Hospital Pharmacy

Module 3: Hospital Pharmacy for Licensure Exam

Institution

a significant and persistent element (as a practice, a relationship, an organization) in the life of a culture that 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, including hospitals, long-term care, hospices, correctional facilities, and others.

Hospital

A place where sick and injured people are being attended to & cared for

Hospital

A place devoted primarily to the maintenance and operation of health facilities for the diagnosis, treatment, and care of individuals suffering from illness, disease, injury, or deformity, in need of obstetrical and other surgical, medical, and nursing care

Requirements for Accepting Special Hospitals for Registration

special diets shall also be available

Requirements for Accepting Special Hospitals for Registration

When the institution provides pregnancy termination services, clinical laboratory services shall include the capability to provide tissue diagnosis

Requirements for Accepting General Hospitals for Registration

The institution shall maintain clinical laboratory service. Anatomical pathology services shall be regularly and conveniently available.

Requirements for Accepting General Hospitals for Registration

The institution shall maintain diagnostic X-ray service

Contemporary Hospital

a community institution that is an instrument of society

Contemporary Hospital

serves as the focal point for coordinating and delivering patient care to its community

coordinated system

A hospital may be viewed as an organized structure that pools together all the health professions, diagnostic and therapeutic facilities, equipment and supplies, and physical facilities into a ___________ for delivering health care to the public.

Indian and Egyptian culture

Hospitals originated in __________ during the sixth century B.C.

temples of the gods in early Greek and Roman civilizations

used as hospitals where healing was associated with divine power

Greek temples

forerunners of the modern hospitals in the sense that they provided refuge and treatment for the sick and also provided for the teaching of young medical students

Temple at Kos, Greece

where Hippocrates (born about 460BC) practiced

Temple of Aesculapius

Greek God of medicine

Hospital of the Immaculate Conception in the Mexico City

first hospital on the American Continent

The Hospital of Jesus of Nazareth

The Hospital of the Immaculate Conception in the Mexico City was later changed to:

Spaniards

who built the first hospital on the American Continent

Type of service, length of stay, according to ownership, and bed capacity

Hospitals are classified by:

Clinical Pharmacy

responsible for the safe and appropriate use of drugs in patients, which includes among other things, the rational selection, monitoring, dosing and control of the patients overall drug therapy program

lack of purity

Continued illness or death was associated with:

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 the essential maintenance, housekeeping, and security functions

Personnel Department

implements personnel policies

Clinical Laboratory Department

performs a multitude of patient Laboratory tests and services

organizational structure of a hospital/institution

Internal forces or a major factor affecting the practice of pharmacy in the hospital setting

Accreditation Agencies

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

Licensing Agencies

exert their legal influences on hospital operations

Federal Government

imposes standards and regulation 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

AHA (American Hospital Association)

has specific definitions for “General” and “Specific” hospitals in order for these institutions to qualify for the association’s registration program

General hospital

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

Special hospital

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

Short-term hospital

one which the average length stay of the patient is less than 30 days

Long-term hospital

one in which the average length stay of the patient is 30 days or longer

Nonprofit nongovernmental hospitals

Church related or operated

For profit nongovernmental hospitals

Individual, partnership, or corporation

Federal hospitals

a renowned and operated by various branches of federal government

State hospitals

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

County hospitals

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

City hospitals

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

Proprietary or Private Hospital Organized for Profit

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

Non-Profit, Nongovernmental Grouping of Hospitals, Some are Church Hospitals

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

Community Hospitals or Private Non-Profit Hospitals

owned and operated by members of the community, but with no relationship to the local government

Large hospital

bed capacity 1000 and above

Medium hospital

bed capacity between 500 -1000

Small hospital

bed capacity between 100-500

Very small hospital

bed less than 100

Level 1

Emergency and out-patient services

Level 1

Isolation facilities

Level 1

Surgical / Maternity facilities

Level 2

Departmentalized clinical services

Level 2

Respiratory unit

Level 2

General ICU

Level 2

High risk pregnancy unit

Level 2

NICU

Level 2

Dental clinic

Level 3

Teaching/training with at least any two accredited residency training programs

Level 3

Physical medicine and rehabilitation unit

Level 3

Ambulatory surgical clinic

Level 3

Dialysis clinic

Level 3

Blood bank

Level 3

3rd level x-ray

Level 2

2nd level x-ray with mobile unit

Level 1

1st level x-ray

Level 1

Pharmacy

Custodial care facility

Sanitarium/Leprosarium

Custodial care facility

Nursing home

Diagnostic/Therapeutic facility

Nuclear medicine

Specialized out-patient facility

In-vitro fertilization (IVF) centers

Specialized out-patient facility

Radiation oncology facility

Specialized out-patient facility

Oncology center/clinic

Patient care

the 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

• the advancement of medical knowledge against diseases

• the improvement of hospital services

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

• education of the medical and allied health professionals

• education of the patient

two major forms of teaching/education:

Public health

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

The American College of Surgeons

Accreditation of hospitals began in 1918 when ___________ initiated its Hospital Standardization Programme.

Joint Commission on Accreditation of Hospitals (JCAH)

The American College of Surgeons Hospital Standardization program was assumed by the _________ in 1951.

Joint Commission on Accreditation of Healthcare Organizations (JCAHO)

The JCAH transitioned to a broader scope accreditation and, in 1988, changed its name to the __________.

Joint Commission International (formerly JCAHO)

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

Governing body

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

CEO (Chief Executive Officer)

Duties of the Governing Board are performed through the:

• Selection of competent personnel, including the medical staff

• Control of hospital funds

• Supervision of the physical plant

Duties of the governing body

• Services involve primarily the professional care of the patient:

• Services that involve primarily the business management or administrative side of the hospital

• Clinical Division

Classification of hospital departments

Physicians

independent agents taking care of their patients, and they utilize the hospital, its departments, facilities, and services to care for these patients

Honorary stuff

composed of physicians who have been active in the hospital but who are retired, and of those to whom it is desired to do honor because of outstanding contribution

Consulting medical staff

consists of specialists who are recognized as such by the right of passing specialty boards or belonging to the rational organization of their specialty and who serve as consultants to other members of the medical staff

Active or Attending medical staff

the group primarily concerned with regular patient care. It is the group most actively involved in the hospital

Active or Attending medical staff

authoritative body in the internal staff government

Associate Medical Staff

comprises junior or less experienced staff members

Courtesy medical staff

consists of those physicians 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. These persons provide specific services for which they receive education & experiences

Health Maintenance Organizations (HMOs)

public or private organization that provides and manages comprehensive health services to individuals enrolled in the health plan's HMO

Hospital pharmacy

Oversee the different steps in the medication management and use system from the drug procurement (selection, purchasing, responsibilities and control), drug storage and inventory control, medication preparation and distribution (unit dose system) until monitoring of the drug therapy outcome to optimize patient safety and improve patients’ health-related quality of life