discharge planners, and other health care professionals.
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Scott, David M., Tom Christensen, Anqing Zhang, and Daniel L. Friesner. "Does improved medication adherence reduce inpatient hospital expenditures?" International Journal of Pharmaceutical and Healthcare Marketing 11, no. 3 (September 4, 2017): 248–70. http://dx.doi.org/10.1108/ijphm-07-2016-0034.
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Purpose This study aims to assess whether patients [who receive community pharmacy services at locations where routine medication therapy management (MTM) care is reimbursed] who were adherent to their medications generated lower inpatient hospitalization expenses. Design/methodology/approach This is a retrospective, descriptive and cross-sectional study using administrative claims data drawn from 84 community pharmacies in North Dakota. The included patients were enrolled in a Blue Cross Blue Shield of North Dakota insurance plan and were taking one or more of eight groups of medications (metformin, antidepressants, anti-asthmatics, ACEs/ARBs, beta-blockers, calcium channel blockers, diuretics and statins) commonly prescribed to treat chronic conditions filled between July 1, 2014 and June 30, 2015. Community pharmacists used software that allowed the pharmacists to provide and bill for MTM services. Data from these sources were used to calculate medication adherence and inpatient costs. Findings Patients prescribed a beta blocker, a calcium channel blocker, and a diuretic or an anti-diabetic medication, and those who are fully adherent to their medications were associated with significantly lower inpatient hospitalization costs (as measured by insurance payments to hospitals) as compared to non-adherent patients. Patients who were fully adherent to their medications had no statistically significant differences in patient-specific costs compared to non-adherent patients. Originality/value Patients receiving services at a community pharmacy that offers MTM services and those who were adherent to their medication regimens generate lower health care expenses. Most of the savings come from lower hospitalization expenses, rather than patient-paid expenses.
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Branham, Ashley R., Aaron J. Katz, Joseph S. Moose, Stefanie P. Ferreri, Joel F. Farley, and Macary W. Marciniak. "Retrospective Analysis of Estimated Cost Avoidance Following Pharmacist-Provided Medication Therapy Management Services." Journal of Pharmacy Practice 26, no. 4 (November 25, 2012): 420–27. http://dx.doi.org/10.1177/0897190012465992.
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Objective: To compare the estimated cost avoidance (ECA) of pharmacist-provided medication therapy management (MTM) services among common disease states encountered in community pharmacy practice. Design: Retrospective analysis. Setting: Nine community pharmacies in North Carolina. Patients: Three hundred and sixty-four patients who are 65 years of age or older, a Medicare Part D beneficiary and a North Carolina resident. Interventions: An MTM pharmacist-provider conducted medication reviews to eligible patients between July 2009 and October 2009. For each encounter, patient interventions, pharmacist recommendations, and ECA were recorded. Main outcome measure: ECA. Results: In 9 pharmacy locations, 634 MTM interventions were documented during the study period. The ECA in a 4-month period yielded approximately $494 000. Comprehensive medication reviews, new prescription counseling and appropriate medication administration, and technique counseling made up nearly two-thirds of interventions. Overall, the probability that an MTM intervention would result in an ECA greater than $0 was .35. Conclusions: Pharmacist-provided MTM effectively reduced costs associated with patient medication use. Such interventions reduced costs in overall health care specifically in the areas of cardiovascular, gastroesophageal reflux disease, pulmonary, and diabetes groups.
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Adelson, Kerin B., Martha Stutsky, Monica Fradkin, Michelle Renee Harrison, Osama Abdelghany, Bret Morrow, Mandeep Smith, et al. "Should Cancer Centers start their own specialty pharmacy? Quality and economic data from the oral chemotherapy program at Smilow Cancer Hospital and Yale New Haven Health System." Journal of Clinical Oncology 35, no. 8_suppl (March 10, 2017): 108. http://dx.doi.org/10.1200/jco.2017.35.8_suppl.108.
