TERMS.Almshouses – for the sick poor

Asylums – for the care and confinement of orphans and the mentally ill

Hospices – for terminally ill

Infirmaries – for short-term acute care

Aesculapius – Greek God of medicine

Temple of Aesculapius – existed in 1134 BC

Hippocrates – Father of Western Medicine born about 460 BC

Fabiola-a wealthy Roman woman; donated her palace for the care of the sick

Bishops – required to provide a shelter for the care of the sick in each diocese

Maimonides – famous rabbi, influenced health care by his teachings and works

Monks – primary health care practitioners during the middle ages.

The Black Plague – killed almost one-third of the inhabitants in Europe

Hotel Dieu – one of the finest hospitals in Europe during the Black Plague

Hospital of the Holy Spirit – founded in 717

- Major site for the education of lay physicians

Hospital of the Immaculate Conception – first hospital on the American Continent built by the Spaniards in 1524

- Name changed to The Hospital of Jesus of Nazareth in 1663

Philadelphia General Hospital – started in 1713 as an almshouse to give relief to the sick

Jonathan Roberts – first American hospital pharmacist

Pennsylvania Hospital – established in 1751

- First incorporated hospital in the United States through the efforts of Dr. Thomas Bond

Massachusetts General Hospital – first hospital to use general anesthesia in surgery

Dr. Crawford Long – performed the first operation with anesthesia

Chloroform and ether – standard anesthetic agents

Union Hospital – poor sanitation and depressing environment

Louisa May Alcott – described the Union Hospital in her published book Hospital Sketches

Saint Dymphna – patron saint for mental disorders

- May 15

Benjamin Rush – Father of American Psychiatry

- Introduced new method of treatment for psychiatric patients based on moral principles

Deinstitutionalization – large number of persons were discharged to communicate

World War I

Major trauma, burns, poison gas & infections of all kinds

Hospital designs Floating hospitals

World War II

Major advances in trauma surgery systemic sulfonamides, penicillin wide use of blood & plasma transfusion Volume of injured increased

Cadet nurse corps PT’s and OT’s came into being

Abraham Flexner – American educator

Florence Nightingale – Lady with the Lamp

Congress of the Hospital Survey and Construction Act – Hill-Burton program

- This act provided federal funds for hospital construction on a matching basis with local communities

Social Security Amendments of 1965 – had a long range impact on the development and expansion of hospitals

Hospital – has become a necessary instrument for providing the fourth basic element of survival—health.

Health care – a right for all, rather than a luxury for few

Hospital – an institution where the ill or injured may receive medical, surgical, or psychiatric treatment, nursing care, food and lodging

- Function is to provide patient services, diagnostic and therapeutic

Institution – a significant and persistent element (as a practice, a relationship, an organization) in the life of a culture

Hospital Pharmacy- practice of pharmacy in hospital settings and includes the organizationally related facilities and services

- Division of hospital wherein the procurement, storage, compounding, etc, are performed by legally, qualified, professionally competent pharmacists and assistants

The Administrator – highest hospital administrative position; implements policies, delegates authority, and passes on responsibility to department leaders

Department Leaders – carry out the patient care, teaching research and public health objectives of the hospital

The Business and Finance Department – handles the financial affairs

The Building Services Department – provides the essential maintenance, housekeeping, and security functions

The Human Resources Department – implements personnel policies

The Clinical Laboratory Department – performs a multitude of patient laboratory tests and services

The Nursing Service – provides continuous care

Accreditation Agencies – exerts their influence on professional standards of practice as they affect patient care

Licensing Agencies – exert their legal influences on hospital operations

The Federal Government – imposes standards and regulation in hospitals

Third-party Agencies – exerts their influence on the methods by which hospitals may be reimbursed for services rendered to patients

Social Agencies and Governmental Welfare Agencies – exert their influences over the policies, objectives and philosophies of hospital operation and services

Governing Board and Public Opinion – exert their influences over the policies, objectives and philosophies of hospital operation and practice

National Hospital Week – (August 6-12, 2010)

DOH: “Ospital na ligtas, handang magbigay lunas.”

