Hospital Pharmacy: Roles and Classifications

• Hospital pharmacy involves various aspects such as the roles of hospital pharmacists, pharmacy staff, organizational structure, and hospital classifications.

Hospital Pharmacists

• Hospital pharmacists ensure the "7 rights" of medication administration are respected.
• The "7 rights" include right patient, right dose, right route, right time, right drug, right information, and right documentation.
• Pharmacists possess knowledge and clinical skills, making them authoritative sources of drug information for physicians, nurses, and patients.
• They are responsible for systems controlling drug distribution to ensure appropriate medication, form, dosage, and timing for each patient.
• Hospital pharmacists maintain patient records to fill medication orders and screen for drug allergies and adverse drug effects.

Pharmacy Staff

• Staff working in a pharmacy department include pharmacists, pharmacy technicians, nurses, students, storekeepers, porters, administrative/clerical staff, and domestic staff.

Pharmacy Director

• The pharmacy director is responsible for maintaining an adequate drug supply.
• They participate in the pharmacy and therapeutics committee and update the hospital formulary for medical staff approval.
• The director attends meetings of the pharmacy and therapeutics committee and implements their decisions.
• Establishing specifications for drug procurement is also a key duty.
• The director is responsible for pharmaceuticals manufactured within the hospital.
• Managing emergency drugs and antidotes falls under their purview.
• They ensure the confidentiality of patient and staff information.
• Cooperation in hospital teaching and research programs is expected.
• The director takes responsibility for drug monitoring.
• They establish drug information services.

Staff Pharmacist

• Staff pharmacists handle daily distributive duties, including physician order review and filling.
• They are responsible for unit dose cart checking and parenteral admixtures.
• Clinical duties involve monitoring drug-drug interactions and adverse drug effects.
• They play a major role in therapeutic drug monitoring and evaluating drug therapy.

Pharmacy and Therapeutics Committee (P&T)

• The P&T committee includes at least 3 physicians, a pharmacist, and a nursing staff representative.
• The committee may invite external experts with specialized knowledge and skills.
• The committee recommends adoption or assists in the formulation of professional policies regarding drug evaluation, selection, and therapeutic use which is advisory.
• The committee recommends or assists in the formulation of programs to meet the professional staff's needs for complete, current knowledge on drugs which is educational.

Hospital Classifications

• Hospitals are classified by ownership (government, private).
• Other classifications include mosque or church affiliated/operated, or corporation.
• Hospitals can be not-for-profit or for-profit.
• Types of care include primary, secondary, and tertiary.
• Classifications also include acute or chronic, general or specialty, and teaching affiliation.

Organizational Structure of a Hospital

• Organizational structure defines the levels of management within a hospital.
• Levels allow for efficient management of hospital departments.
• The structure helps one understand the hospital's chain of command.
• Organizational structure varies from hospital to hospital; large hospitals have complex structures, while smaller ones have simpler structures.

Grouping of Hospital Departments

• Hospital departments are grouped to promote efficiency.
• Grouping is generally done according to similarity of duties.

Common Categorical Grouping

• Common groupings include administrative, informational, therapeutic, diagnostic, and support services.

Administrative Services

• Hospital administrators include the chief executive officer (CEO), vice president(s), executive assistants, and department heads.
• They establish hospital policies and procedures.
• Their duties involve running the hospital and supervising budgeting and finance, and they often perform public relation duties.

Informational Services

• Informational services document and process information.
• They include admissions, billing and collection, medical records, computer information systems, health education, and human resources.

Therapeutic Services

• Therapeutic services provide treatment to patients and include physical therapy (PT), occupational therapy (OT), speech/language pathology, respiratory therapy, medical psychology, social services, pharmacy, dietary, sports medicine, and nursing.
• Physical therapy improves large muscle mobility.
• Occupational therapy helps patients regain fine motor skills.
• Speech/language pathology identifies, evaluates, and treats speech/language disorders.
• Respiratory therapy treats patients with heart and lung disease.
• Medical psychology is concerned with the mental well-being of patients.
• Social services connect patients with community resources.
• Pharmacy dispenses medications.
• Dietary maintains nutritionally sound diets for patients.
• Sports medicine provides rehabilitative services to athletes.
• Nursing provides care for patients.

Diagnostic Services

• Diagnostic services determine the cause(s) of illness or injury.
• They include the medical laboratory, medical imaging (radiology, MRI, CT, ultrasound), and emergency medicine.
• Medical laboratory studies body tissues.
• Medical imaging uses radiology, MRI, CT, and ultrasound.
• Emergency medicine provides emergency diagnoses and treatment.

Support Services

• Support services provide support for the entire hospital.
• They include central supply, biomedical technology, and housekeeping & maintenance.
• Central supply orders, receives, stocks, and distributes equipment and supplies.
• Biomedical technology designs, builds, and repairs medical equipment.
• Housekeeping and maintenance maintain a safe, clean environment.