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108 Background: Recent focus has shown that oral chemotherapy is high risk for medical error. Our QOPI certification process identified that oral oncologic processes were marked by: lack of documentation in the EMR, patients receiving refills from third party pharmacies after prescription discontinuation, incorrect self-administration of medications due to lack of education, delivery delays, high copays, and underuse of available patient assistance programs. Methods: A multidisciplinary task force developed a program to expedite drug access, standardize consent, and ensure clinical support including education, adherence and toxicity monitoring. We expanded an existing health-system pharmacy to provide specialty services. Treatment protocols were created for every oral oncologic drug, which are routed to a clinical oncology pharmacist and the specialty pharmacy. Nursing and pharmacist verify all orders. Medication Assistance Program for copay support. Day 1, 5 and 21 pharmacist to patient calls. Multidisciplinary flow sheet documentation. Results: Today, 80% of our patients receive medication within 72 hours. Specialty pharmacists monitor toxicity even for patients whose prescriptions are filled by other pharmacies. Pharmacists have prevented more than 400 prescription errors. Today, monthly revenue before cost for the oral chemotherapy program is nearly than $4 million. The total revenue since initiation in February 2015 is over $44 million, yielding an approximately $9 million margin after costs. Funding through the medication assistance program exceeded $1 million thus far in 2016, with an average of 140 patients receiving assistance each month. Conclusions: A patient-centered multidisciplinary model integrating clinical, operational, financial, and IT resources optimized care for patients receiving oral oncologic therapy. This project transferred revenue from for-profit third party pharmacies to our non-profit health system, and revenue is used to provide enhanced education, monitoring, and patient assistance. Our collaborative improvement model can be adapted to many practice settings.
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Rabie, Dalia, and Salah I. Kheder. "Assessment of Prescribing and Dispensing Practices Based on WHO Core Prescribing Indicators in Hospital and Community Pharmacies in Khartoum State - Sudan." Journal of Medical Informatics and Decision Making 1, no. 3 (July 29, 2020): 1–11. http://dx.doi.org/10.14302/issn.2641-5526.jmid-20-3493.
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Background Rational drug management has become an increasingly important topic in order to make optimal use of the drug budget to offer health services of the highest possible standard. It is important that continuous assessment for rational prescribing and use of drug have to be carried. Objective of this study was to gather data on existing drug prescription and dispensing practices and to evaluate the prescribing and dispensing indicators as described by the WHO. Method Observational, cross-sectional, prospective study was designed and conducted to evaluate the performance of hospital and community pharmacies in Khartoum state, related to rational drug use and prescribing and dispensing practices during the period from November 2018 to March 2019. 297 Hospital and community pharmacies from public and private sectors were contacted for carrying out this study survey and the collected data were analysed against WHO standards for core drug use indicators. Results The average number of drugs per encounter was 3.98 drugs. Hospital pharmacies had a higher (4.18±1.516) number of drugs prescribed than community pharmacies (3.87±1.331) with significance difference between mean of two types of pharmacies (P = 0.015). The percentage of antibiotic per prescription was (53.7%). Antibiotic prescribing was much higher (54.0%) in the hospital pharmacies compared to (48.6 %) in community pharmacies. The average percentage of injections per prescription at the facilities was found to be (57.6%). The percentage of prescription with written diagnosis was (26%.0) and the percentage of prescriptions with written dose was (78%.0). The average dispensing time was (1.75) minutes, The Percentage of drugs actually dispensed was (55.99%), the average adequacy of labelling of drugs was (30.4%). Overall prescribing and dispensing indicators were higher than WHO standard. Conclusion The degree of poly pharmacy was greater than of WHO criteria. The completeness and rationality of prescription was found suboptimal and components were missed.
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Ghibu, Steliana, Anca Maria Juncan, Luca Liviu Rus, Adina Frum, Carmen Maximiliana Dobrea, Adriana Aurelia Chiş, Felicia Gabriela Gligor, and Claudiu Morgovan. "The Particularities of Pharmaceutical Care in Improving Public Health Service during the COVID-19 Pandemic." International Journal of Environmental Research and Public Health 18, no. 18 (September 16, 2021): 9776. http://dx.doi.org/10.3390/ijerph18189776.
