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1206_Topics_in_hospital_pharmacy_management_Aspen_Systems_Corporation

Topics in hospital pharmacy management /

Aspen Systems Corporation (Top Hosp
Pharm Manag)
Publisher: Aspen Systems Corporation

Journal Impact: 0.00*

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Other titles Topics in hospital pharmacy management, THPM

ISSN 0271-1206

OCLC 6550764

Material type Periodical

Document type Journal / Magazine / Newspaper

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Publications in this journal

Article: Communication strategies to improve drug use evaluation

D R Saine

[Show abstract] [Hide abstract]ABSTRACT: Successful examples of teams and drug

use evaluations explore communication strategies to enhance quality improvement of
medication use. Topics highlighted include establishing contacts within key
departments, creating committee connections, fostering physician and nurse
participation, and increasing visibility and maintaining awareness. Multidisciplinary
collaboration and linkage between the hospital and the managed care pharmacy are
also reviewed. Medication use can be improved by integrating these communication
tactics.

Article Feb 1995 Topics in hospital pharmacy management / Aspen Systems

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Article: Development of a continuous quality improvement/total quality management

program for medication use monitoring

M L Ryan B W Chaffee

[Show abstract] [Hide abstract]ABSTRACT: The design of institutional medication use

programs that are effective and meet regulatory and accreditation standards is
becoming increasingly dependent upon a thorough understanding of the principles and
applications of continuous quality improvement (CQI) and total quality management
(TQM). Both the Joint Commission on Accreditation of Healthcare Organizations and
the federal government have recently begun to make significant attempts to transform
our existing quality assurance programs into indicator-based quality improvement
management systems that are based on the principles of CQI and TQM. The article
outlines and illustrates an effective approach for developing and implementing a
comprehensive CQI/TQM program for medication use monitoring.
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Article: Use of total quality management techniques to improve compliance with a

medication use indicator

P S Woster M L Ryan L Ginsberg-Evans J Olson

[Show abstract] [Hide abstract]ABSTRACT: Total quality management techniques were

used to lay the groundwork for and to implement procedural changes designed to
improve compliance with the Joint Commission on Accreditation of Healthcare
Organizations' medication use indicator for ordering and administering presurgical
antibiotics. The effect of these procedural changes on patient outcomes (i.e.,
postsurgical infection rates and length of hospitalization) is described. In a study to
assess compliance, 57 (30 percent) of 40 control patients received a presurgical
antibiotic within 1 hour of incision compared with 65 (52 percent) of 126 study group
patients, and 83 (44 percent) of the control group received a presurgical antibiotic within
2 hours of incision compared with 88 (70 percent) of 126 study group patients.
Postsurgical infection rates and length of hospitalization were not significantly different
(p = .407 and p = .885, respectively).

Article Feb 1995 Topics in hospital pharmacy management / Aspen Systems

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Article: Opportunities for pharmaceutical care with critical pathways

K E Koch

[Show abstract] [Hide abstract]ABSTRACT: Critical pathways are multidisciplinary tools

designed to improve patient care and efficiency. Almost every path requires some type
of pharmacotherapeutic intervention, from selection of surgical prophylaxis to
management of anticoagulation. Pharmacists should become involved with the critical
pathway process because it offers an excellent opportunity to incorporate
pharmaceutical care and to meet Joint Commission on Accreditation of Healthcare
Organization compliance criteria.

Article Feb 1995 Topics in hospital pharmacy management / Aspen Systems

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 Article: Technical considerations in the preparation and dispensing of chemotherapy

B G Peters

[Show abstract] [Hide abstract]ABSTRACT: The safe handling of cytotoxic agents is

intimately related to the technical aspects of drug preparation, dispensing, and
administration. The appropriate equipment, supplies, protective clothing, and waste
disposal systems must be available to the health care worker who is called upon to
prepare cytotoxic agents. In addition, the health care worker must be adequately trained
in and familiar with the safe use of these products and equipment and the preparation
techniques or manipulations necessary during cytotoxic drug compounding. The article
describes in detail and reviews the technical considerations, such as aseptic technique,
proper use of the biological safety cabinet, gowning and gloving, labeling, and waste
disposal, that are essential to the safe preparation and dispensing of chemotherapy.

