Final Hospital Pharmacy Module 1 2024-2025 PDF

Mariano Marcos State University College of Health Sciences Pharmacy Department City of Batac 2906 Ilocos Norte PHARM 105: Hospital Pharmacy 1st Semester of A.Y. 2024-2025...

Mariano Marcos State University College of Health Sciences Pharmacy Department City of Batac 2906 Ilocos Norte PHARM 105: Hospital Pharmacy 1st Semester of A.Y. 2024-2025 Title Pharmacy Management and Control Introduction Effective management of a pharmacy requires much more than what a pharmacist normally performs, namely dispensing drugs and consulting patients. It requires skills to effectively manage staff, keep track of inventory, and adhere to various licensing formalities, as well as provide documentation regarding finances and facilities. Pharmacists are required to know how to manage stock levels, make provisions for alternatives, know how to budget and manage the finances of a pharmacy, and, above all, ensure access to safe, effective, and affordable drugs. This chapter describes the duties of a pharmacist and the concepts of hospital pharmacy management and control, financial management and purchasing and inventory control. Learning Outcomes At the end of the chapter, student must have: 1. discussed pharmacy management as an essential component of hospital pharmacy operations; 2. analyzed the management strategies for optimizing hospital pharmacy operations to ensure the efficient use of resources; 3. assessed the impacts of financial decisions and management on the overall pharmacy operations. Warm-Up Activity Do an inventory check of your belongings. What things did you buy but never use? “An attitude of gratitude is also a proven antidote to impulse purchasing because it creates a sense of abundance within the individual. When you’re feeling full of 1  gratitude, you’re less likely to subconsciously try to fill emotional holes by treating yourself with gifts and accumulating more stuff.” Central Activities ))))))))))))))))))))))))))))))))))))))0000000000000000000000000000000000000 Pharmacy Management/Material Management Learning Input 1 (Lecture) Pharmacy Management/Material Management It is concerned with planning, organizing, and controlling the flow of materials from their initial purchase through internal operations to the service point through distribution. AIM of material management is to get: the right quality; right quantity of supplies; at the right time; at the right place; for the right cost. PURPOSE of material management is: 1) To gain economy in purchasing 2) To satisfy the demand during period of replenishment 3) To carry reserve stock to avoid stock out 4) To stabilize fluctuations in consumption 5) To provide reasonable level of client services Financial Management Developing the Budget A budget is an instrument through which hospital administration, management at department levels, and governing board can review the hospital’s services in relationship to a prepared plan in a comprehensive and integrated form expressed in financial terms- -- --HAHN Goals of properly developed and used budget 1. Development of standards of performance 2. Comparison of the actual results with these standards thus identifying deviations 3. Subsequent analysis of deviations to determine whether they are controllable or uncontrollable 2 Division of the budget a. Revenue accounts A commonly used method whereby either the department of the pharmacy or the accounting department maintains a daily, weekly, monthly or annual total of the cost of the pharmaceutical issued to the various patient services as to the special services department. This total when added to that obtained from the processing of patient prescriptions and requisitions presents the true income of the department. b. Expense accounts May be divided into four general categories: administration; general professional care of patients; out-patient; and emergency and other expenses. Department of pharmacy is listed under the category of Professional Care of Patients. It includes: 1. Salaries and wages 2. Supplies and expense Drugs and pharmaceuticals Purchased service Miscellaneous supplies and expense c. Capital equipment’s accounts A comprehensive and detailed budget should be prepared for equipment and constructions needed in the hospital. Many hospitals required that any piece of equipment with a unit of 100 or more is considered to be in a capital equipment budget same as in construction to be done. Purchasing and Inventory Control The purchase and inventory control of pharmaceuticals is a special and important phase of the operation of a successful hospital pharmacy. Purchase To obtain by paying money or its equivalent To buy for a price Inventory An itemized list of goods with their estimated worth, specifically an annual account of stocks taken in any business Control 3  To exercise, directing, guiding or restraining of power over Role of purchasing agent and pharmacist in drug procurement The purchase of drugs and pharmaceuticals is specialty which can be carried out to be the best advantage by pharmacist trained in managing a hospital pharmacy. a. Pharmacist Furnish specifications for the purchase of all drugs, chemicals and pharmaceutical preparations Reject any article below standards or not complying with specifications Responsibilities 1. Acquaint the purchasing agent with the different avenues of drug purchasing such as By direct purchase from the manufacturer By direct purchase from a wholesaler By bid from either manufacturer or wholesaler By purchase from a local retail pharmacy (EP) By a contract purchase arrangement with the manufacturer By a contract purchase through a hospital bureau of corporation 2. Maintains a list of the names, address and contact number of drug manufacturers, wholesalers and their local representatives 3. Prepare details specification for drug, chemicals and biologicals 4. Prepare receiving memo if drugs are received direct by the pharmacy 5. Prepare Return Goods memo, whenever applicable b. Purchasing agent Do the actual procurement or purchasing through a centralized department Duties 1. Issues purchase order 2. Maintain purchase orders 3. Follow up delayed orders 4. Initiates competitive bidding procedures 5. Obtains quotations from specified sources 4 Receiving/Storage of Drugs a. Narcotic and controlled substances shall be delivered to the institution's pharmacy department directly or, where applicable, to the receiving area and subsequently delivered to the pharmacy department forthwith. b. The pharmacist manager shall be responsible to ensure established policy and procedures provide for the proper storage of received drugs when storage within the pharmacy department is not possible. c. The pharmacist manager shall be responsible to ensure established policy and procedures provide for the security of all medication received during the time elapsed from the actual receiving until it is stored properly by the pharmacy. d. All drugs (including investigational drugs, patient's own medication from home and clinical evaluation packages (i.e. samples) within the pharmacy and throughout the hospital) shall be stored under