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Nowadays, humanity is confronted with one of the most difficult challenges. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was identified for the first time in Hubei, China in December 2019 and produced the COVID-19 pandemic, a devastating disease that led to many complications and deaths. The authorities and the global healthcare system have been alerted regarding the prevention and treatment of this pathology. Even though worldwide quarantine was declared, health care professionals, including pharmacists, have been at the frontline in this war. Since the beginning of the pandemic, the authorities relied on the involvement of the community, hospital, or clinical pharmacists in offering support to the entire population. Also, the authorities implemented measures for emergency authorization of the vaccines, or the drugs used in COVID-19 treatment. In order to facilitate the population’s access to healthcare services, the authorities have established regulations regarding, the extension of prescriptions by pharmacists, working hours, prevention of shortages and price-increase, drive-thru services, etc. However, several countries have taken financial measures to support the pharmacies’ activity. At the same time, pharmaceutical associations elaborated guidelines for the protection of pharmacists and patients alike. Additionally, the pharmacies have come to support the health system and patients by adapting pharmaceutical care to the new needs like preparation and supply of disinfectants, patient care, information, and counseling, especially to COVID-19 patients, as well as the implementation of home drugs-delivery systems. The important roles played by pharmacists were to perform COVID-19 tests and further vaccines, as well as to combat the abundance of misinformation and fake news. The clinical and hospital pharmacy services have also been adapted. Strengthening the role of the pharmacist in the medical team was important for the purpose of providing correct and complete information regarding drugs used in the COVID-19 pathology. In all these activities, pharmacists needed creativity and professionalism, but also the support of pharmacy owners and managers. With this crisis, pharmaceutical care has entered a new phase, demonstrating the ability of pharmacists to be competent and accessible providers of public health. Based on this information, we conducted a narrative review whose purpose was to identify the impact of the authorities’ decisions on pharmaceutical practice, the involvement of professional associations, and the responsibilities of the pharmacy owners and management. On the other hand, we performed a global assessment on the pharmaceutical care services provided by community pharmacists as well as by clinical or hospital pharmacists during the COVID-19 pandemic.
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Bragazzi, Nicola Luigi, Muhammad Mansour, Alessandro Bonsignore, and Rosagemma Ciliberti. "The Role of Hospital and Community Pharmacists in the Management of COVID-19: Towards an Expanded Definition of the Roles, Responsibilities, and Duties of the Pharmacist." Pharmacy 8, no. 3 (August 7, 2020): 140. http://dx.doi.org/10.3390/pharmacy8030140.
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Since late December 2019, a novel, emerging coronavirus was identified as the infectious agent responsible for a generally mild but sometimes severe and even life-threatening disease, termed as “coronavirus disease 2019” (COVID-19). The pathogen was initially named as “2019 novel coronavirus” (2019-nCoV) and later renamed as “Severe Acute Respiratory Coronavirus type 2” (SARS-CoV-2). COVID-19 quickly spread from the first epicenter, the city of Wuhan, province of Hubei, mainland China, into neighboring countries, and became a global pandemic. As of July 15th 2020, the outbreak is still ongoing, with SARS-CoV-2 affecting 213 countries and territories. The coronavirus has caused a dramatic toll of deaths and imposed a severe burden, both from a societal and economic point of view. COVID-19 has challenged health systems, straining and overwhelming healthcare facilities and settings, including hospital and community pharmacies. On the other hand, COVID-19 has propelled several changes. During the last decades, pharmacy has shifted from being products-based and patient-facing to being services-based and patient-centered. Pharmacies have transitioned from being compounding centers devoted to the manipulation of materia medica to pharmaceutical centers, clinical pharmacies and fully integrated “medical-pharmaceutical networks”, providing a significant range of non-prescribing services. Moreover, roles, duties and responsibilities of pharmacists have paralleled such historical changes and have known a gradual expansion, incorporating new skills and reflecting new societal demands and challenges. The COVID-19 outbreak has unearthed new opportunities for pharmacists: community and hospital pharmacists have, indeed, played a key role during the COVID-19 pandemic, suggesting that a fully integrated, inter-sectoral and inter-professional collaboration is necessary to face crises and public health emergencies. Preliminary, emerging evidence seems to suggest that, probably, a new era in the history of pharmacies (“the post-COVID-19 post-pharmaceutical care era”) has begun, with community pharmacists acquiring more professional standing, being authentic heroes and frontline health workers.