Article Feb 1995 Topics in hospital pharmacy management / Aspen Systems

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Article: Pharmacotherapy quality improvement in the managed care setting

K W Kolb

[Show abstract] [Hide abstract]ABSTRACT: Physician partnering, value-added

relationships, and integrated delivery systems with risk/incentive arrangements are
emerging in managed care. These arrangements require time-sensitive program
information that can be used in continuous quality improvement programs. Components
of any clinical intervention program designed to improve the quality of pharmacotherapy
are on a continuum, from those that are primarily individual patient focused to those that
are disease or system/process focused. Components include case management,
patient profile review, brand to generic drug conversion, targeted therapeutic
evaluations, provider profiling, and pharmacoeconomic analysis. All health care
professionals involved in pharmacotherapy need to be involved in implementation of
these quality improvement programs.

Article Feb 1995 Topics in hospital pharmacy management / Aspen Systems

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Article: The transition to medication system performance indicators

 A Petitta S Kaatz C Estrada [...] J V Anandan

[Show abstract] [Hide abstract]ABSTRACT: Economic and competitive pressures in the

health care market are causing hospitals and other health care providers to seek more
effective ways to improve the quality of care and to decrease costs. Integrating total
quality management and continuous quality improvement techniques into traditional
drug use evaluation methodology allows for the development of critical performance
indicators. These indicators integrate the selection, use, delivery methods, and
outcomes of drug therapy with other operational therapeutic modalities. The article
describes the development of medication system performance indicators using heparin
dosing as a model.

Article Feb 1995 Topics in hospital pharmacy management / Aspen Systems

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Article: Use of critical pathways and indicators in pharmacy practice

R Shane B Vinson

[Show abstract] [Hide abstract]ABSTRACT: The development of critical pathways along

with continuous quality improvement and patient-focused care represents one of the key
initiatives in health care in the 1990s. The critical pathway defines the components of
care, including treatments, diagnostic measures, and activities to be performed each
day, to achieve the desired outcome for a patient with a given diagnosis. Indicators can
then be used to define opportunities for improving the pathway. Participation in the
critical pathway development process provides pharmacists with an opportunity to utilize
their expertise in the medication use process to ensure optimal medication
management.

Article Feb 1995 Topics in hospital pharmacy management / Aspen Systems

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Article: Nutritional support: pharmacists' influence on the prescribing process

L A McDermott J T Albrecht D H Good

[Show abstract] [Hide abstract]ABSTRACT: A commitment was made at a 1,025-bed

county teaching facility to increase staff pharmacists' involvement in nutritional support
and physician prescribing. The plan was to utilize the Nutritional Support Clinical
Pharmacy Specialist (NSCPS) to train the staff pharmacists to provide direct patient
 care for patients receiving parenteral nutrition. The implementation included specialized
training for staff pharmacists, staff pharmacists monitoring all parenteral nutrition
patients, pharmacists' attendance at nutritional support rounds, documentation of all
pharmacist interventions, and pharmacists' involvement in the drug-usage evaluation
(DUE) process. The results of the increased influence of pharmacists on the prescribing
process included more appropriate parenteral nutrition therapy, earlier transitioning from
parenteral to enteral nutrition, recognition of staff pharmacists as resources by the
physicians, and increased job satisfaction for pharmacists.

Article Nov 1994 Topics in hospital pharmacy management / Aspen Systems

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Article: Pharmacy-based automated medication records: methods, application, and a

survey of use

B S Grabowski

[Show abstract] [Hide abstract]ABSTRACT: A literature review of articles describing the

development and implementation of automated medication administration records is
summarized, and the results of a survey undertaken of all hospitals in Missouri to
determine the extent of an automated medication administration record (MAR) are
reported. For hospitals with an automated MAR, the survey compiled information about
the demographics of responding facilities and production and distribution, design,
implementation, and procedures for use of automated MARs. The most frequently
reported advantages of an automated MAR were a more legible document, increased
accuracy, savings in nursing personnel time, and fewer medication errors. The most
frequently reported disadvantages were increases in pharmacy personnel time, different
interpretation of orders by pharmacy and nursing, and multiple entries required for a
medication order to appear correctly on the MAR.

Article Nov 1994 Topics in hospital pharmacy management / Aspen Systems

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Article: Patient information: community pharmacy needs and perspectives

J P Juergens L R Basara

[Show abstract] [Hide abstract]ABSTRACT: Providing complete and understandable

information to patients about medicines is considered an integral component of high-
quality medical and pharmaceutical care. With such information, not only can the level
 of general health increase, but costs associated with noncompliance, including
polypharmacy and hospitalization, can decrease. Although patient information leaflets
(PILs) have been available since the 1970s, their use is more relevant today because of
the counseling requirements of the Omnibus Budget Reconciliation Act of 1990. A
national survey of community pharmacists was conducted to determine their attitudes
toward this patient education strategy. Results demonstrate that pharmacists believe
PILs benefit patients, but that PILs need revision in terms of readability,
understandability, and standardization.