General Hospital – provide patient services, diagnostic and therapeutic, for a variety of medical conditions

Special Hospitals –for patients who have specified medical conditions, both surgical and nonsurgical

Rehabilitation and Chronic Disease Hospitals – for handicapped or disabled individuals requiring restorative and adjustive services

Psychiatric Hospitals - for patients who have psychiatric-related illnesses

Short-term – less than 30 days

Long-term – 30 days or longer

Federal – owned and operated by various branches of the federal government

State – owned by the state and controlled by a board of control or division of the state government

County – owned by the county and financed and controlled similarly to state hospitals, only on county level

City – owned, financed and controlled by the city government

Non-profit – fees from paying patients or by contributions from the several religious orders or churches

Patient Care – involves the diagnosis and treatment of illness or injury, preventive medicine, rehabilitation, covalescent care, and personalized services

Education of the medical and allied health professions – includes formal programs; in-service training programs

Education of the patient – includes providing general education for children confined to long-term hospitalization; special education in the area of rehabilitation

1988 – JCAH JCAHO

2007 – JCAHO TJC

JCAHO – Independent, voluntary agency and its actions are not subjected to ratification by the organizations represented by its component members

- Operates voluntary accreditation programs for hospitals

- Private sector, US based

1956 – Pharmacy department was included among the essential services of the hospital

Governing Body – has total accountability with organization’s structure

CEO – lead organization and make recommendations to the board

Administrator/s – assists the CEO; appoints leader to each department

Department Leaders – operate departments effectively and properly

Open Staff – certain physicians other than those attending or active medical staff are allowed to use the facilities

- Courtesy medical staff

Closed Staff – all professional services, private and charity, are provided and controlled by the attending or active medical staff

Honorary Medical Staff – physicians who have been active in the hospital but who are retired and those whom it is desired to honor because of outstanding contributions

Consulting Medical Staff – specialists who are recognized as such by right of passing specialty boards or belonging to the national organization of their specialty

Active or Attending Medical Staff – concerned with regular patient care

- Most actively involved in the hospital

Associate Medical Staff – junior or less-experienced medical staff

Courtesy Medical Staff – physicians who desire the privilege of attending private patients, but those who do not desire active staff membership

Resident Medical Staff – residents, who are full-time employees of the hospital

- Persons who provide specific services in the care of a patient

Pharmaceutical Care

- Responsible provision of drug therapy for the purpose of achieving definite outcomes that improve a patient quality of life.

- Monitoring the regimen’s effect

Separation of Pharmacy to Medicine – took place in charitable institutions

Hospital Pharmacist – first recognized practitioner

Materia Medica – drug and medicinal remedies

Myrrh – a remedy used as an appetite stimulant, carminative, skin protective; with healing properties

Olibanum (frankincense) –oleogum resin

Ebers Papyrus (1500 BC) – Found in Egypt by George Ebers

- One of the 11 medical scrolls that preserve the knowledge of early Egyptian medicine

- 700 drugs w/ formulas for over 800 remedies

- Use of mortars & pestles, hand mills, mills, sieves & weighing scale

AHFS – comprehensive unbiased source of information on drugs provided on a supplemented basis annually

Institutes – a continuing education program served to help the hospital pharmacy practitioner keep up with current trends of professional service

1910 – End result system of hospital accreditation

Medical Malpractice – improper, negligent treatment of a patient by a health care professional

ASHP – formed during clinical years

- Patient as the focal point for existence of pharmacy practice

IPA – provides extensive coverage of the pharmaceutical literature

ACRONYMS.SSA – Social Security Amendments

AHA – American Hospital Association

PHA – Philippine Hospital Association

DOH – Department of Health

CEO – Chief Executive Officer

PRC – Professional Regulation Commission

SALAD – Sound Alike Look Alike Drugs

HAM – High Alert Medications

ACS – American College of Surgeons

JCAH – Joint Commission on Accreditation of Hospitals

JCAHO- Joint Commission on Accreditation of Health Care Organizations

UDDDS – Unit Dose Drug Distribution System

ASHP – American Society of Hospital Pharmacists (1942)- American Society of Health-System Pharmacists

AJHP – American Journal of Hospital Pharmacy

IPA – International Pharmaceutical Abstract

AHFS – American Hospital Formulary Service

TJC – The Joint Commission

JCI – Joint Commission International

ACCP – American College of Clinical Pharmacists

AACP – American Association of Colleges of Pharmacy

APhA – American Pharmacists Association

ACCP – Asian Conference on Clinical Pharmacy

FAPA – Federation of Asian Pharmaceutical Association

PPRC – Philippine Pharmaceutical Research Congress

ENUMERATION.Internal forces:

Organizational structure of a hospital There is a physician – pharmacist –

nurse – patient relationship in the hospital

Organizational Structure:

The Administrator Department Leaders The Business and Finance Department The Building Services Department The Human Resources Department The Clinical Laboratory Department The Nursing Service Other

External Forces:

Accreditation Agencies Licensing Agencies The Federal Government Third-party Agencies Social Agencies and Governmental

Welfare Agencies Governing Board and Public Opinion

Mission:

Lead Enable Assist Protect

Hospitals towards quality service

Classification of Hospitals

Type of service Length of stay Ownership Bed capacity Service capability

Type of service:

