Application in PHARMACY PRACTICE

INPUT
RESOURCES

OUTPUT
Goods And Services
NEEDS WANT DEMANDS

transformation

INPUT
RESOURCES

OUTPUT
Goods And Services
OUTCOMES

Pharmacy operations

Processes
Goods and services offered by the business Outputs
prescription medications patient counselling immunization OTC medications Durable medical equipment Disease state management

Processes
Outputs (consumable offerings) drive patients perceptions of your pharmacy Outputs influence outcomes in patients Keep in mind..... patients develop perceptions of your business based on the outputs and outcomes

 Goods and services

Processes

GOODS compounded prescription durable medical equipment OTC medications Rx medications SERVICES refill reminders

patient counselling disease state management

PROCESSES
Service Typology
services can be viewed in terms of specificity and intensity Specificity customer service product service service as a product Intensity tactic strategic cultural

processes
Service specificity Customer servicegeneral quality of interactions Product services support of products (distribution, technical assistance) Service as a product independent of companys goods Organizational intensity Tactic actions within the marketing mix Strategic adds a key competency Cultural reshapes the mission

PROCESSES
I n t e n s i t y

tactic
S P E C I F I C I T y

strategic Delivery

cultural Customers always right

Customer Service

24 hour emergency

Product Service
Service Product

Refill reminder
Refilling competitor Rx

Online refills
DSM

Counsel every patient

Diabetes education only

INPUT

Transformation

RX MEDS

Initial patient interact -ion

Rx Proce -ssing

Rx Filling

Rx Handling for delivery to patient

Second ary Patient Interaction

INPUT
Ingredients, both active and inactive Container Computer that creates the label the Insurance company Fee charged to verify and fill the Rx over the phone line Bag that Rx is place Cost of electricity Rent on the facility Salary and benefits who compound the prescription

P R O D U T

processes
All of the resources needed to create the output Examples of INPUTS (Rx Meds)
stock medications pharmacists technicians labels utilities containers computers

processes
OUTCOMES
the result of patient behaviours can be measured (although not always easy) can be influenced by the pharmacys outputs can be monitored outcomes can occur along a continuum

Typical Community Pharmacy Output

Filling the prescription medication Compounding the prescription OTC medication Nutritional supplements Offering and fitting durable medical equipment Information about Rx drugs Information about OTC drugs Health and beauty aids Greeting cards Counseling in prescription drug use Screening for drug interactions Special convenience packaging

P R O F I T

TYPICAL HOSPITAL PHARMACY OUTPUT

Filling the prescription medication Compounding Preparation of IV and solutions Delivery of medication to floors Collection of order from hospital floors Drug event monitoring Formulary management Therapeutic management Prescription medication counseling Filling of Rx medication carts Drug information to physicians TPN and enteral nutritions

P R O F I T

Factors Affecting the Drug Delivery of Pharmacy Product and Services

1.Patient Demographic a. Aging population b. Females as decision-makers c. Ethnic composition of patient

2.Attitudes and Belief system

a. Belief about disease, sick role, medication taking

b. Trust in health care delivery system

c. Direct-to- consumer advertising of Rx drug

Factors Affecting the Drug Delivery of Pharmacy Product and Services

3. Third party payers a. Complexity/differences among payers policies b. Formularies c. Limited networks d. Limited access for some patients

e. Lack of knowledge by patients

Factors Affecting the Drug Delivery of Pharmacy Product and Services

4.Competitive market

a. Diminished margins
b. Diversity in the types of providers offering products and services

5.Technology
a. Software b. Automated dispensing technology

Pharmacoeconomics
1.Determine optimal mix of labor and capital 2.Determine optimal output 3.Determine optimal hours of business operation 4.Determine levels of investment into risk management

10 Decisions under the purview of Management

Designing goods and services Managing quality Process strategies Location strategies Lay out strategies Human resource Scheduling strategies Supply chain strategies Inventory management Maintenance

1.Designing Goods and Services

@ needs and wants of consumers
@ require analysis and planning @ tangible or not tangible

2. Managing Quality
Compound Prescription Quality Product

2 Types of Costs
1.Cost maintaining quality

a. Prevention cost
b. Appraisal cost 2.Cost associated with poor quality

a. Internal failure
b. External failure

3. Process Strategies

STEPS Performed During Operations

Efficiency

Good Services

Profitability

4. Location Strategy
1. How can easily and efficiently the input for operations can be required? 2.How easily the outputs operation can be transferred to the consumers of those outputs?

3.Which outputs are chosen to be offered by a given business?

5. Pharmacy Layout
Pharmacy needs to be designed to maximize the efficiency of the process conducted to create the goods and services

6. Human Resource
@ most important resources in a pharmacy @ goods and services offered are transferred using personnel @ efficiency and ability to interact with patient

7. Scheduling Strategy
@ scheduling with personnel is a critical aspect of operation

@ pharmacist must be present when the pharmacy is open

@ CHASE Strategy chase the demand having personnel available = great demand @ LEVEL Scheduling to provide amount of production so that a constant workforce can be employed to handle the demand day after day, and week after week

8. Supply chain management

@ chain of business that supply pharmacies with necessary inputs @ build relationship and agreements with other companies

9.Inventory management
@ largest expense that a pharmacy has @ too much inventory is seen as money sitting on the shelf @ too little causes inefficiency in the system

10. Maintenance Strategy

P R O F I T

INEFFICIENT PRODUCTION OF GOODS SERVICES

Ensuring Quality in Pharmacy Operations

Quality of Care is the degree to
which health services for individuals and populations increase the likelihood of desired health outcomes and care consistent with current professional knowledge

Quality in Pharmacy Practice

1.Represent degree of excellence

2.Increases the probability of positive outcomes

3.Decreases the probability of negative outcomes

4.Corresponds with current medical knowledge

5.Offers the patient what he wants 6.Provides the patients with what he needs

How is Quality Measured

1.Structure
2.Process
= refers to the raw materials needed for production = method and procedure used

3.Outcomes

= end result

Different Ways to Look Outcomes

ECHO Model
3 Basic Types of Outcomes

a. Economical Outcomes
b. Clinical Outcomes

c. Humanistic outcomes

A.Economical Outcomes
@ include direct costs and consequences @ include indirect cost and consequences @ both medical and non medical

B.Clinical Outcomes
@ include morbidity and mortality, event rates, and symptoms resolution

C. Humanistic Outcomes
@ measures of the human aspects of care - HRQoL

Methods for Ensuring Quality in Pharmacy Practice

1.Quality Assurance (QA)
The systemic monitoring and evaluation of the various aspect of a project, service, or facility to ensure that standards of quality are being met

Methods for Ensuring Quality in Pharmacy Practice

2. Quality Control (QC) an aggregate of activities designed to ensure adequate quality

Methods for Ensuring Quality in Pharmacy Practice

3.Continuous Quality Improvement (CQI)
a philosophy of continual improvement of the processes associated with providing a good or service that meets or exceeds customer expectations

2 Important Ideas that Trascend QA and QC

1.CQI represents total system perspective concerning quality (all works are interconnected) 2.CQI demands that the quality improvement process is continuous (never ending)