Article Nov 1994 Topics in hospital pharmacy management / Aspen Systems

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Article: Influencing prescribers

A L Wilson

[Show abstract] [Hide abstract]ABSTRACT: Appropriate drug therapy is centered on the

acts of selection and dosing of pharmaceuticals. Prescribing drugs has been the
exclusive province of physicians until recently. Pharmacists and others who seek to
encourage physicians to prescribe specific drugs or therapies or to use pharmaceuticals
in a particular manner have addressed their concerns through influence. The article
examines direct and indirect methods of influencing prescribers. The changing goals of
providers, payers, pharmacists, and patients are discussed, and the effectiveness of
various methods of influencing prescribers are reviewed, including financial incentives,
drug use evaluation, persuasion, collaboration, and computer-aided information
delivery.

Article Nov 1994 Topics in hospital pharmacy management / Aspen Systems

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Article: Physician perceptions of clinical pharmacy encounters in a family practice clinic

S O Price M A Newnham

[Show abstract] [Hide abstract]ABSTRACT: The purpose of this study was to classify
pharmacist-physician encounters in a family medicine center into three progressive
levels of service in order to determine the physician's perception of the relative value of
each level. The three levels of service were drug information, pharmacy consultation
individualized to the patient, and pharmaceutical care-consultation with follow-up to
monitor patient outcome. Physicians received a questionnaire with each encounter and
 were asked to rank questions regarding the quality of the information provided, the
impact they perceived that the information had on patient care, and to assign a
monetary value for each encounter. A total of 106 of 141 (75 percent) questionnaires
suitable for analysis were stratified into drug information (25.5 percent), pharmacy
consultation (49 percent), and pharmaceutical care (25.5 percent). Physicians'
perceptions toward the quality, impact, and value of pharmacy services were favorable
overall, but they perceived a significantly higher quality, impact, and value to
pharmaceutical care encounters than for drug information and pharmacy consultation (p
< 0.05).

Article Oct 1994 Topics in hospital pharmacy management / Aspen Systems

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Article: Influencing prescribing practices and associated outcomes utilizing the drug use
evaluation process

N E Sloan J A Peroutka D E Morgan [...] A H Mutnick

[Show abstract] [Hide abstract]ABSTRACT: Influencing prescribing practices and the

implementation of pharmaceutical care utilizing the drug use evaluation (DUE) process
at a 891-bed teaching hospital are described. The DUE program has been structured to
provide for significant pharmacy involvement while maintaining medical staff
responsibility as outlined by the Joint Commission on Accreditation of Healthcare
Organizations. A multidisciplinary approach is used to identify problems and develop
prescribing criteria and educational initiatives. Pharmacists provide drug therapy
monitoring and engage in clinical interventions and documentation of outcomes on a
daily basis. DUE program pharmacists help target possible interventions, assure
monitoring and outcome documentation, and compile results of all initiatives for
reporting purposes to the medical staff and quality assessment program. Specific
performance compliance and problems are identified and incorporated into the
credentialing process. Corrective measures are determined by the Pharmacy and
Therapeutics (P&T) Subcommittee with subsequent actions carried out by peer
physicians. The net result is a positive influence on prescribing practices that improves
the appropriate and effective use of drugs and improves patient outcomes.

Article Oct 1994 Topics in hospital pharmacy management / Aspen Systems

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Article: Automated order-entry mechanisms to influence prescribing

 G T Schumock T R Marwaha J M McBride T Clark

[Show abstract] [Hide abstract]ABSTRACT: On-line prescribing is available in many

hospitals in the United States and has distinct advantages. On-line drug prescribing can
be influenced by the use of automated prompts that guide and direct the prescriber to
the preferred agent, dosage, or regimen. The authors have adapted screen prompts to
facilitate appropriate prescribing as defined by pharmacy and therapeutic (P&T)
committee decisions, restricted drug or target drug initiatives, drug-usage evaluation
(DUE) actions, departmental guidelines and order-sets, and other institutional directives.
Objective evidence for the effectiveness of on-line prompts is provided for H2-
antagonists and antibiotics. As computer technology advances even further and is
increasingly utilized in the health care setting, on-line interventions to facilitate
appropriate prescribing may become increasingly useful.