proper conditions of sanitation, temperature, light, humidity, ventilation, regulation and security. e. The pharmacy personnel shall make regular inspections of all drugs storage areas. A written record shall verify that: disinfectants and drugs for external use are stored separately from internal and injectable medications drugs requiring special environmental conditions for stability are properly stored 5  no outdated drugs are stocked narcotics and controlled drugs substances are being stored with proper measures of security drugs are not being overstocked drugs which may be required on an urgent or emergency basis are in adequate and proper supply f. Patient medications no longer required are returned to pharmacy. g. Standards of neatness and cleanliness are consistent with good medication handling practices. Inventory Management The pharmacist shall maintain or be involved in maintaining an inventory control system to ensure: detection, segregation and proper disposal of outdated, deteriorated, recalled, obsolete or hazardous drugs medication storage within the pharmacy and throughout the hospital is the responsibility of pharmacists medications are stored under proper conditions of sanitation, temperature, light, humidity, ventilation, regulation and security access to medication storage areas is restricted to authorized personnel only Inventory control procedures should include, but not be limited to: the establishment of minimum and maximum stock levels, procedures to ensure proper stock rotation, accountability for medications as they are removed from stock, analysis and interpretation of medication usage trends and their economic impact. Non-usable and expired medications shall be stored in a separate, secure area under the control of the pharmacy, until final disposal. There shall be drug recall procedures that can be readily implemented and documented. All repackaged product that has been recalled, lacking lot numbers, shall be removed from all drug storage areas. Controls on Purchases Inventory turnover Computed by dividing the cost of goods sold during the fiscal period by the average of opening and closing inventories 6 Low turnover Duplication of stocks Large purchase of slow-moving items Dead inventory High turnover Suggests strong sales Generally indicates that a company is efficiently managing its inventory by selling products quickly and replenishing stock frequently Due to small volume purchasing which indicate a failure to take advantage of the maximum quantity discounts Discounts 1. Volume contract. Usually offered by most of the manufacturers and it includes contract to cover total purchases of parenteral solutions, ampules, tablets or even gallon of goods. Under this system, the institutions approximate its annual consumptions of the particular class of product and signs an argument with the company to purchase this amount. A hidden benefit of this type of purchase is the fact that the contract price 2. Deals. It represents that type of a transaction that involves the purchase of a specified volume and receiving certain merchandise at no additional cost. 3. Discounts. It may accrue to the institution for the prompt payment of its drug bills. Because of large volume of drug consumption, these discounts amount to a sizable sum of money at the end of the year. Pharmacy Storeroom and Arrangement The responsibility for the storage of drugs should be placed with competent individuals who have been educated, trained and licensed to handle pharmaceuticals. Storage of drugs is directly under the control and supervision of a pharmacist. The pharmacist has the freedom of stock arrangement, instituting inventory control, the adjustment of inventory based upon his/her knowledge of the prescribing trends of the staff and the preparation of inventory cost reports to management. No definite rule on arrangement of the pharmacy storeroom. Arrangement is based on the need of the pharmacist and the institution. Divisions of Storeroom 1. Alcohols and liquors 2. Capsules and tablets 3. Chemicals 4. Narcotic vault 7  5. Ointments 6. Biologicals and other cold room inventory 7. Laboratory supplies 8. Surgical instruments 9. Rubber goods 10. Sutures 11. Medical and surgical supplies Alphabetical arrangement is followed where possible within the section. Each shelf, drawer or within the section is numbered to facilitate location of the item during the taking of physical inventory as well as to locate the item for new personnel. Marking of Merchandise This may be accomplished by the utilization of a marking machine to print small adhesive-backed tags that contain the following information: Date received The date is placed in the first line and consist of the month and year. Cost price It is on the second line and the figure is usually coded in order to preserve confidential price quotations. It is of great value in taking and pricing in physical inventory. Selling/Retail price It is placed on the third line and enables the pharmacist to price the charge ticket without having to refer to the charge or rate book. Pricing of Drugs 1. Professional fee concept This system incorporates two basic elements in the charge; the cost of medications and an added fee that will recover the expense of operating the pharmacy and the share of the total hospital expense assumed by the pharmacy. 2. Break-even point pricing It is defined as that level at which there is neither profit/loss. It requires the pharmacist to ascertain the fixed and indirect expenses of his department and then be in a position to charge to the dispensing unit its fair share of these expenses. Once the direct and indirect operational costs are determined, the cost of the container and cost of drugs are added. 3. The profit aspect Most commonly employed, “marked up pricing strategy”. Computerized pricing and inventory control a. Patient number 8  b. Drug identification number c. Dose factor d. Total number of doses dispensed Advantages 1. Itemized bill for all pharmaceutical charges 2. Accounts for all medication costs whether or not they are charged to the patients 3. Revenue can be projected and adjusted accurately 4. Charges are fair and equitable 5. Patient is charged for medication administered only 6. Accurate statistical reports for both pharmacy and financial departments Physical inventory Required by the auditing firm employed to audit the hospital’s fiscal operation Recorded on inventories sheets Name of the item or other identification Duplicate Proper spaces Done by pharmacy staff Activity 1 Couse learning material available for viewing/downloading via mVLE. Wrap-Up Activity Discussion Forum You are expected to participate in the discussion forum as scheduled. Please refer to the course guide for your scheduled time. Open-ended questions will be asked randomly among students during the discussion proper. Moreover, you are also given the opportunity to ask/raise any clarifications or questions during the discussion. Assessment (Post-assessment) Quiz Course Facilitator Franklin Viernes Ibana, MSc, CPh, RPh, CIP Assistant Professor III 9 Pharmacy Department 09673375038 [email protected] 10