HOW TO GET STARTED PLANNING CLINICAL
1 HOW TO GET STARTED PLANNING CLINICAL PHARMACY SERVICES PHCL 471 Nouf Aloudah, lecturer, college of pharmacy, King Saud University How To Get Started Planning Clinical Pharmacy Services 2 introduction How To Get Started Planning Clinical Pharmacy Services 3 Developing a clinical pharmacy philosophy I. The first consideration in developing a plan should be your department goals and objectives Is there a mission statement for your pharmacy? Are broad goals stated in writing? Is there long range department plan? Do these documents, if exits, establish a “clinical pharmacy philosophy” for the department? How To Get Started Planning Clinical Pharmacy Services 4 I. Developing a clinical pharmacy philosophy Any thoughts you have about establishing a program of clinical services should be examined in terms of the purpose, goals, and objectives of the pharmacy departments You may see a need to formalize a statement of philosophy for the department that speaks to the pharmacist’s responsibilities in promoting rational drug therapy How To Get Started Planning Clinical Pharmacy Services 5 I. Developing a clinical pharmacy philosophy If your pharmacy has strong philosophical commitment to clinical pharmacy services, you already past the first major hurdle in getting started How To Get Started Planning Clinical Pharmacy Services 6 Clinical pharmacy and drug use process II. Before begin the planning, the pharmacist first must understand the stages of the drug use process and the pharmacist’s role 7 8 How To Get Started Planning Clinical Pharmacy Services 9 Clinical pharmacy and drug use process II. Very complicated system Traditionally we have concerned mainly with the purchasing and distribution functions, but put in mind any failure in other stages will result in system failure ex if drugs are not administered properly How To Get Started Planning Clinical Pharmacy Services 10 II. Clinical pharmacy and drug use process Roles includes Detection and prevention of drug related problems Irrational prescribing Dispensing excessive quantities Inappropriate routes of administration and other drug administration errors Inappropriate and excessive dosages due to failure to accommodate for changes in metabolism and excretion of drugs Adverse reactions Drug interactions And many others How To Get Started Planning Clinical Pharmacy Services 11 III. Assessing the need for clinical services First step is need assessment Identifies and defines needs and sets priorities for addressing those needs Four components Recognition of need Investigation of need Analysis of need Needs selection Needs assessments 12 How To Get Started Planning Clinical Pharmacy Services 13 III. Assessing the need for clinical services Recognition of need A review of any concern or problems that have been identified Evaluation of drug utilization (DUR), medication variance reports, quality assurance audits, cost analysis of antibiotic usage, committee reports on drug related problems How To Get Started Planning Clinical Pharmacy Services 14 Assessing the need for clinical services Recognition If of need do not exist in your hospital, you might consider the value of implementing them How To Get Started Planning Clinical Pharmacy Services 15 Assessing the need for clinical services Recognition Discussion of need with key individuals within institution ( P & T committee, nursing ….) would be helpful How To Get Started Planning Clinical Pharmacy Services 16 III. Assessing the need for clinical services Recognition Should of need evaluate both quality and quantity of activities associated (wrong time blood samples, how much) How To Get Started Planning Clinical Pharmacy Services 17 III. Assessing the need for clinical services Recognition Should of need be viewed in light of the hospital objectives, hospital standards within the community, JCAH accreditation standards Unique features of your institution How To Get Started Planning Clinical Pharmacy Services 18 III. Assessing the need for clinical services Investigation of need You recognized the need, your current pharmacy services program should be reviewed in an effort to determine whether any of the needs can be met through improving or expanding existing services or if totally new service programs are needed Ex squeezing in extra 30 min per day of a pharmacist’s time to review charts in the ICU or establishing of a full time clinical pharmacist in the ICU How To Get Started Planning Clinical Pharmacy Services 19 III. Assessing the need for clinical services Investigation of need Consideration of the medical staff’s level of knowledge about and concern for drug therapy How receptive the members of the medical staff are to having others involved in How nursing staff will face that their work will be affected Effect on other departments How hospital administration may react to a proposed new services How To Get Started Planning Clinical Pharmacy Services 20 III. Assessing the need for clinical services Analysis of need Is the process whereby one develops an understanding of the nature, extent, and cause of the need Revaluation of all data collected previously Yes or no decision How To Get Started Planning Clinical Pharmacy Services 21 III. Assessing the need for clinical services Needs selection You should set priorities Which need is most critical? Which ones will I most likely be successful in meeting? 22 How To Get Started Planning Clinical Pharmacy Services 23 IV. Evaluation of resources Single most important resource is personnel Competence , asses knowledge, skills, attitudes, and commitment Pharmacy staff attitude toward any proposed new clinical services Technical and administrative support space How To Get Started Planning Clinical Pharmacy Services 24 V. Developing a plan Careful, through and analytical thinking of all steps which will be required to implement your new program Whose permission do I need to get started? What must I do to get any additional resources needed to implement the program? Are there any hospital or medical staff committees I need to go through? ……… How can I evaluate the new service program once it have been implemented? How To Get Started Planning Clinical Pharmacy Services 25 V. Developing a plan Framework for your plan Sets of strategies related to individual components of the plan Timetable for implementation of the program (what you will do in wait time) How To Get Started Planning Clinical Pharmacy Services 26 Gaining acceptance for the program Selling Consider A. Political process B. Costs C. Key people ad departments D. Timing E. Program justification VI. How To Get Started Planning Clinical Pharmacy Services 27 VI. A. Gaining acceptance for the program Political process Organizations includes hospitals are subject to endless pressure both external and internal Demands of the community, the requirements of legal and regular bodies, the economy, personnel problems, pressure from medical staff and department heads and others How To Get Started Planning Clinical Pharmacy Services 28 5. A. Gaining acceptance for the program Political process Limited resources and endless demands Remember spending decision in hospitals were made solely on the basis of improved patient care Don’t be upset just keep them informed of your goals, good relationship How To Get Started Planning Clinical Pharmacy Services 29 5. B. Gaining acceptance for the program cost Total cost of materials, duplicating, office overhead, secretarial time, others Cost benefit analysis, cost effectiveness studies Complex and Difficult in obtaining the information necessary to make decision You may justify the need without such studies How To Get Started Planning Clinical Pharmacy Services 30 V. C. Gaining acceptance for the program Key people and department 31 How To Get Started Planning Clinical Pharmacy Services 32 5. D. Gaining acceptance for the program Timing Very important Weak proposal presented at just the right time may have a better chance than a much stronger proposal at the wrong time How To Get Started Planning Clinical Pharmacy Services 33 5. E. Gaining acceptance for the program Program justification Your ability to justify it to hospital administration Proposal should contain …. (Go and look at it) Accepted physical appearance How To Get Started Planning Clinical Pharmacy Services 34 6. Pharmacy preparation Good foundation Self evaluation in each appropriate subject area Self study modules Continuous education programs, journal clubs, conferences timetable How To Get Started Planning Clinical Pharmacy Services 35 Summery Just remember that pharmacist with little or no formal training in clinical practice can provide good clinical services
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