b) Hospital pharmacy and its organization
Definition, functions of hospital pharmacy, Organization structure, Location, Layout and staff requirements, and Responsibilities and functions of hospital pharmacists
MINIMUM STANDARD FOR HOSPITAL PHARMACY
Pharmaceutical services in institutions have numerous components,
the most prominent being
(1) The procurement, distribution, and control of all pharmaceuticals used within the facility.
(2) The evaluation and dissemination of comprehensive information about drugs and their use to the institution’s staff and patients.
(3) The monitoring, evaluation, and assurance of the quality of drug use.
These functions are carried out in cooperation with other institutional departments and programs.
The primary function of this document is to serve as a guide for the development and provision of pharmaceutical services in institutions. It will also be useful in evaluating the scope and quality of these services. It
does not, however, provide detailed instructions for operating a.pharmacy—other Society publications serve this function.
Standard 1: Administration
The pharmaceutical service shall be directed by a professionally competent, legally qualified pharmacist. He or she must be on the same level within the institution’s administrative structure as directors of other clinical services. The director of pharmaceutical services is responsible for:
(1) Setting the long- and short-range goals of the pharmacy based on
developments and trends in health care and institutional pharmacy practice and the specific needs of the institution.
(2) Developing a plan and schedule for achieving these goals.
(3) Supervising the implementation of the plan and the day-to-day activities associated with it.
(4) Determining if the goals and schedule are being met and instituting
corrective actions where necessary.
The director of pharmaceutical services, in carrying out these tasks, shall employ an adequate number of completent and qualified personnel
Standard II: Facilities
There shall be adequate space, equipment, and supplies for the
professional and administrative functions of the pharmacy.
The pharmacy shall be located in an area (or areas) that facilitate (s)
the provision of services to patients. It must be integrated with the facility’s communication and transportation systems.
Space and equipment, in an amount and type to provide secure, environmentally controlled storage of drugs, shall be available.
There shall be designated space and equipment suitable for the preparation of sterile products and other drug compounding and packaging operations.
The pharmacy should have a private area for pharmacist-patient consultations. The director of pharmaceutical services should also have a private office or area.
Current drug information resources must be available. These should include appropriate pharmacy and medical journals and texts and drug literature search and retrieval resources.
ORGANIZATIONAL STRUCTURE OF PHARMACY DEPARTMENT
With the selection and categorizing of the employees, it now becomes essential to develop a chart showing the flow of administrative authority. Obviously, in the very small departments, this is usually generally understood and no problems arise. However, in the large units with assistant chief pharmacists, supervisors, and lay personnel, authority must be delegated by the chief pharmacist.
Sample distributions are depicted in Figures (1-1) and (1-2). Clearly this
can and should be tailored to meet the specific requirements of the department and hospital. Once prepared and approved, it should be conspicuously posted for each of the departmental employees to read and adhere to.
In large hospitals, departments of pharmacy have a more complex
organization. Note for example, the Ohio State University Hospital’s Department of Pharmacy organizational chart. It should seem obvious to the student that each of the subdivisions of the department are assigned specific responsibilities. The following are some of the responsibilities of each division.
Administrative Services Division
1. Plan and coordinate departmental activities.
2. Develop policies.
3. Schedule personnel and provide supervision.
4. Coordinate administrative needs of the Pharmacy and Therapeutics
5. Supervise departmental office staff.
Education and Training Division
1. Coordinate programs of undergraduate and graduate pharmacy
2. Participate in hospital-wide educational programs involving nurses,
3. Train newly employed pharmacy department personnel.
Pharmaceutical Research Division
1. Develop new formulations of drugs, especially dosage forms not
commercially available, and of research drugs.
2. Improve formulations of existing products.
3. Cooperate with the medical research staff of projects involving
In-Patient Services Division
1. Provide medications for all in-patients of the hospital on a 24-hour
per day basis.
2. Inspection and control of drugs on all treatment areas.
3. Cooperate with medical drug research.
Out-Patient Services Division
1. Compound and dispense out-patient prescriptions.
2. Inspect and control all clinic and emergency service medication
3. Maintain prescription records.
4. Provide drug consultation services to staff and medical students.
Drug Information Services Division
1. Provide drug information on drugs and drug therapy to doctors,
nurses, medical and nursing students and the house staff.
2. Maintain the drug information center.
3. Prepare the hospital’s pharmacy newsletter.
4. Maintain literature files.
Departmental Services Division
1. Control and dispense intravenous fluids.
2. Control and dispense controlled substances.
3. Coordinate and control all drug delivery and distribution systems.
Purchasing and Inventory Control Division
1. Maintain drug inventory control.
2. Purchase all drugs.
3. Receive, store and distribute drugs.
4. Interview medical service representatives.