complete and detail learning on the introduction to the hospital and hospital pharmacy. this ppt help to learn more on this topic for the teachers , students as well as health care professionals

1. INTRODUCTION
TO HOSPITALS & HOSPITAL PHRMACY

2. CHAPTER 1: INTRODUCTION
TO HOSPITALS & HOSPITAL
PHRMACY
Section 1.1- Definition
Classification
Organizational structure of Hospital,
Administration and Functions of Hospitls

3. Hospital
• Hospital is an institution for the care, cure and treatment
of the sick and wounded, for the study of the diseases,
and for the training of the doctors and nurses.
• Definition according to WHO:
The hospital is a complex organization utilizing
combination of intricate, specialized scientific equipment,
and functioning through a corps of trained people
educated to the problem of modern medical science.
• These are all welded together in the common purpose of
the maintenance of good health.

4. Classification of Hospitals
Hospitals have been classified, on the basis of different criteria.
A. Size or Bed Capacity: The size of a hospital is determined
by the number of beds it has. Based on the bed capacity,
hospitals can be categorized as follows:
a) Small hospital - Bed capacity of 100 or less.
b) Medium size hospital - Bed capacity of 101 to 300 beds
c) Large hospital - Bed capacity of 301 to 1000 beds
The bed strength of different types of hospitals is as follows:
a) Teaching and Referral Hospital - 200 to 300
b) District Hospital - 50 to 200
c) Taluka Hospital - 50 to 200
d) Community Health Centre - 30 to 50
e) Primary Health Centre - 6 to 10

5. B. Ownership or Control: On the basis of ownership or
control, hospitals are classified into the following:
1. Government or Public Hospital:
• These are run by Central or State Governments.
• These are funded by the government.
• They can be general or specialized hospitals.
2. Non–Government Hospitals:
• They are supported by client’s fees, donations, or endowments (relating
to funds or property donated to institutions or individuals).
 Non-government hospitals are further classified as either proprietary or
non–profit organization.
a. Proprietary hospitals are owned by individuals, partnerships or
corporation whose dividend is shared by the partners.

6. b. Non–profit organization- They can be categorized as follows:
a). Voluntary hospitals:
• These are established and incorporated under the Societies
Registration Act 1860 or Public Trust Act 1882 or any other
Central or State Governments.
• They are run by public or private funds on a non– commercial
basis.
b). Private Nursing homes / hospitals:
• They are generally owned by an individual doctor or group of
doctors and they are run on a commercial basis.
c). Corporate hospitals:
• They are public limited companies formed under the
Companies Act and are run on commercial lines.
• They can be either general or specialized or both.

7. C. Objectives of the Hospital: Based on the objectives, hospitals can be classified
into the following:
1. Teaching-cum-Research Hospital: The primary objective is training of doctors
and research. Healthcare is secondary. For example, Medical Colleges.
2. General Hospitals: These hospitals offer treatment for common diseases. The
main objective is to provide medical care, whereas teaching is secondary.
3. Specialized Hospitals: These hospitals concentrate on giving medical and
nursing care in a specific area, e.g. ophthalmic hospital, heart hospital, etc.
4. Isolation Hospital: This is a hospital in which client requiring isolation or clients
suffering from communicable diseases are taken care of.
5. Rural Hospitals are those located in rural areas permanently staffed by at least
one or more physicians.

8. D. Systems: According to the system of medicine, hospitals are
classified into the following:
a) Long – term care hospitals or chronic care hospital:
 In this client stays in the hospital for a long time and the
disease may be of chronic nature (Chronic Disease is a long-
lasting condition that can be controlled but not cured).
 e.g. leprosy (Leprosy is an infectious disease that causes
severe, disfiguring skin sores and nerve damage in the arms
and legs), cancer, etc.
b) Short – term care hospital or acute care hospital:
 In this the client stay in the hospital for a short period only and
the disease is usually of acute nature
 e.g. pneumonia gastroenteritis.

9. E. Management: According to the management, hospitals are classified as follows:
1. Hospitals run by Union Government / Government of India: These hospitals are funded
by Government of India. For eg, hospitals run by railways and army.
2. Hospitals run by State Government: These are hospitals which are funded and
administered by State Government.
3. Hospitals run by local bodies e.g. hospitals run by municipality, Zila parishad, Panchayat,
etc.
4. Autonomous bodies: These hospital have the operational responsibility to the hospital
governing board, usually granted by the government. The management authority with
respect to personnel administration and budget administration rests with the governing
board for more efficient performance and more discretion by management to achieve
it.
5. Private hospital: A private hospital is owned by a profit company or a non-profit
organisation and privately funded through payment for medical services by patients
themselves.
6. Voluntary hospital: It is a hospital supported in part by voluntary contributions and
under the control of a local, usually self-appointed board of governors.

