Assuntos
Serviços de Assistência Domiciliar/normas , Farmácias/normas , Aconselhamento , Atenção à Saúde , Tratamento Farmacológico/normas , Serviços de Assistência Domiciliar/economia , Serviços de Assistência Domiciliar/organização & administração , Educação de Pacientes como Assunto , Pacientes , Farmácias/economia , Farmácias/organização & administração , Estados UnidosRESUMO
A pharmacy department at a 340-bed community hospital based its strategic plan for developing patient-oriented services on a sound drug distribution system, a credible work-measurement program, and fiscal responsibility. In 1982 the department of pharmacy and i.v. therapy implemented a strategic plan for improving pharmaceutical services. The plan involved developing goals and objectives for the department; marketing the department's services and fiscal management to hospital administrators, medical staff, and nursing staff; building teamwork among the pharmacy staff; and improving the drug distribution system before instituting clinical services. Hiring of additional pharmacy staff was justified on the basis of work-measurement data. By adjusting staffing levels every two weeks based on work-measurement data, the department increased the efficiency of drug distribution activities; the pharmacy also implemented cost-saving programs like selection of therapeutic alternates and formulary restrictions. The savings were then reinvested in labor-intensive patient-oriented pharmaceutical services. A staff development program using staff pharmacists as preceptors expanded the breadth and depth of pharmacists' clinical skills. The planning efforts were successful because the needs of hospital administrators, the pharmacy department, and staff members were addressed.
Assuntos
Serviço de Farmácia Hospitalar/organização & administração , Hospitais com 300 a 499 Leitos , Marketing de Serviços de Saúde , Sistemas de Medicação no Hospital/organização & administração , Técnicas de Planejamento , Análise e Desempenho de Tarefas , WashingtonRESUMO
A panel of hospital pharmacy managers representing three institutions discussed issues related to planning for patient-oriented pharmacy services. The panelists discussed organizational benefits of strategic planning, ways to gain momentum for change among pharmacy staff members and from others within the institution, the need for setting realistic goals, and problems in differentiating roles for pharmacy staff. They also discussed the funding of strategic-planning programs. The panelists advocated an integrated approach to providing drug distribution and clinical services. Management must provide whatever support is necessary for integrating patient-oriented services into the daily activities of all pharmacists. That support may be in the form of additional personnel, better use of supportive personnel, staff development programs, or automation. Pharmacists, too, must recognize their combined responsibilities for drug distribution and clinical services. Only by having all pharmacists clinically trained can a department provide clinical services when needed. The experiences of these panelists may be useful to other institutions planning patient-oriented pharmacy services.
Assuntos
Serviço de Farmácia Hospitalar/organização & administração , Sistemas de Medicação no Hospital/organização & administração , Administração de Recursos Humanos em Hospitais , Técnicas de PlanejamentoRESUMO
The composition, effect on blood components, relative value compared with intravenous dextrose, clinical applications as a caloric and fatty acid source, adverse reactions, limitations, and administration of intravenous fat emulsions are reviewed. Fat emulsions provide essential fatty acids and calories and are primarily used to supplement of parenteral nutrition regimens. Their use as a major source of calories remains limited because of cost. However, the trend toward aligning intravenous nutrition to that of the normal diet and the increased demand for peripherally administered parenteral nutrition have increased demand for use. The advantages and disadvantages presented may be used by clinicians to assist in establishing the role of intravenous fat therapy in nutritional support services.