HOSPITAL PHARMACY

Administrator

implements the policies and philosophies of the governing board

Department Heads

coordinate their services and activities with other department heads

Business and Accounting Department

handles the financial affairs

Building Services Department

provides essential maintenance, housekeeping and security functions

Personnel Department

implements personnel policies

Clinical Laboratory Department

performs a multitude of patient laboratory tests and services

Accreditation agencies

exert their influence on professional standards of practice as they affect patient care

Licensing Agencies

exert their legal influences on hospital operation

Federal Government

imposes standards on regulations on hospitals, such as the "conditions of Participation for Hospitals" under Medicare

Third-party (Hospitalization insurance) Agencies

exerts their influence on the methods by which hospitals may be reimbursed for services rendered to patients

Social Agencies and Governmental Welfare Agencies

exert their influences over the policies, objectives and philosophies of hospital operation and services

Patient care

modern hospital is charged with maintaining and restoring health to its community

Teaching/Education

an important function of the modern hospital, whether it is or is not affiliated with a university

Research

hospitals carry out research as a vital function for two major purposes

Public Health

prime objective is to assist the community in reducing the incidence of sickness and to increase the general health of the population

Partially

total medical indigent (charity) patient

Proprietary or Private Hospital Organized for Profit

corporation composed of physicians, although paying patients or by contributions from the several

Institution

centers on a fundamental human need, activity or value, occupies an enduring and cardinal position within a society, and is usually maintained and stabilized through social and regulatory agencies

institutional Pharmacy Practice

Provision of distributional and clinical pharmacy services in a broad range of institutional settings (hospitals, long-term care, hospices, correctional facilities)

Clinical Pharmacy

practice of pharmacy in a hospital setting including its organizationally related facilities or services

AHA (American Hospital Association)

has specific definitions for "General" and "Special" hospitals in order for these institutions to qualify for the association's registration program

contemporary hospital

community institution which is an instrument of society; serves as the focal point for the coordination and delivery of patient care to its community

Greek temples

forerunners of the modern hospitals: provided refuge and treatment and provided for the teaching of young medical students

Temple of Aesculapius

Greek God of Medicine

temple at Kos, Greece

Hippocrates

first hospital on the American Continent

built by the Spaniards (led by Cortez) in 1524

Hospital of the Immaculate Conception

in the Mexico City

Hospital of Jesus of Nazareth

changed name of Hospital of the Immaculate Conception

Types of services

General and Special Hospital

General hospital

provides care to patients with any type of illness: medical, surgical, pediatric, psychiatric

Special hospital

those which restrict the care they provide to special conditions, such as cancer, psychiatric, or pediatric cases

Length of stay

short term and long term hospital

Short term

<30 days of stay; patients with acute disease conditions

Long term

>30 days of stay; psychiatric or mental retardation conditions

According to ownership

governmental hospital & non-governmental hospitals (proprietary/private)

Non profit

church related or operated; other profit(NGO)

Large hospital

1000 and above beds

Medium hospital

between 500-1000 beds

Small hospital

between 100-500 bed

Very small hospital

bed less than 100

Federal hospital

renowned and operated by various branches of federal government.

Regional hospital

owned by the state and controlled by a board of control or division of the state government, or a similar organization responsible to state government

Provincial hospital

owned by the county and are financed and controlled similarly to state hospitals, only on a county level; general hospital caring for the indigents

City hospital

owned, financed, and controlled by the city government. They are usually general hospital caring for the indigents

Proprietary or Private hospital Organized for profit

corporation composed of physicians, although other businessmen may be involved in the corporate profit-making structure

Non-profit, nongovernmental grouping of hospitals

supported financially by fees from paying patients or by contributions from the several religious orders or churches

Community hospitals

private non-profit hospitals; owned and operated by members of the community, but with no relationship to the local government

Patient care

e modern hospital is charged with maintaining and restoring health to the community which it serves

Teaching/Education

important function of the modern hospital whether it is or it is not affiliated with a university

Research

hospitals carry out research as a vital function

Public Health

prime objective is to assist the community in reducing the incidence of sickness and to increase the general health of the population

Local SOP

ISO 9001 standards, PhilHealth Benchbook, Occupational Safety and Health Administration (OSHA)

American College of Surgeons

initiated its Hospital Standardization Programme

Joint Commission International

Establishes standards and provides accreditation services for other components of health care delivery including, home care, ambulatory care, behavioral health care organizations, as well as hospitals

Governing body

where the administrator, director, medical director or whatever the individual is titled must report.