Article Oct 1994 Topics in hospital pharmacy management / Aspen Systems

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Article: Chemotherapy administration

S G Yackzan

[Show abstract] [Hide abstract]ABSTRACT: The administration of cancer chemotherapy

is a unique combination of scientific exercise and clinical practice. The clinical practice
involves the holistic care of a human being whose cancer and normal physiology are
unique. The scientific exercise includes the manipulation of doses, combinations, and
administration schemes of the small number of chemicals known as chemotherapy.
Bringing science and clinical practice together to formulate a treatment plan that offers
the most favorable outcomes and that minimizes short- and long-term toxicities is a
challenge. This article discusses the scientific rationale for various methods of
chemotherapy administration and outlines the specific clinical steps necessary to
achieve the most safe and efficacious administration plan possible.

Article Aug 1994 Topics in hospital pharmacy management / Aspen Systems

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Article: An overview of chemotherapy toxicities

B G Peters
 [Show abstract] [Hide abstract]ABSTRACT: Understanding the toxicities associated
with cancer chemotherapeutic agents is essential to pharmacists involved in the clinical
management of oncology patients. Anticipation of various treatment-related toxicities
may provide the opportunity for pharmacists to develop intervention strategies that
could minimize or eliminate an expected side effect of chemotherapy such as
myelosuppression, nausea, or emesis. Effective management of chemotherapy
toxicities may lead to decreased lengths of stay in the hospital or administration of
chemotherapy in the outpatient setting. This article addresses the onset of
chemotherapy toxicities, the major organ system toxicities, and the management of
many of these chemotherapy-induced toxicities. Chemotherapy dose modifications are
discussed as well as maximum lifetime doses and the use of prophylactic medications
to prevent various side effects.

Article Aug 1994 Topics in hospital pharmacy management / Aspen Systems

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Article: Managing oncology research protocols

M C Lunik

[Show abstract] [Hide abstract]ABSTRACT: Oncology research protocol management is

important for the effective execution of clinical trials with oncology patients. Clinical trials
explore investigational drug safety, efficacy, and effectiveness. Investigational drugs
have not received approval for widespread use and marketing by the Food and Drug
Administration (FDA). The National Cancer Institute (NCI) has several branches
concerned with investigational drug procurement, distribution, and recordkeeping of
investigational cancer chemotherapy agents. Before an investigational drug is approved
by the FDA for marketing in the United States, it must undergo several phases of pre-
clinical and clinical trials. The Institutional Review Board (IRB) must review and approve
clinical trials to ensure that studies meet legal, ethical, and scientific standards. The
principal investigator (PI) takes responsibility for the clinical trial. Informed consent must
be obtained from subjects before they may participate in clinical trials. The informed
consent form is reviewed by the IRB. The investigational drug storage, accountability,
ordering, distribution, and drug information dissemination process is improved with a
pharmacy-coordinated investigational drug service.

Article Aug 1994 Topics in hospital pharmacy management / Aspen Systems

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Article: Oncologic emergencies

 C J Cunningham

[Show abstract] [Hide abstract]ABSTRACT: Early recognition and prompt control are
the two major factors in dealing with oncologic emergencies. The most common
emergencies are tumor lysis syndrome, hypercalcemia, spinal cord compression, and
superior vena cava syndrome. Emergencies in cancer can occur at any stage of the
disease process or its treatment. It is very important that caregivers are able to
recognize and manage these emergencies; serious complications can arise if they are
not treated promptly.

Article Aug 1994 Topics in hospital pharmacy management / Aspen Systems

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Article: Safe handling of antineoplastic drugs

B R Harrison

[Show abstract] [Hide abstract]ABSTRACT: Managers should be aware of the

hazardous properties of antineoplastic drugs and of the procedures and equipment
commonly recommended to provide a safe working environment for employees,
patients, and visitors. Compliance with the many published guidelines should help
ensure passage of the inevitable Occupational Safety and Health Administration
(OSHA) or Joint Commission inspection. Acute and chronic toxicities of the
antineoplastic drugs, the potential for exposure in the workplace, and the basic
guidelines for safe handling of these agents are reviewed.

Article Aug 1994 Topics in hospital pharmacy management / Aspen Systems

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Some research opportunities in hospital pharmacy.
Wertheimer AI.

Abstract

Research opportunities in hospital pharmacy, especially in administrative and managerial areas, are
discussed. Six areas of hospital pharmacy practice that have potential for research are discussed:
personnel, inventory, services, evaluation, management, and research/education. Specific topics
mentioned are employee satisfaction, technicians and their impact on hospital pharmacy, purchasing, use
of electronic data processing in inventory control, extent of decentralization of pharmaceutical services,
pharmacy and therapeutics committees, reimbursement for consultations and pharmacokinetics services,
quality assurance, evaluation of pharmacy management, and the cost-benefit ratio of research and
education activities.