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Sheikh, Tehsinabanu, Cindy Wu, Niree Kalfayan, Leanne Sakamoto, and Rita Shane. "Health-system specialty pharmacy impact on oral chemotherapy outcomes." Journal of Clinical Oncology 39, no. 28_suppl (October 1, 2021): 240. http://dx.doi.org/10.1200/jco.2020.39.28_suppl.240.
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240 Background: Oral chemotherapy usage has grown significantly over the years as it provides a more convenient and less invasive administrative option for patients.In 2019, 89% of large hospitals owned and operated their own Health System Specialty Pharmacies (HSSP)1.Pharmacist-led medication therapy management services are crucial to provide patient education, monitoring of medication adherence and adverse effect management. With the current vertical integration of health plans and pharmacy benefit managers (PBMs) increasing their dominance over specialty dispensing channels, HSSP are often excluded from specialty networks. The objective of this study is to compare outcomes of oncology patients filling their oral chemotherapy at Cedars Sinai Medical Center (CSMC) Specialty Pharmacy versus those who are filling their medications at outside specialty pharmacies (OSP). Methods: Electronic health records were used to conduct a retrospective chart review of patients started on oral chemotherapy at CSMC between January 2019 to January 2021. Primary endpoints included time to treatment (TTT) and proportion of days covered (PDC). Secondary endpoints included drug-related problems (DRPs) and treatment-related ED visits and hospitalizations. DRPs were categorized by severity and type of intervention. Results: There were 100 patients included in the study: CSMC group (n = 50) and OSP group (n = 50). Patients in the CMSC group had significantly shorter TTT compared to OSP group (4 days vs. 9.5 days, respectively [P < 0.0026]), as well as a higher PDC (99.5% vs 91%, respectively [P < 0.0005]). Pharmacists identified and resolved 31 DRPs in CSMC arm with 19 DRPs categorized as serious and 1 DRP categorized as life-threatening. For the OSP group, 23 preventable DRPs were identified with 12 DRPs categorized as serious and 1 DRP categorized as life-threatening. There were no treatment-related ED visits or hospitalizations in either group. Conclusions: Patients filling their oral chemotherapy at CSMC Specialty Pharmacy had significantly quicker TTT and higher adherence rates as measured by PDC. Numerous DRPs were identified for OSP patients; potential pharmacist-interventions could have led to optimized and safer medication therapy if filled at a HSSP. Continued research comparing treatment outcomes and interventions made between HSSP and OSP can create a strong argument for health plans and PBMs to consider inclusion of HSSPs into their specialty networks. References: Pedersen CA, Schneider PJ, Ganio MC, Scheckelhoff DJ. ASHP national survey of pharmacy practice in hospital settings: Prescribing and transcribing—2019. American Journal of Health-System Pharmacy. 2020;77(13):1026-1050. doi:10.1093/ajhp/zxaa104
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Samrin-Balch, Lamia, and Jessica Laxaman. "P50 Time and motion study to assess workload versus staffing at in paediatric hospital chemotherapy manufacturing unit." Archives of Disease in Childhood 105, no. 9 (August 19, 2020): e33.1-e33. http://dx.doi.org/10.1136/archdischild-2020-nppg.59.