10. Organizational Structure of the Hospital
A. The uppermost level of hospital management:
• The hospital director = Chief Executive Officer (CEO) or president
B. Second level managers:
• Chief Operating Officer (COO)
• Chief Financial Officer (CFO)
• Director of Nursing
C. Bigger hospital may have third level management to assist second level
and called as Hospital Assistant Director
D. The next level of management:
• Department heads or directors (pharmacy, nursing, other clinical and
support services)
• They have responsibility for managing and directing all aspects of
particular service such as pharmacy services

11. ROLES
Chief Executive Officer (CEO):
 sets direction by creating vision & mission
 reports to the hospital’s board of directors
 responsible for budget, personnel, & operations
• Chief operating officer (COO)
 responsible for daily operations
• Chief financial officer (CFO)
 responsible for financial management
• Hospital Assistant Director
 Responsible for direct patient care departments (pharmacy,
nursing etc).

12. Departments in a Hospital
The following departments are generally available in a hospital:
1. Outpatient Department (OPD):
 An outpatient is a patient who is not hospitalized for 24 hours or
more but who visits a hospital, clinic, or associated facility for
diagnosis or treatment.
 Treatment provided in this fashion is called ambulatory care.
 The admission to the hospital involves the production of an “admission
note”.
 The leaving of the hospital is officially termed discharge, and involves
the production of a “discharge note”.
2. Inpatient Department (IPD):
 An inpatient is admitted to the hospital and stays overnight or for an
indeterminate time, usually several days or weeks.
 Treatment provided in this fashion is called “inpatient care”.

13. 3. Medical Departments: The medical departments may include, but not limited
to the following:
1. Internal Diseases Department:
• This Department includes specialties of cardiology (related to heart),
dermatology (related to skin), diabetics (related to pancreas), endocrine glands
(related to hormone), digestive system, hematology diseases (related to blood),
infectious diseases, internal diseases, kidney unit, neurology (related to brain
and nerves), psychiatry clinic, lung diseases, and rheumatic diseases (related to
joints and connective tissues).
2. Surgery Department:
• This department deals with general surgery unit, orthopedics unit, urinary
tracts surgery, plastic surgery, brain and neurology surgery, children surgery,
ophthalmic surgery, and Ear Nose Throat (ENT) surgery.
3. Anesthesia: Doctors in this department give anesthetics for operations.
4. Gynecology Department:
• These departments investigate and treat problems of the female urinary tract
and reproductive organs.

14. 5. Pediatrics Department:
• It is the department that deals with the medical care of infants, children, and
adolescents, and the age limit usually ranges from birth up to the age of 18
years.
6. Dentistry Department:
• This department deals with the diagnosis, prevention, and treatment of
diseases, disorders and conditions of the oral cavity, especially the teeth, and
to an extent related conditions in the jaws and face area.
7. Emergency Department:
• An emergency department, also known as accident and emergency
department, emergency room, or casualty department is a medical treatment
facility specializing in acute care of patients who are present without prior
appointment, either by their own means or by ambulance.
8. Nursing:
• Nursing department provides nursing to patients at all general and specialized
clinics in addition to specialized care services to inpatients at all units.

15. Pharmacy Department
This department is responsible for providing
patients with medicines prescribed by specialist
physicians and provision of services
corresponding to applicable drug precautions
and professional regulations.

16. Functions of a Hospital
1) Diagnosis and testing
2) Treatment and therapy
3) Public processing (including admissions, record keeping,
billing, and planning for post-release patient care)
4) Public health education and promotion, done through a
variety of programs, including smoking cessation
programs, weight loss programs, support group
programs, and screening of community members
(including mammographies and testing of blood pressure
and cholesterol)
5) Teaching (i.e., training health professionals)
6) Research (i.e., carrying out programs that add to the sum
of medical knowledge)

17. SECTION 1.2- Hospital Pharmacy

18. Hospital Pharmacy
Definition- The department or service in a hospital which is under
the direction of a professionally competent, legally qualified
pharmacist, and from which all medications are supplied to the
nursing units and other services, where
• special prescriptions are filled for patients in the hospital,
• Where prescriptions are filled also for ambulatory patients and
out-patients,
• Where pharmaceuticals are manufactured in bulk, where
narcotic and other prescribed drugs are dispensed,
• where injectable preparations should be prepared and
sterilized, and
• where professional supplies are often stocked and dispensed.

