The Role of Pharmacists in the Hospital Setting - American Society ...
The Role of Pharmacists in the Hospital Setting - American Society ...
The Role of Pharmacists in the Hospital Setting - American Society ...
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<strong>The</strong> <strong>Role</strong> <strong>of</strong> <strong>Pharmacists</strong> <strong>in</strong> <strong>the</strong> Health Care System<br />
<strong>The</strong> <strong>Role</strong> <strong>of</strong> <strong>Pharmacists</strong> <strong>in</strong> <strong>the</strong><br />
<strong>Hospital</strong> Sett<strong>in</strong>g<br />
Presentation to <strong>the</strong> Interim Jo<strong>in</strong>t Committee on Health and Welfare<br />
October 18, 2006<br />
John A. Armitstead, MS, RPh, FASHP<br />
President, Kentucky <strong>Society</strong> <strong>of</strong> Health-System <strong>Pharmacists</strong><br />
Director <strong>of</strong> Pharmacy Services, University <strong>of</strong> Kentucky <strong>Hospital</strong><br />
Assistant Dean, University <strong>of</strong> Kentucky, College <strong>of</strong> Pharmacy
Kentucky <strong>Hospital</strong>s<br />
• 121 hospitals<br />
– (120 counties <strong>in</strong> KY)<br />
• 17,000 beds<br />
• 600,000 admissions<br />
• 9,400,000 outpatient visits<br />
• $6,000,000,000 <strong>in</strong> expenses<br />
• Population <strong>of</strong> Kentucky<br />
Over 4.2 Million
<strong>Hospital</strong> Pharmacy <strong>in</strong> Kentucky<br />
• Approximately 10% <strong>of</strong> Kentucky<br />
pharmacists practice <strong>in</strong> hospitals<br />
• Kentucky <strong>Society</strong> <strong>of</strong> Health-System <strong>Pharmacists</strong> (KSHP)<br />
– www.kshp.org<br />
– Pr<strong>of</strong>essional society , over 300 members<br />
– Mission: To assist KSHP members <strong>in</strong> <strong>the</strong> provision <strong>of</strong><br />
pharmaceutical care <strong>in</strong> organized health care sett<strong>in</strong>gs<br />
throughout <strong>the</strong> Commonwealth <strong>of</strong> Kentucky.
Selected Types <strong>of</strong> Institutional<br />
Practice for <strong>Pharmacists</strong><br />
• <strong>Hospital</strong>s<br />
• Nurs<strong>in</strong>g Homes<br />
• Long Term and Extended Care Facilities<br />
• Intermediate Care Facilities<br />
• Assisted Liv<strong>in</strong>g Facilities<br />
• Correctional Facilities<br />
• Behavioral and Mental Health Facilities<br />
• Ambulatory Care Facilities<br />
• Home Care Providers
<strong>Hospital</strong> Classifications<br />
• Ownership<br />
– Government - Federal, State, City, County<br />
–Private<br />
• Church Operated/Affiliated, Corporation<br />
• Not-for Pr<strong>of</strong>it or For Pr<strong>of</strong>it<br />
• Types <strong>of</strong> Care - Primary, Secondary, Tertiary<br />
• Acute or Chronic<br />
• General or Specialty<br />
• Teach<strong>in</strong>g Affiliation(s)
<strong>The</strong> <strong>Role</strong> <strong>of</strong> <strong>Pharmacists</strong> <strong>in</strong> <strong>the</strong> <strong>Hospital</strong> Sett<strong>in</strong>g<br />
Medication Distribution and Control<br />
• Medication Orders<br />
• Formulary<br />
Development<br />
• Medication<br />
Adm<strong>in</strong>istration<br />
• Extemporaneous<br />
Compound<strong>in</strong>g<br />
• Compound<strong>in</strong>g Sterile<br />
Products<br />
• Unit Dose Packag<strong>in</strong>g<br />
• Medication Storage<br />
• M<strong>in</strong>imiz<strong>in</strong>g Adverse<br />
Drug Reactions<br />
• Elim<strong>in</strong>at<strong>in</strong>g<br />
Medication Errors<br />
• Manag<strong>in</strong>g Drug<br />
Product Recalls<br />
• Controll<strong>in</strong>g Drug<br />
Samples
<strong>The</strong> <strong>Role</strong> <strong>of</strong> <strong>Pharmacists</strong> <strong>in</strong> <strong>the</strong> <strong>Hospital</strong> Sett<strong>in</strong>g<br />
Medication Distribution and<br />
• Cytotoxic and<br />
Hazardous Drug<br />
Products<br />
• Controlled Substances<br />
• Non-Approved<br />
Substances<br />
• Medication Storage<br />
Area Inspections<br />
• Floor Stock<br />
Control<br />
• Disaster Services<br />
• Counter-terrorism<br />
Services<br />
• Medical Emergency<br />
Management<br />
• Drug Delivery<br />
Systems<br />
• Automated Dispens<strong>in</strong>g<br />
Mach<strong>in</strong>es
<strong>The</strong> <strong>Role</strong> <strong>of</strong> <strong>Pharmacists</strong> <strong>in</strong> <strong>the</strong> <strong>Hospital</strong> Sett<strong>in</strong>g<br />
Facilities, Equipment and<br />
Information Resources<br />
• Medication Storage<br />
• Packag<strong>in</strong>g and Compound<strong>in</strong>g<br />
• Cytotoxic and Hazardous Drug Products<br />
• Consultation Space<br />
• Office and Meet<strong>in</strong>g Space<br />