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ObjectivesIn order to improve efficiency of the staff workload in the Paediatric Hospital Chemotherapy Manufacturing Unit, tasks conducted by the pharmacy staff were evaluated with their expected roles. The aims of this study were to establish an understanding of the workload at this unit and to develop a proposal for the unit to become technician-led.MethodsThe time taken to perform a pre-determined list of tasks by the senior pharmacy technician was recorded, collated, and compared to tasks performed by the pharmacist. This established the key activities that could be delegated from the pharmacist and the senior pharmacy technician to other members of staff. The findings were discussed with a focus group to establish the efficiency of the manufacturing unit and enable a proposal to be formed.Key findingsA substantial part of the pharmacist’s and senior pharmacy technician’s time was spent on activities which could be delegated to other members of staff of a lower pay band. The financial implication of this estimated that there would be a reduction of around £8,696.70 with the correct utilisation of the staff members. The pharmacists leading this manufacturing unit were spending most of their time on computing and training, therefore reducing the time available for them to focus on patient-facing clinical activities.ConclusionsThe current skill mix was highlighted as being inefficient, due to a lack of delegation from the pharmacists and senior pharmacy technician. A technician-led manufacturing unit can improve the focus of pharmacists on clinical tasks while reducing the cost of activities.ReferencesLord Carter of Coles. Operational productivity and performance in English NHS acute hospitals: unwarranted variations. An independent report for the Department of Health 2016; 10–11: 34–40.Willett MS BK, Rich DS, Ereshefsky L. Prospectus on the economic value of clinical pharmacy services. A position statement of the American College of Clinical Pharmacy. Pharmacotherapy 1989; 9:45–50.Barnett MJ, et al. Analysis of pharmacist-provided medication therapy management (MTM) services in community pharmacies over 7 years. J Manag Care Pharm 2009;15:18–31.Napier P, et al. Introducing a checking technician allows pharmacists to spend more time on patient-focused activities. Res Social AdmPharm 2018;14:382–386.
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Alomi, Yousef Ahmed, Saeed Jamaan Alghamdi, and Radi Abdullah Alattyh. "National Survey of Drug Information Centers practice: Leadership and Practice management at Ministry of Health Hospital in Saudi Arabia." Research in Pharmacy and Health Sciences in Volume 4, Issue 3: July 2018- September 2018 4, no. 3 (September 30, 2018): 497–503. http://dx.doi.org/10.32463/rphs.2018.v04i03.17.
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Objective: To explore the National Survey of Drug Information Centers practice in Saudi Arabia: Leadership and Practice management at Ministry of Health hospital. Method: It is a cross-sectional four months national survey of Drug Information Services at Ministry of Health hospital. It contained ten domains with 181 questions designed by the authors. It was derived from Internal Pharmaceutical Federation, American Society of Health-System Pharmacists best practice guidelines. This survey was distributed to forty hospital pharmacies that run drug information services. In this study, domain of Drug Monitoring and Patient Counselling System explored and analyzed. It consisted of eight questions about the written policy and procedure and application methods for Leadership and Practice management in the drug information centers. All analysis was done through survey monkey system. Results: The survey distributed to 45 of hospitals, the response rate, was 40 (88.88%) hospitals. The highest score of the DIC had policy and procedures with a clear mission, vision, and values were Evidence of valid Saudi Council of Health Specialties license to practice in Saudi Arabia did not exist in 3 (7.5%) hospitals while 30 (75%) of hospitals 100% applied the elements. The highest score of the Drug information centers had a space, adequate furniture, hours of operation were determined and announced as well as there was a qualified and licensed staffing. All Drug Information Centers staff had valid licenses from Saudi Commission for Health Specialties to practice in Saudi Arabia, did not exist in 6 (15%) hospitals while 30 (75%) of hospitals 100% applied the elements. The highest score of the Drug Information Centers Supervisor, reports workload statistics to the appropriate and leadership number of Full Time Employee staff and actual workload published was the answering question depends on the priority of the question did not exist in 6 (15%) hospitals while only 22 (55%) of hospitals 100% applied the elements. The highest score of the Drug Information Centers showed evidence of Quality Improvement, and the process for Drug Information Centers Networking. The reporting any questionable drug quality to Pharmacy director, did not exist in 4 (10 %) hospitals while only 25 (62.5%) of hospitals 100% applied the elements. Conclusion: There were an acceptable implementation leadership and practice management in drug information centers practice. The drug information centers workload analysis and quality management should improve. Drug information centers network indication required an implementation to improve the services at Ministry of Health hospital in Kingdom of Saudi Arabia.
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Shah, Sarit. "P042 Evaluation of ‘let’s talk medicines’ helpline." Archives of Disease in Childhood 104, no. 7 (June 19, 2019): e2.48-e2. http://dx.doi.org/10.1136/archdischild-2019-nppc.52.
