Financial management of hospital pharmacies

This paper launches a 12-part series of articles on financial management of hospital pharmacies. This series is designed to help hospital pharmacists develop expertise in financial management so that they can keep pace with changing reimbursement structures and shrinking departmental budgets. The objectives, responsibilities, and capabilities of the hospital financial department will be reviewed, and the need for pharmacy directors to develop departmental financial management systems will be stressed. Methods of collecting financial information and preparing financial reports will be reviewed, as well as how those reports can be used in managing the pharmacy. Budgeting techniques will be demonstrated, methods for analyzing expenses and revenues will be illustrated, and possible cost-containment activities will be identified. Methods used by hospital administration to control costs of all departments will be reviewed.     

Pseudomonas aeruginosa in hospital pharmacies.

The environments of hospital pharmacies and the preparations made in these pharmacies were examined for Pseudomonas aeruginosa. This organism was widely distributed in the pharmacies and was isolated from 9% of preparations. In 11 instances strains of Ps aeruginosa from the preparations bore a close resemblance to strains previously found in the pharmacy environments.     

Availability of information on renal function in Dutch community pharmacies

Background Early detection and monitoring of impaired renal function may prevent drug related problems. Objective To assess the availability of information on patient’s renal function in Dutch community pharmacies, for patients using medication that might need monitoring in case of renal impairment. Methods Per pharmacy, 25 patients aged ≥65 years using at least one drug that requires monitoring, were randomly selected from the pharmacy information system. For these patients, information on renal function [estimated glomerular filtration rate (eGFR)], was obtained from the pharmacy information system. When absent, this information was obtained from the general practitioner (GP). Results Data were collected for 1632 patients. For 1201 patients (74 %) eGFR values were not directly available in the pharmacy, for another 194 patients (12 %) the eGFR value was not up-to-date. For 1082 patients information could be obtained from the GP, resulting in 942 additional recent eGFR values. Finally, recent information on renal function was available for 72 % (n = 1179) of selected patients. Conclusion In patients using drugs that require renal monitoring, information on renal function is often unknown in the pharmacy. For the majority of patients this information can be retrieved from the GP.     

Diversification strategies for hospital pharmacies

Several ways used by the pharmacy department of a large university hospital to generate revenue through diversification are described. The department offers its facilities and staff as a resource in training medical service representatives for several pharmaceutical manufacturers, which is projected to provide $85,000 in net income for fiscal year (FY) 1983-84. The pharmacy department also conducts a six-month program for training pharmacy technicians, which yields a small net profit. The pharmacy department actively participates in educational programs such as college courses and clerkships earning extra income. An apothecary-style outpatient pharmacy was set up under a for-profit corporation. Services have been expanded to include the preparation of i.v. solutions that support home care. A durable medical equipment (DME) business is planned. The ambulatory and home-care programs are expected to generate approximately $165,000 in net profit next year. Contract pharmaceutical services are provided to another hospital. The net income generated through diversification in this pharmacy department will exceed $250,000 in FY 1983-84.     

National survey of state psychiatric hospital pharmacies.

The results of a winter 1990 nationwide mail survey of pharmaceutical services provided in state psychiatric hospitals are reported and discussed. The survey universe consisted of all 207 state psychiatric hospitals registered by the American Hospital Association. Private and federal and other government-operated psychiatric hospitals were not included. Questionnaires were mailed to the director of pharmacy at each institution. Two questionnaires were not deliverable. There were 117 usable replies, for a net response rate of 57.1%. Compared with community hospitals, state psychiatric hospitals had pharmacy departments that were open fewer hours per week, occupied more floor space, were less likely to have a complete unit dose distribution system and i.v. admixture program, had lower inventory turnover rates, and had fewer full-time positions. About 28% of the respondents employed pharmacists who spent at least two thirds of their time providing clinical services. Differences in the provision of pharmaceutical services between state psychiatric hospitals and community hospitals may be due in part to the fact that most of the former are long-term-care institutions rendering a specific class of therapies.     

Survey of sterile product compounding practices in Canadian hospital pharmacies

Improper preparation of sterile products by hospital or community pharmacies may have serious consequences. Recent reports of deaths or injury to patients as a result of receiving products that were contaminated during their preparation in a pharmacy have highlighted the importance of maintaining good sterile compounding practices. Efforts are now underway to develop revised guidelines for the compounding of sterile products in order to minimize the potential for future recurrence of similar incidents. This survey study was undertaken to provide background data on current sterile products compounding practices and procedures in Canadian hospital pharmacies. It was also anticipated that these data would be helpful in identifying issues that needed to be addressed in the new guidelines. Surveys were distributed to 700 Canadian hospitals with 50 or more beds. Responses from returned surveys were entered into and analyzed using the database program RBase. A total of 306 hospital pharmacies responded, with 200 indicating that sterile products were compounded within their department. The information provided by respondents provides insight into the types of sterile products being prepared in Canadian hospitals, the training background of staff involved in sterile product preparation, the type of facilities and equipment used for compounding these preparations, and the quality control/quality assurance procedures that are in place in hospital pharmacies. The information arising from this survey underscores the need for comprehensive guidelines or standards with respect to sterile product compounding, and the need for improved training of personnel involved in sterile product compounding. The results should be of interest to hospital pharmacy administrators, pharmacy regulatory bodies, and government agencies responsible for assuring the safety of pharmaceutical products used in patient care.