Hospital Pharmacy Management

hospital pharmacy managers oversee the operations of the pharmacy department that provides service 24/7 regardless of the ...

hours of operation

managers ensure that quality ____________________________ services are provided according to accreditation, legal requirements and professional standards

pharmaceutical

the role of the hospital pharmacy is to provide at all times an ______________ supply of safe, effective, and quality ___________________ in appropriate ___________ forms consistent with the needs of the _____________

adequate; medications; dosage; patients

the role of the hospital pharmacy includes rationalizing drug ______________________ in collaboration with the medical staff

utilization

the goals for the hospital pharmacy service and the manager include: to provide the benefits of a qualified hospital _____________________ to patients and to the allied health professionals and institution

pharmacist

the goals for the hospital pharmacy service and the manager include: to assure a high quality of professional practice through establishment and maintenance of standards of professional __________, education, and attainment and promotion of _____________________ welfare

standards; economic

the goals for the hospital pharmacy service and the manager include: to promote ___________________ in hospital pharmacy practice

research

the goals for the hospital pharmacy service and the manager include: to disseminate pharmaceutical knowledge by providing an __________________ of information among hospital pharmacists and members of a ____________________________ team

exchange; multidisciplinary

responsibilities of a hospital pharmacy manager: effective ________________________ and management of a pharmaceutical service in a hospital

administration

responsibilities of a hospital pharmacy manager: development and provision of _______________-oriented services

patient

responsibilities of a hospital pharmacy manager: maintenance of the hospital ___________________ through the pharmacy and therapeutics committee

formulary

responsibilities of a hospital pharmacy manager: medication management and ________________ management

budget

________________ tasks of a pharmacy manager include scheduling, operational/clinical situations, drug movement/inventory discrepancies, drug shortages, occurrence reports, technology downtimes, hiring for open positions

daily

is hiring for open positions a daily or monthly task?

daily

_________________ tasks of a pharmacy manager include staff development, staff discipline (union vs. non-union), strategic planning, budget review (flexible budgets, variance review), facility review

monthly

_______________ concerns of the pharmacy manager include the Joint Commission, Center for Medicaid & Medicare (CMS), Board of Pharmacy, Drug Enforcement Agency (DEA), Department of Public Health (DPH), Office of the inspector general (compliance), Health Resources and Services Adm (HRSA), USP 795, 797, 800, Human Resources (HR) - Payroll, Discipline, FMLA

regulatory

every business has an _____________________________ chart

organizational

every business has an organizational chart - defines who reports to which "___________________", defines ________ of responsibility, maps out structure for _______________ solving

manager; scope; problem

the larger the organization - the larger the organizational chart - a small community hospital with 3 FTE pharmacists - the _____________ of pharmacy may enter orders, a large academic hospital manager will most likely not enter any orders

director

the pharmacy reports to someone in the ___-Suite

C

the pharmacy reports to someone in the C-Suite like the ________ _________________ of Operations, the Chief _____________ Officer, the Chief ______________ officer

vice president; medical; nursing

other C-Suite members include the _______, COO, ________, and CIO

CEO; CFO

a ___________________________ service encompasses everything that is within the control of the hospital pharmacy department, including clinical services, drug distribution, drug information, investigational drug services, medication safety, drug disposal, formulary management

pharmaceutical

effective administration and management of a pharmaceutical service involves being totally familiar with the entire health care system and the specific ___________________ of the hospital

functions

effective administration and management of a pharmaceutical service - must consider the physical _______________ of the pharmacy department and the entire facility

layout

effective administration and management of a pharmaceutical service - requires organization of the hospital pharmacy ________________________, requires an up-to-date manual of _________________ and ____________________________ as well as continuous __________________ and competency assessment

personnel; policies; procedures; training

patient-oriented services - requires developing and maintaining a wide spectrum of ________________ __________________ geared toward your patient population

clinical services

patient-oriented services - some of these services are not geared toward __________ _________________________ activities (anticoagulation clinic, pain clinic, heart failure clinic, etc.)

drug dispensing

patient-oriented services - fundamental to these services is the pharmacist's knowledge of _________, ______________ states, ____________ variables, and the ability to _______________ routinely with other health care professionals and patients

drugs; disease; patient; interact

development and provision of patient-oriented services - academic training in ________________, _________________________, and __________________ as well as clinical experience provide the background for a pharmacist to provide patient-oriented services (post graduate education, professional experience, research interests)

toxicology; pathophysiology; therapeutics

all of the following are examples of ______________-________________ services: heart failure service, antibiotic stewardship services, surgical intensive care service, cardiac intensive care service, pediatric inpatient service, solid organ transplant service, oncology service, medical intensive care service, drug information service, medication safety service

patient-oriented

maintenance of the hospital formulary through the ___ & ____ committee

P; T

maintenance of the hospital formulary through the P & T committee: the committee promotes the ___________________ use of medications through the development of ________________ policies & procedures for: medication selection, procurement, distribution, pharmacy and staff education, response to medication shortages, therapeutic substitutions

rational; rational

maintenance of the hospital formulary through the P & T committee: the committee promotes the rational use of medications through the development of rational policies & procedures for: medication _________________, ____________________, ____________________, pharmacy and staff _________________, response to medication _______________, therapeutic ___________________

selection; procurement; distribution; education; shortages; substitutions

the manager's role is to ensure that routine ______________ about which medications to buy, how many, and from what source are appropriately made

decisions

the manager's role is to focus on _________-term planning and policies for improving safe and cost-effective use of _______________________