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IntroductionStudies and research have shown that providing patient education through knowledge and counselling of the disease process and subsequent treatment empower patients and carers to improve patient’s health. Through understanding rationale for treatment, implications of non- compliance, non-adherence, disease progression and adverse effects of therapy, pharmacy staff are perfectly placed to empower patients and carers with evidence based knowledge and information to make their own educated decisions regarding therapy. The ‘Let’s Talk Medicines’ telephone service was set up in 2015 for exactly this purpose. It is a dedicated medicines information (MI) service aimed at patients, parents and carers, giving the opportunity to ask questions and obtain advice from specialist paediatric pharmacists about their child’s medicines once leaving the hospital. The services have vastly expanded over the last 2 and half years with the addition of an email address as an alternative means for contact. The helpline number and email address are heavily publicised to parents and carers through posters throughout the hospital, details published on all paediatric discharge summaries and printed information cards given to all outpatients during counselling.AimTo evaluate the service progression by analysing the sheer volume and types of queries over the last 3 years to identify how beneficial the novel service has proven to be.MethodsTo retrospectively analyse data from 3 monthly reports over the last 2.5 years of the service to identify number of calls, emails, types of queries received and users of the service.ResultsThe current service relies on all members of the pharmacy team answering calls on a dedicated patient line on an ad-hoc basis with several specialist pharmacists reviewing queries on a daily basis. Average call durations were between 5 to 8 minutes with more complex queries requiring in depth data search taking up to 30 minutes. All queries are logged on paper and then reviewed on a monthly basis as they are entered onto a database. Since the introduction of the service, the volume of calls received has increased by more than 50% with average of 35 per month in 2015 and 54 in 2017. Originally, the service was designed primarily for patients, parents and carers. Due to the increased recognition, the service has now been expanded to a variety of internal and external healthcare professionals, community practitioners and pharmacies, drug companies, commissioning staff, researchers and students. The types of queries range from supply issues, procurement of unlicensed medicines, to adverse effects, administration advice and complex pharmaceutical queries.ConclusionThe service has grown and developed with focus based around improving patient care, medication adherence and minimising medicines related risks. Through providing accurate, up-to-date and evidence based information its appeal has reached a wider audience including healthcare professionals. Combined with an increase in the number of calls and technological advances, a new email service has been rolled out in 2017, as an alternate means to contact the service. Direct comments from users of the service has shown positive feedback and trust.
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Carson-Stevens, Andrew, Peter Hibbert, Huw Williams, Huw Prosser Evans, Alison Cooper, Philippa Rees, Anita Deakin, et al. "Characterising the nature of primary care patient safety incident reports in the England and Wales National Reporting and Learning System: a mixed-methods agenda-setting study for general practice." Health Services and Delivery Research 4, no. 27 (September 2016): 1–76. http://dx.doi.org/10.3310/hsdr04270.
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BackgroundThere is an emerging interest in the inadvertent harm caused to patients by the provision of primary health-care services. To date (up to 2015), there has been limited research interest and few policy directives focused on patient safety in primary care. In 2003, a major investment was made in the National Reporting and Learning System to better understand patient safety incidents occurring in England and Wales. This is now the largest repository of patient safety incidents in the world. Over 40,000 safety incident reports have arisen from general practice. These have never been systematically analysed, and a key challenge to exploiting these data has been the largely unstructured, free-text data.AimsTo characterise the nature and range of incidents reported from general practice in England and Wales (2005–13) in order to identify the most frequent and most harmful patient safety incidents, and relevant contributory issues, to inform recommendations for improving the safety of primary care provision in key strategic areas.MethodsWe undertook a cross-sectional mixed-methods evaluation of general practice patient safety incident reports. We developed our own classification (coding) system using an iterative approach to describe the incident, contributory factors and incident