• Automation/Computerization<br />
• Record Ma<strong>in</strong>tenance
<strong>The</strong> <strong>Role</strong> <strong>of</strong> <strong>Pharmacists</strong> <strong>in</strong> <strong>the</strong> <strong>Hospital</strong> Sett<strong>in</strong>g<br />
Leadership and Practice<br />
Management<br />
• Education and Tra<strong>in</strong><strong>in</strong>g<br />
• Mission<br />
• Support Personnel<br />
• Work Schedules and<br />
Assignments<br />
• Education and Tra<strong>in</strong><strong>in</strong>g<br />
• Recruitment<br />
• Orientation<br />
• Performance Evaluation<br />
• Position Descriptions<br />
• Policies and Procedures<br />
• Operations Manuals<br />
• Drug Expenditures<br />
• Workload and F<strong>in</strong>ancial<br />
Performance<br />
• Committee Involvement<br />
• Quality Improvement<br />
• Laws and Regulations<br />
• Patient Confidentiality
<strong>The</strong> <strong>Role</strong> <strong>of</strong> <strong>Pharmacists</strong> <strong>in</strong> <strong>the</strong> <strong>Hospital</strong> Sett<strong>in</strong>g<br />
Optimiz<strong>in</strong>g Medication <strong>The</strong>rapy<br />
• Medication Histories<br />
• Medication Orders<br />
• Medication <strong>The</strong>rapy<br />
Monitor<strong>in</strong>g<br />
• M<strong>in</strong>imiz<strong>in</strong>g Bacterial<br />
Resistance<br />
• Collaborative Pharmacist<br />
Consultations<br />
• Medical Record<br />
Documentation<br />
• Medication Use<br />
Evaluation<br />
• Medication Use Policy<br />
Development<br />
• Pharmaceutical Care<br />
Provision<br />
• Cont<strong>in</strong>uity <strong>of</strong> Care<br />
• Cl<strong>in</strong>ical Care Plans<br />
• Immunization<br />
Programs
Pharmacy Presence <strong>in</strong><br />
UK HealthCare - Chandler Medical Center<br />
Ma<strong>in</strong> or Satellite Pharm<br />
Cl<strong>in</strong>ical Pharmacist<br />
Adm<strong>in</strong>istration
UK HealthCare Pharmacy Services<br />
(Pharmacist Participation <strong>in</strong> Collaborative Medical Rounds)<br />
• Pulmonary<br />
• Medic<strong>in</strong>e<br />
• Surgery<br />
• Trauma<br />
• Adult Oncology<br />
• Pediatrics<br />
• Pediatric Oncology<br />
• Emergency Medic<strong>in</strong>e<br />
• Cardio-Thoracic Surgery<br />
• Solid Organ Transplant<br />
• Bone Marrow Transplant<br />
• Nutritional Support<br />
• Infectious Disease<br />
• Neurosurgery/Neurology<br />
• Psychiatry<br />
• Nephrology<br />
• Family Medic<strong>in</strong>e<br />
• Cardiology
<strong>The</strong> <strong>Role</strong> <strong>of</strong> <strong>Pharmacists</strong> <strong>in</strong> <strong>the</strong> <strong>Hospital</strong> Sett<strong>in</strong>g<br />
Drug Information and Education<br />
• Drug Information Requests<br />
• Reference Materials for Drugs<br />
• Medication <strong>The</strong>rapy Monographs<br />
• Patient Education<br />
• Dissem<strong>in</strong>ation <strong>of</strong> Drug Information<br />
• Pharmacy and <strong>The</strong>rapeutics Committee<br />
Support/Analysis<br />
– (Drug Policy Development)
<strong>The</strong> <strong>Role</strong> <strong>of</strong> <strong>Pharmacists</strong> <strong>in</strong> <strong>the</strong> <strong>Hospital</strong> Sett<strong>in</strong>g<br />
Research<br />
• Policies and Procedures<br />
• Distribution and Control<br />
• Institutional Review Board<br />
• Scientific Contribution<br />
– Pharmacy Research<br />
– Medical Staff Support<br />
– Multidiscipl<strong>in</strong>ary Research
<strong>The</strong> <strong>Role</strong> <strong>of</strong> <strong>Pharmacists</strong> <strong>in</strong> <strong>the</strong> Health Care System<br />
<strong>The</strong> <strong>Role</strong> <strong>of</strong> <strong>Pharmacists</strong> <strong>in</strong> <strong>the</strong><br />
<strong>Hospital</strong> Sett<strong>in</strong>g<br />
• <strong>The</strong> traditional role <strong>of</strong> pharmacists <strong>in</strong> <strong>the</strong> hospital sett<strong>in</strong>g is<br />
well established<br />
• Medication Distribution and Control<br />
• Facilities, Equipment and Information Resources<br />
• Leadership and Practice Management<br />
• Kentucky pharmacists have been leaders <strong>in</strong> <strong>the</strong> <strong>in</strong>novative<br />
and develop<strong>in</strong>g roles for pharmacists<br />
• Optimiz<strong>in</strong>g Medication <strong>The</strong>rapy<br />
• Drug Information and Education<br />
• Research<br />
• Development/ref<strong>in</strong>ement <strong>of</strong> collaborative medication<br />
<strong>the</strong>rapy management with physicians, nurses and allied<br />
health providers will cont<strong>in</strong>ue to enhance <strong>the</strong> lives <strong>of</strong> those<br />
<strong>in</strong> <strong>the</strong> Commonwealth
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