long; medications

the manager's role is to ensure appropriate membership on the P & T committee including _______________ staff, pharmacy, ________________, hospital ______________________________, and _________________ assurance staff

medical; nursing; administration; quality

ultimately the responsibility and goal of the pharmacy manager is: to conserve resources by limiting the ____________________, to eliminate generic and therapeutic ______________________ and to minimize the number of _________________ stocked of the same medication; to select medications for the formulary based on ____________ and conditions treated at the facility, to specify formulary medication of choice for common therapeutic _________________________

formulary; duplication; strengths; diseases; indications

hospital formulary management - to include second-line _________________ to medications of choice as needed while minimizing therapeutic ________________________

alternatives; duplication

hospital formulary management - to ensure that the hospital _________________ corresponds with any national and regional standard treatment guidelines formally approved by the health system

formulary

hospital formulary management - to ensure based practices and _________________-based practices are adhered to

evidence

the P & T committee's basic functions include: ensuring that the national ________________ medicines list and local ___________________ are used appropriately in the facility (check the WHO website for lists)

essential; formularies

the P & T committee's basic functions include: ________________________ national standard treatment guidelines and ___________________ institution specific treatment guidelines for common diseases and medical conditions

disseminating; developing

the P & T committee's basic functions include: conducting medication use evaluations (MUE) and conducting facility-based ________________________________________ activities

pharmacovigilance

the P & T committee monitors medication usage at the facility, provides ______________________ to hospital staff, monitors medication ____________ and ____________ drug events and implements ____________ changes to minimize events; development, approval, and monitoring of all therapeutic substitution, restricted drug and non-formulary medication use policies

education; errors; adverse; systems

_________ ______________________ has historically been the primary function of the hospital pharmacy

drug distribution

most hospitals utilize __________________ dispensing systems along with a system for distributing patient specific unit dose/unit of use medications

automated

challenges to medication _________________________ increase exponentially along with increases in the size of the institution

management

true or false: challenges to medication management INCREASE with increase in size of the institution

true

inpatient medication management includes routine (at least monthly) _______________________ of all medication storage areas throughout the hospital in order to monitor expiration dates, refrigerator temperature logs, stock levels, patient specific medications and pharmacy returns

inspections

inpatient medication management may include _______-hours medication distribution policies and procedures as well as an ___-______ pharmacy service to cover emergent situations

after; on-call

the Joint Commission required _____________________ order review by a pharmacist prior to the administration of medications in a ______________ setting

prospective; hospital

significant number of drug ________________ that impact the hospital pharmacy

shortages

causes of drug shortages include reduced ___________ on generic IV drugs, ____________________________ generic manufacturers in industry, ________ market (no requirement to make drugs), 80% of raw ingredients for IV drugs from ________________

profit; consolidated; free; overseas

non-sterile product compounding is most often for a ___________________ form or _________________________ that is not commercially available

dosage; concentration

sterile product compounding occurs in the ____________ room and must meet all USP ______ standards. Compliance is a focus of the Joint Commission Survey

clean; 797

policies and procedures as well as all levels of accountability for compounding are the ______________________'s responsibility

manager

_______________ management is one of the most critical responsibilities of the hospital pharmacy manager, with the largest ______________ lines being drug and HR costs

budget; budet

largest budget lines are the ________ budget and costs of _____________ _______________

drug; human resources

_________________ management is most likely the main responsibility that the manager's performance is evaluated on

budget

many other aspects of the ____________________ management are delegated to supervisors, lead pharmacists, clinical specialists, though the pharmacy director or manager is ultimately accountable

operational

the do more with ________ philosophy is prevalent in this practice area

less

true or false: there is often no backup when staffing issues occur

true

HR issues include the difficulty to hire qualified pharmacists/techs, no backup when staffing issues occur, and you need 24/7 coverage including ____________________ and overnights

holidays

HR issues include continuous ___________________ as well as competency assessment documentation

education

HR issues - _______________ includes multiple levels of educational and professional requirements

staffing

HR challenges include scheduling, performance evaluations, progressive ____________________, cross-discipline relationships, per-diem staff, and ______________________________ within and outside of the department

discipline; communication

___________________ ___________________ are stored in the pharmacy and in the patient care areas in the automated dispensing units including the inpatient, outpatient, and procedure rooms

controlled susbtances

true or false: controlled substances are stored only in the pharmacy in the hospital

false

true or false: CSs can be stored in the pharmacy and in automated dispensing units in inpatient, outpatient, and procedure rooms

true

one missing dosage unit of the controlled substance requires _________________________ and immediate ________________________ to the DPH and the BOP

investigation; notification

discrepancy resolution of CSs occurs ____________ and is performed by pharmacy staff as well as nursing, anesthesiologists, and physicians

daily

the most unique aspects of hospital pharmacy management include that the manager may report to someone without any _________________ background, the manager with most often interact with healthcare professionals _______________ of pharmacy, the manager will spend more time focusing on satisfying outside _____________________ than the pharmacy staff, the manager is responsible for systems that cross many ________________________, and regulatory bodies differ as well as _____________________ bodies

pharmacy; outside; customers; disciplines; accrediting

the advantages of practicing in a hospital pharmacy environment are multidisciplinary practice, based on best practices and ________________-based medicine, constant _________________ environment, level of professionalism, and ________________ ladder (staff pharmacist up to director)

evidence; learning; career

how to become part of a pharmacy management team - show off your _________________________ skills, volunteer for opportunities, demonstrate great ________________ with everyone, invest extra time; look for additional __________________ like ASHP or HR programs, committee work in pharmacy organization

leadership; teamwork; training