outcomes. Exploratory data analysis methods with subsequent thematic analysis was undertaken to identify the most harmful and most frequent incident types, and the underlying contributory themes. The study team discussed quantitative and qualitative analyses, and vignette examples, to propose recommendations for practice.Main findingsWe have identified considerable variation in reporting culture across England and Wales between organisations. Two-thirds of all reports did not describe explicit reasons about why an incident occurred. Diagnosis- and assessment-related incidents described the highest proportion of harm to patients; over three-quarters of these reports (79%) described a harmful outcome, and half of the total reports described serious harm or death (n = 366, 50%). Nine hundred and ninety-six reports described serious harm or death of a patient. Four main contributory themes underpinned serious harm- and death-related incidents: (1) communication errors in the referral and discharge of patients; (2) physician decision-making; (3) unfamiliar symptom presentation and inadequate administration delaying cancer diagnoses; and (4) delayed management or mismanagement following failures to recognise signs of clinical (medical, surgical and mental health) deterioration.ConclusionsAlthough there are recognised limitations of safety-reporting system data, this study has generated hypotheses, through an inductive process, that now require development and testing through future research and improvement efforts in clinical practice. Cross-cutting priority recommendations include maximising opportunities to learn from patient safety incidents; building information technology infrastructure to enable details of all health-care encounters to be recorded in one system; developing and testing methods to identify and manage vulnerable patients at risk of deterioration, unscheduled hospital admission or readmission following discharge from hospital; and identifying ways patients, parents and carers can help prevent safety incidents. Further work must now involve a wider characterisation of reports contributed by the rest of the primary care disciplines (pharmacy, midwifery, health visiting, nursing and dentistry), include scoping reviews to identify interventions and improvement initiatives that address priority recommendations, and continue to advance the methods used to generate learning from safety reports.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Abad-Sazatornil, María Reyes, Ainhoa Arenaza, Juan Bayo, Jesus García Mata, José María Guinea De Castro, Josefa León, Javier Letellez, Virginia Reguero, Carmen Martínez Chamorro, and Antonio Salar. "Impact of the subcutaneous formulations of trastuzumab and rituximab on efficiency and resource optimization in Spanish hospitals: H-Excelencia study." BMC Health Services Research 21, no. 1 (April 8, 2021). http://dx.doi.org/10.1186/s12913-021-06277-8.
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Abstract Background Subcutaneous (SC) versus intravenous (IV) administration is advantageous in terms of patient convenience and hospital efficiency. This study aimed to compare the effect of optimizing the processes involved in SC versus IV administration of rituximab and trastuzumab on hospital capacity and service quality. Methods This cross-sectional resource utilization study interviewed oncologists, hematologists, nurses, and pharmacists from 10 hospitals in Spain to estimate changes in processes associated with conversion from IV to SC rituximab and trastuzumab, based on clinical experience and healthcare use from administrative databases. Results Efficient use of SC formulations increased the monthly capacity for parenteral administration by 3.35% (potentially increasable by 5.75% with maximum possible conversion according to the product label). The weekly capacity for hospital pharmacy treatment preparation increased by 7.13% due to conversion to SC formulation and by 9.33% due to transferring SC preparation to the cancer treatment unit (potentially increasable by 12.16 and 14.10%, respectively). Monthly hospital time decreased by 33% with trastuzumab and 47% with rituximab. In a hypothetical hospital, in which all processes for efficient use of SC rituximab and/or trastuzumab were implemented and all eligible patients received SC formulations, the estimated monthly capacity for preparation and administration increased by 23.1% and estimated hospital times were reduced by 60–66%. Conclusions Conversion of trastuzumab and rituximab to SC administration could improve the efficiency of hospitals and optimize internal resource management processes, potentially increasing care capacity and improving the quality of care by reducing time spent by patients at hospitals.
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Newman, Paula, Sammu Dhaliwall, Olena Polyakova, and Kevin McDonald. "Pharmacy Distribution, Clinical, and Management Services: A Survey of Small Hospitals in Canada Supported by Telepharmacy Services." Canadian Journal of Hospital Pharmacy 74, no. 3 (July 5, 2021). http://dx.doi.org/10.4212/cjhp.v74i3.3153.