General Special Rehabilitation and Chronic Disease Psychiatric

Length of Stay:

Short-term Long-term

Ownership:

GovernmentalFederalState

a. Countyb. Cityc. City-county

NongovernmentalNonprofitFor profit

a. Individualb. Partnershipc. Corporation

Bed Capacity:

Large (above 1000) Medium (between 500-1000) Small (between 100-500) Very Small (less than 100)

Service Capability

Primary Care Hospital Secondary Care Hospital Tertiary Care Hospital

PRIMARY SECONDARY TERTIARYNon-departmentalized hospital that provides clinical care and management on the prevalent

diseases in the locality

Departmentalized hospital that provides clinical care and management on the prevalent diseases in the locality, as well as particular forms of treatment, surgical procedures and intensive care

Teaching and training hospital that provides clinical care and management on the prevalent diseases in the locality, as well as specialized and sub-specialized forms of treatment, surgical procedure and intensive care

Clinical services include: General medicine Pediatrics Obstetrics and

Gynecology Surgery Anesthesia

Clinical services provided in Primary care, as well as Specialty Clinical Care

Clinical services provided in Secondary Care, as well as sub-specialty clinical care

Provides appropriate administrative and ancillary services (clinical, laboratory, radiology and pharmacy)

Provides appropriate administrative and ancillary services (clinical, laboratory, radiology and pharmacy)

Provides appropriate administrative and ancillary services (clinical, laboratory, radiology and pharmacy)

Provides nursing care for patients who require intermediate, moderate and partial category of supervised care for 24 hrs or longer

Nursing care provided in Primary Care, as well as total and intensive skilled care

Nursing care provided in Secondary Care, as well as continuous and highly specialized critical care

Fundamental functions of Hospitals:

Patient Care Education Research Public Health

Major purposes of Research:

Advancement of medical knowledge against disease Improvement of hospital services

Internal organization of Governing Board:

President/Chairman Vice-Chairman Secretary Treasurer

Committees appointed:

Executive committee Hospital committee Finance committee Committee on Public Relations

Responsibilities of CEO:

Selection of Competent Personnel Control of funds Supervision of the physical plant

Groups of Hospital Staff:

Professional Care Business Management

Types of Hospital Staff:

Open Staff Closed Staff

Categories of the Medical Staff:

Honorary Consulting Active/Attending Associate Courtesy Resident

Sources of Income:

Patients Government Third-party Hospitalization Insurance Voluntary Contributions Endowment funds and Investments

2 groups of services

Traditional Functions of Pharmacists:

Procurement Packaging Storage Controlling Distribution Compounding Assaying Monitoring of Medication Manufacturing Dispensing

Developed Minimum Standards for Hospitals:

Dr. Ernest Codman, MD Dr. Franklin Martin

Objective:

Health Care Provide safe and effective care of the

highest quality and value

Significant Contributions of ASHP:

Development of standards of practice Continuing education Various publications to support

practices Standard for residency training Residency accreditation services

Residency Training Programs:

Nuclear Community Pediatric Psychiatric Geriatric Drug Information Oncology Primary Care Critical Care Intensive Care

NOT INCLUDED IN THIS REVIEWER:

Administrative Structure of the Hospital Pharmacy

ASHP Guidelines: Minimum Standards for Pharmacies in Hospitals

((Ewan ko na)) :D

~~~GoodLuck!~~~

-Kim Manlangit :)

COMPUTATIONS:DP = cost of drug + % markup

DP = cost of drug + professional/dispensing fee

DP = cost of drug + % markup + cost of supplies

Amoxicillin 10 mg = P9.50 from manufacturer

DP = 9.50 + (9.50 x 0.50) = 9.50 + 4.75 = P14.25 / capsule

A prescription calls for Cefalexin 500mg capsules (1 cap 3x a day fow 1 week). The acquisitor cost of Cefalexin 500mg/cap is P17.75. The % markup is 25%. Compute for the DP to complete the medication.

DP = 17.75 + (17.75 x 0.25) = 17.75 + 4.4375 = P22.19 / capsule x 21 = P465.94

RXDrug A 325mg/pptabDispense (1 pptab 3x a day) pptabs good for 3 weeks

Commercially available: Drug A 625mg tabAcquisitor cost: P15.75 / tabletPE/pptab: P3.50 (ANO YUNG PE?????)

Total Amount of Drug A3x day x 21 days = 63 pptabs325 mg drug : 1 pptab = x : 63 pptabX= 20,475 mg drug A

625 mg : 1 tablet = 20,475 mg : xX = 33 tablets

33 tablets x P15.75 = P519.75

DP = P519.75 + (63 + 3.50)DP = P740.25