A satellite pharmacy program in a community hospital

A satellite (decentralized) pharmacy program in a medium-size community hospital is described. The hospital is a private institution consisting of three divisions: an acute-care division, a psychiatric division, and a long-term care division. Pharmacy services are provided on an around-the-clock basis, and the satellites are operational 16 hours daily. Pharmacy services include unit dose distribution, I.V. admixture services, and clinical pharmacy programs. Structurally, the department is divided into four satellite units and a central pharmacy unit to provide care to all areas of the health center. The professional staff is divided into several categories as a means to overcome the difficulties and take full advantage of all of the benefits of the satellite system. The Associate Director and the Assistant Director perform primarily administrative functions in order to maintain overall control, coordination, and quality assurance of the department. The Education Coordinator helps maintain the level of basic competence of the staff and coordinates the development and implementation of new departmental programs. Staff Pharmacists II provide both administrative and professional functions in their roles as team leaders of individual satellite units. Staff Pharmacists I serve the traditional staff functions in a satellite unit or in the central pharmacy.     

Development and implementation of a pharmacy technician training program.

A nine-month on-the-job training program for hospital pharmacy technicians is described. The first three months of the program are devoted to didactic training and the remaining six months to acquiring practical experience. Candidates for the program are provided through state-sponsored public assistance or manpower training programs. A minimum of six individuals are needed to begin a program to ensure that during at least three complete it. Forth technicians have completed the program during the past six years, and eight are currently employed by the hospital. Thirteen others are known to be employed at other institutions or in health-related occupations.     

Development and implementation of a smoking cessation clinic in community pharmacy practice

OBJECTIVE: To describe a pharmacist-operated program to help people stop smoking. SETTING: Community chain (mass-merchandise) pharmacy practice sites in Virginia. PARTICIPANTS: Faculty at the Virginia Commonwealth University School of Pharmacy (VCU) and 15 practicing pharmacists. PRACTICE DESCRIPTION: Smoking cessation clinics within the pharmacy departments of seven Target stores. PRACTICE INNOVATION: With input from the practicing pharmacists and using the most current strategies reported in the literature, faculty at VCU developed a training manual for smoking cessation counseling. This manual was used to facilitate a 4-hour training session and also served as a resource for pharmacists in the smoking cessation clinics. Pharmacists were taught about behavioral modifications, the Transtheoretical Model of Change as applied to smoking cessation, documentation, the Fagerstr?m Test for Nicotine Dependence, smoking cessation therapies, patient counseling techniques, physical assessment skills, and how to develop an individualized action plan for smoking cessation. As pharmacists established smoking cessation clinics, issues such as workflow, continuous quality improvement, and marketing were addressed by the faculty members and practitioners. RESULTS: Using the process and tools described in this article, pharmacists successfully established and operated smoking cessation clinics. CONCLUSION: The process and materials developed for this demonstration project can serve as templates for other pharmacy faculty members and community pharmacists who wish to offer smoking cessation clinics.     

Modeling the cost-effectiveness of a smoking-cessation program in a community pharmacy practice

OBJECTIVES: To describe some of the costs of providing a smoking-cessation program in a community pharmacy practice, and to model the program's cost-effectiveness compared with that of a self-directed quit attempt. DESIGN AND SETTING: Data used were based primarily on results from a pharmacist-directed smoking-cessation program in a community pharmacy chain practice that achieved continuous abstinence for at least 1 year in 25% of patients. Baseline assumptions were formulated from a MEDLINE literature review and were varied in the sensitivity analysis. Overall costs were based on program costs and retail cost of the selected cessation method (cold turkey, nicotine patch, nicotine gum, or bupropion). PATIENTS: Forty-eight patients, more than two thirds of whom were women, aged 21-70 years, who had tried at least once to quit smoking. MEASUREMENTS AND MAIN RESULTS: Incremental cost-effectiveness was measured in terms of cost/successful quit attempt based on the payer's perspective. Cost/life-year saved and cost/quality-adjusted life-year saved also were calculated for the societal perspective. Incremental cost for an additional patient to quit smoking using the pharmacist-directed program alternatives versus a self-directed quit attempt was $236 for the cold turkey method, $936 for nicotine patch, $1232 for nicotine gum, and $1150 for bupropion. Depending on the smoker's age at the time of cessation, the incremental discounted cost-effectiveness was $720-1418/life-year saved. CONCLUSION: This analysis demonstrates that a pharmacist-directed cessation program is a cost-effective alternative to a self-directed quit attempt with respect to payers and society. Additional analyses conducted in community pharmacy practice are necessary to corroborate our results.     

A residency program in community pharmacy practice.

As pharmacists increase their involvement in patients' drug therapy, the lack of opportunity for advanced clinical and administrative training becomes more critical, particularly for community pharmacists. To assist in the postgraduate development of community pharmacists, the faculty of pharmaceutical sciences at the University of British Columbia began a residency program in community pharmacy practice in June 1981. Modeled on the successful hospital pharmacy residencies, the program goals are to provide advanced clinical training in ambulatory patient care, and detailed and practical management training, and to develop pharmacists with skill in clinical teaching who will participate in the undergraduate programs of the faculty. The 12-month residency includes guided self-study and a series of practica in areas of therapeutics, management, drug information, clinical and teaching skill, professional service, and continuing education. These practica are served mainly in clinical practice settings such as community pharmacies, clinics, physicians' offices, and teaching hospitals. The residency has demonstrated its value and viability. Growing interest in such programs, and the success of this program in particular, should encourage the development of similar programs in Canada.     

Impact of a community pharmacy transitions-of-care program on 30-day readmission

Objectives

The primary objective of this study was to evaluate the impact of a transitions-of-care (TOC) program on both all-cause and related 30-day hospital readmission. The secondary objective was to evaluate which patient-specific factors, if any, are predictive of 30-day hospital readmissions.

Integrating community pharmacy with NHS Direct: evaluation of a pilot scheme

□ The National Health Service plan promised referral to pharmacy by NHS Direct by 2002 □ Evaluation of a pilot scheme showed that the initial referral rate to pharmacists fell markedly over a few months □ Pharmacists were positive about both NHS Direct and the pilot scheme but we found no evidence of added benefit in terms of callers' views of the service □ NHS Direct nurses supported the scheme in principle, but in practice had concerns about referring to pharmacists in the absence of a clear rationale     

Development and pilot testing of a multiple mini-interview for admission to a pharmacy degree program

Objectives. To develop and pilot test a multiple mini-interview (MMI) to select students for admission to a pharmacy degree program.Methods. A nominal group process was used to identify 8 important nonacademic attributes of pharmacists, with relative importance determined by means of a paired-comparison survey of pharmacy stakeholders (ie, university-affiliated individuals with a vested interest in the quality of student admitted to the pharmacy program, such as faculty members, students, admissions staff members, and practitioners). A 10-station MMI based on the weighted-attribute blueprint was pilot tested with 30 incoming pharmacy students. MMI score reliability (intraclass correlation coefficient [ICC]) and correlation with other admissions tool scores were determined.Results. Station scores provided by student interviewers were slightly higher than those of faculty member or practitioner interviewers. While most interviewers judged a 6-minute interview as “just right” and an 8-minute interview “a bit long,” candidates had the opposite opinion. Station scenarios had face validity for candidates and interviewers. The ICC for the MMI was 0.77 and correlations with prepharmacy average (PPA) and Pharmacy College Admission Test (PCAT) composite were negligible.Conclusions. MMI feasibility was confirmed, based on the finding that interview scores were reliable and that this admissions tool measures different attributes than do the PCAT and PPA.