Developing The Infrastructure For A Patient Care

Developing The Infrastructure For A Patient CarePHCL 472Nouf M AloudahClinical Pharmacy LecturerCollege of PharmacyKing Saud University1QuizPrevious quiz was bad! If cheating happened I will deduct one mark from ALL Today quiz 2Developing The Infrastructure For a Patient CareIntroductionPharmaceutical care requires the right infrastructure1990 Charles Hepler and Linda Strand an organization structure that facilitates the provision of careHolland et al the physical environment is one of three key areas to focus on when changing pharmacy practice 3Developing The Infrastructure For a Patient CareIntroduction (cont)Infrastructure assessment and planningAutomation and technologyUsing pharmacy techniciansPolicy and procedure manualsUsing space effectively4Developing The Infrastructure For A Patient CareInfrastructure Assessment And PlanningExamine what you have in place nowThink through the results you wantRushing may be costly and counterproductive

5Developing The Infrastructure For A Patient CareInfrastructure Assessment And PlanningIdentify The Ideal PracticeBegin with the end in your mind

6The drug use Process

7Developing The Infrastructure For A Patient CareInfrastructure Assessment And PlanningIdentify The Ideal PracticeImagine the ideal practice Create a flow diagram that shows each process should be unfold in your settingEach step consider:Who will do it? When they do it? How will they do it? Why will they do it?

8 Sample Flow Diagram

9Developing The Infrastructure For A Patient CareInfrastructure Assessment And PlanningIdentify The Ideal PracticeHow each component affect other and how will your flow diagram be changed

10Developing The Infrastructure For A Patient CareInfrastructure Assessment And PlanningIdentify prioritiesImmediate change is beyond your financial, physical, psychological resourcesWhich element are top priority and which can wait

11Developing The Infrastructure For A Patient CareAutomation and technologyBefore askIs it needed?What is the cost benefit ratio?Is it affordable?What is its longevity?Will it really do what I think it can do?What will be needed to support it?Will staff and customers accept this change?12AGREE/ DISAGREE/ NEUTRAL GAME

Automation in pharmacy will help me move to better patient care13Developing The Infrastructure For A Patient CareAutomation and technologyPhysician today has powerful expensive tools to diagnose and treat illness while others are lagging behinds!Electronic medical device, electronic prescription processing systemWe are not adapting fast enough14Developing The Infrastructure For A Patient CareAutomation and technologyPutting Automation In PlaceIt will free pharmacists time so they can provide patient careHow it fits in the ideal drug use processDecentralized unit dose cabinetryCentral fill technology 15Developing The Infrastructure For A Patient CareAutomation and technologyPutting Automation In PlaceIncrease efficiency and reduced errors, waste, and costsIn pharmacy cur risks to personnel by keeping them away from dangerous material such toxic chemos, decrease waste bec. Material are tracked more closely, 16Developing The Infrastructure For A Patient CareAutomation and technologyVendor and Product Analysis (reading only not in exam)Numbers has explodedOutdated quickly as new technology is introducedwww.pharmacyautomation.com17Developing The Infrastructure For A Patient CareAutomation and technologyDeveloping the RFP or RFI (reading only not in exam)List of criteria is expected to meet (track inventory, reconcile purchasing invoice with payment and shipments)Request for proposal, request for informationDetailed document asking them for a formal proposal describing their products and services18Developing The Infrastructure For A Patient CareAutomation and technologyDeveloping the RFP or RFI (reading only not in exam)Challenging process but with the help of flow diagram think of your needs19Developing The Infrastructure For A Patient CareAutomation and technologyVariables to considerPrice and leasing or purchasingAll costs before not after purchasing (installation, interface with current computer system, software, supplementary equipment, supplies, user training, maintenance)Reducing the staff you need, bigger Rx volume, payback analysis to calculate how long it will take for the automation to pay for it self20Developing The Infrastructure For A Patient CareAutomation and technologyVendor supportGood customer supportHow and when vendors will respond to problemsNegotiate it early to avoid problems21Developing The Infrastructure For A Patient CareAutomation and technologyinterfacesGet it in written if they mention it is simple22Developing The Infrastructure For A Patient CareAutomation and technologycalibrationYour staff will do it them selves, what is the cost? And how long will it take?23Developing The Infrastructure For A Patient CareAutomation and technologyAncillary expensesSpecific types of labels, bar code packagingEvaluate both cost and availability24Developing The Infrastructure For A Patient CareAutomation and technologyadaptabilityPotential changes in workloadWhat additional costs will be associated with expanding the equipments capacity?25Developing The Infrastructure For A Patient CareAutomation and technologyImplementation issuesExpect a learning curve and pumps in the road before things function smoothly26Developing The Infrastructure For A Patient CareAutomation and technologyQuality controlMechanisms to Maintain itProcedure should be spelled out in detail so they always are performed consistly

27Developing The Infrastructure For A Patient CareAutomation and technologyQuality controlStocking mechanismsMachine cassettesDocumentationEnsure pt safety and meets lawsGarbage in garbage outCatch human errors

28Developing The Infrastructure For A Patient CareAutomation and technologyLegal and regular issuesJCAHONational committee for quality assuranceUltimate goal is to ensure public safety90% of regulation on drug use process that cause less than 10% of pt drug related problemsOBRA 90 made it mandatory for pharmacists to counsel Medicade pt about their medications and to perform prospective drug use review

29Developing The Infrastructure For a Patient Care

30Developing The Infrastructure For A Patient CareAutomation and technologyJustifying the dollarsCapital expenditureActual dataEfficiencyReducing errorsReduce waste, increasing paymentsReducing costsConvincing decision makers

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32AGREE/ DISAGREE/ NOT sure

Technician do all drug process steps starting from computer entry till preparing it, pharmacist do the final check and counsel the patient

33Developing The Infrastructure For A Patient CareUsing Pharmacy TechnicianTechnicians are helpful in freeing pharmacists from drug distribution tasksWhich tasks can be delegated to technicians?What systems must be in place to ensure pt safety?34Developing The Infrastructure For A Patient CareUsing Pharmacy TechnicianTo expand their knowledge you mustChange old habits: min time spend in product related activitiesImplement appropriate training programsEstablish methods to asses their competencyWork activity analysis3536

Calculating staff adjustments

37Developing The Infrastructure For A Patient CareUsing Pharmacy TechnicianMaking staff adjustmentsFocus first in few tasks38Developing The Infrastructure For A Patient CareUsing Pharmacy TechnicianPreparing technician for new rolesPharmacy technician certification board (PTCB) www.ptcb.org39Developing The Infrastructure For A Patient CarePolicy and procedure manualsWritten document outlining expectations and processOutdated quicklyPolicies generated in reaction to a specific, short term problemsNo table of content

40Developing The Infrastructure For A Patient CarePolicy and procedure manualsIf I were a new employee, how would I determine what is expected of me, the standards I will be held accountable for, and the tasks I must carry out?

41Developing The Infrastructure For A Patient CarePolicy and procedure manualsBefore you start writing

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Developing The Infrastructure For A Patient CarePolicy and procedure manualsAssembling the manualHuman resources managementDistribution and clinical operationsContinuous quality improvement

43Developing The Infrastructure For A Patient CarePolicy and procedure manualsAssembling the manualHuman resources management

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45Developing The Infrastructure For A Patient CarePolicy and procedure manualsAssembling the manualoperations

46Developing The Infrastructure For A Patient CareUsing space effectively

47Developing The Infrastructure For A Patient Careconclusion

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