Medical staff

falls in a different category organizationally than the departments listed previously

Honorary staff

active but retired; desired to do honor because of outstanding contribution

Consulting Medical Staff

specialists by right of passing specialty boards

Active or attending medical staff

group primarily concerned with regular patient acre.

Associate Medical Staff

composed of junior or less experienced members of the staff

Courtesy Medical Staff

who desire the privilege of attending private patients but who do not desire active staff membership

Resident medical staff

composed of residents, who are full time employees of the hospital

Open staff

other than those on the attending or active medical staff are allowed to utilize the private room facilities; "courtesy"; open staff hospital

Closed staff hospital

professional services, private and charity are provided and controlled by the attending or active medical staff; closed staff hospital; more desirable for the average hospital

HMO

public or private organization; provides and or manages comprehensive health services to individuals enrolled in the HMO of the health plan

Hospital Pharmacy

separation of pharmacy from medicine took place in charitable institutions operated under governmental or ecclesiastical authority

division of labor in the physician-apothecary

led to the recognition of pharmacy as a separate discipline from medicine

Jonathan Roberts

Pennsylvania Hospital

Charles Rice

Bellevue hospital in New York City

Martin I Wilbert

German Hospital in Philadelphia

Clinical Pharmacy

Responsible for the safe and appropriate use of drugs in patients, including the rational selection, monitoring, dosing, and control of the patient's overall drug therapy program

Organization

organizational structure of the hospital the director of pharmacy, as a department head, reports to the Hospital administrator

Director of pharmacy

formulates and implements departmental administrative and professional policies of the pharmacy subject to the approval of the administrator

Pharmacy and Therapeutics Committee

advisory group of the medical staff which serves as the organizational line of communication between the medical staff and pharmacy department; policy recommending body to the medical staff and the administration of the hospital

PTC general role

optimize the rational use of medicines by evaluating the clinical use of pharmaceuticals, developing the policies for managing medicine use and administration and managing the formulary system

Advisory PTC

committee recommends the adoption of, or assists in the formulation of, broad professional policies regarding evaluation, selection and therapeutic use of drugs in hospitals

Educational PTC

recommends or assists in the formulation of programs assigned to meet the needs of the professional staff (physicians, nurses, pharmacists and other health care practitioners) for complete current knowledge on matters related to drugs and drug use

Formulary Drug

FDA approved drug which is recommended as being essential for good patient care with a well-established usage

Specialized formulary drug

FDA approved drug which is recommended for use in specialized patient care

Investigational Drug

which has been approved by the FDA for a specific use by its principal investigator and designated associates; not commercially available

Non-formulary drugs

drugs which do not qualify for the four categories listed and will not be stocked in the pharmacy

Drug recall

emanate from manufacturers, regulatory agencies, or the Pharmacy Department, and may be of a general nature or a specific recall for one or more lot numbers

Routine drug orders

physician's medication order written on an inpatient order form is deemed a legal prescription

IV orders

Orders for intravenous medications must be written in the same manner as routine drugs

Total Parenteral Nutrition

designed to serve as a nutritional infusion providing essential amino acids, carbohydrates, and electrolytes for patients incapable of ingesting, digesting, or absorbing food substances given by mouth

Self Medication

Only Nitroglycerin and antacids may be left at the patient's bedside for self administration if so ordered by the physician

Quantity of nitroglycerin

limited to 10 tablets

Automatic stop orders

Applies to instances when the physician did not specify the exact number of doses or duration of therapy

Discharge prescriptions

separate prescription is required for each medication which the patient is to take home

Emergency (STAT) Orders

Bonafide emergency orders should be rare and obtained from the nursing station emergency drug supplies

Computerized Physician order entry

variety of computer-based systems that share the common features of automating the medication ordering process and that ensure standardized, legible, and complete orders

Emergency Kit/Kart or Stat Boxed

Contains drugs and supplies readily available in case of emergencies

TPN

essential amino acids, carbohydrates, and electrolytes

Unit dose dispensing system

contained in single unit packages and are dispensed in ready-to-administer form as possible; not more than a 24 hour supply

Centralized Unit Dose Distribution System

all drugs are stored in a central area pharmacy

Decentralized Unit Dose Drug Distribution System

operates through satellite pharmacies

Satellite Pharmacies

sub-pharmacies that receive their supplies from the main pharmacy

Rectal Medication Administration

should be firm, not soft and may need to be moistened with water-soluble lubricant for ease of insertion

Transdermal products

method of topically administered drugs such as nitroglycerin into the bloodstream for a sustained period of time

Sublingual tablet

method of topically administered drugs such as nitroglycerin into the bloodstream for a sustained period of time