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Background: The Canadian Society of Hospital Pharmacists’ Hospital Pharmacy in Canada Report presents data from pharmacy departments that service hospitals with at least 50 acute care beds. This report provides valuable data on pharmacy distribution, clinical, and management services in relation to hospital size, type, and geographic region. Pharmacy and hospital leadership use these extensive data in identifying baseline, benchmarking current, and planning enhanced pharmacy services. However, for most of Canada’s small hospitals, such data remain unknown, and leadership remains uninformed. Objective: To gather and analyze data about current pharmacy distribution, clinical, and management services in hospitals with fewer than 50 acute care beds receiving third-party remote pharmacy (telepharmacy) services. Methods: In April 2019, pharmacy administrators of hospitals in Ontario, Quebec, and Saskatchewan that had fewer than 50 acute care beds and were using third-party telepharmacy services were invited to complete a comprehensive survey addressing concepts similar to those in the Hospital Pharmacy in Canada Survey. The following data on clinical pharmacy practice were collected: models of care, assignments to patient care programs, pharmacists’ activities, performance indicators, and professional evaluation. The description of pharmacy distribution services comprised type of system, technology, location, hours of operation, method of medication order entry and verification, and medication administration records. Details on facilities’ parenteral admixture infrastructure, policy for and provision of sterile compounding, and pharmacy department human resources, including composition and staffing ratios, were also collected. Results: Of the 27 hospitals in Ontario, Quebec, and Saskatchewan that were invited to participate, 24 (89%) completed the survey. The median facility size was 19 acute care beds. Conclusions: Previously unavailable in Canada, these quantitative data from small hospitals supported by telepharmacy services provide facts about pharmacy distribution, clinical, and management services to inform hospital and pharmacy leaders. Creation of a survey unique to small hospitals, whether or not they use telepharmacy services, could provide a valuable resource to assist in the benchmarking, planning, and enhancement of pharmacy services in remote and rural communities. RÉSUMÉ Contexte : Le Rapport sur les pharmacies hospitalières canadiennes de la Société canadienne des pharmaciens d’hôpitaux expose les données provenant des services de pharmacie qui appuient les hôpitaux comptant au moins 50 lits de soins aigus. Il offre de précieuses données sur les services de distribution des médicaments, les services cliniques et de gestion en relation avec la taille, le type et la région géographique des hôpitaux. Les équipes de direction des pharmacies et des hôpitaux utilisent ces données exhaustives pour déterminer une base de référence, évaluer les services de pharmacie actuels et planifier l’amélioration des services. Cependant, la plupart des petits hôpitaux du Canada ne disposent pas de ce type de données, et les équipes de direction n’en sont pas informées. Objectif : Réunir et analyser des données sur la distribution de médicaments, les services cliniques et la gestion des services pharmaceutiques actuels dans les hôpitaux comptant moins de 50 lits de soins aigus, qui reçoivent des services de pharmacie à distance (services de télépharmacie) fournis par des tiers. Méthode : En avril 2019, les administrateurs de pharmacie d’hôpitaux en Ontario, au Québec et en Saskatchewan remplissant ces critères ont été invités à répondre à une enquête exhaustive abordant des concepts similaires à ceux de Sondage sur les pharmacies hospitalières canadiennes. Les données suivantes sur la pratique de la pharmacie clinique ont été recueillies : modèles de soins, affectation des pharmaciens à des programmes particuliers de soins des patients, activités des pharmaciens, indicateurs de performance et évaluation professionnelle. La description des systèmes de distribution des médicaments par les pharmacies comprenait : le type de système, la technologie, le lieu, les heures de service, le mode de saisie et de vérification des ordonnances de médicaments ainsi que les dossiers d’administration. Les détails concernant l’infrastructure pour l’administration de solutions parentérales, la politique relative aux composés stériles et à leur distribution ainsi que les ressources humaines des services de pharmacie, y compris la composition et les ratios en personnel, ont également été recueillis. Résultats : Sur les 27 hôpitaux en Ontario, au Québec et en Saskatchewan invités à participer à l’enquête, 24 (89 %) y ont répondu. La taille moyenne des installations était de 19 lits de soins aigus. Conclusions : Autrefois indisponibles au Canada, ces données quantitatives provenant de petits hôpitaux soutenus par des services de télépharmacie livrent des faits concernant le système de distribution des médicaments au sein des pharmacies, les services cliniques et de gestion, qui permettent de guider les cadres des hôpitaux et de la pharmacie. La création d’une enquête unique destinée aux petits hôpitaux, utilisant ou non des services de télépharmacie, pourrait constituer une précieuse ressource pour aider à évaluer, à planifier et à améliorer les services pharmaceutiques dans les communautés rurales et éloignées.