19. Organization of Hospital Pharmacy
 DIRECTOR OF PHARMACY
 ASSOCIATE DIRECTOR OF PHARMACY
 ASSISTANT DIRECTOR OF PHARMACY: Dealing with
• ASSAY & QUALITY CONTROL DIVISION
• DRUG INFORMATION SERVICES
• CENTRAL SUPPLY DIVISION
• IN-PATIENT SERVICES DIVISION
• OUT-PATIENT SERVICES DIVISION
• INTRAVENOUS ADMIXTURE DIVISION
• PURCHASE AND INVENTORY CONTROL
• MANUFACTURING AND PACKAGING
 RESEARCH PHARMACIST: Dealing with PHARMMCEUTICAL RESEARCH DIVISIONS
 PHARMACIST SPECIALIST: Dealing with RADIOPHARMACEUTICAL DIVISIONS
Above all are commonly dealing with;
• ADMINISTRATIVE SERVICES DIVISION
• UNIT DOSE DISPENSING AND ADMINSTRATION
• EDUCATION & TRANING DIVISION

20. Duties & Responsibilities of Hospital Pharmacy
1. To provide the benefits of a qualified hospital pharmacist to patients and
health care institutions, to the allied health professions (dental
hygienists, diagnostic medical sonographers, dietitians, medical
technologists, radiographers, respiratory therapists etc), and to the
profession of pharmacy.
2. To assist in providing an adequate supply of such qualified hospital
pharmacists.
3. To assure a high quality of professional practice through the
establishment and maintenance of standards of professional ethics,
education.
4. To promote research in hospital pharmacy practices and in the
pharmaceutical sciences in general.
5. To disseminate (To spread) pharmaceutical knowledge by providing for
interchange of information among hospital pharmacists and with
members of allied specialties and professions.

21. DEPARTMENT/DIVISION WISE DUTIES OF
HOSPITAL PHARMACIST
• Administrative Services Division
1. Plan and coordinate departmental activities.
2. Develop policies regarding health professionals.
3. Schedule personnel and provide supervision.
4. Coordinate administrative needs of the Pharmacy and Therapeutics
Committee.
5. Supervise departmental office staff.
• Education and Training Division
1. Coordinate programs of undergraduate and graduate pharmacy students.
2. Participate in hospital-wide educational programs involving nurses,
doctors etc.
3. Train newly employed pharmacy department personnel.

22. • Pharmaceutical Research Division
1. Develop new formulations of drugs, especially dosage
forms not commercially available, and of research drugs.
2. Improve formulations of existing products.
3. Cooperate with the medical research staff of projects
involving drugs.
• In-Patient Services Division
1. Provide medications for all in-patients of the hospital on a
24-hour per day basis.
2. Inspection and control of drugs on all treatment areas.
3. Cooperate with medical drug research.
4. Maintain prescription records.

23. • Out-Patient Services Division
1. Compound and dispense out-patient prescriptions.
2. Inspect and control all clinical and emergency services
3. Maintain prescription records.
4. Provide drug consultation services to staff and medical
students.
• Drug Information Services Division
1. Provide drug information on drugs and drug therapy to
doctors, nurses, medical and nursing students.
2. Maintain the drug information center.
3. Maintain literature files.

24. • Departmental Services Division
1. Control and dispense intravenous fluids.
2. Control and dispense controlled substances.
3. Coordinate and control all drug delivery and
distribution systems.
• Purchasing and Inventory Control Division
1. Maintain drug inventory control.
2. Purchase all drugs.
3. Receive, store and distribute drugs.
4. Interview medical service representatives.

25. • Central Supply Services Division
Develop and coordinate distribution of medical
supplies and irrigating fluids.
• Assay and Quality Control Division
1. Perform analyses on products manufactured and
purchased.
2. Develop and revise assay procedures.
3. Assist research division in special formulations.

26. • Manufacturing and Packaging Division
1. Manufacture wide variety of items in common use at the
hospital.
2. Operate an overall drug packaging and prepackaging
program.
3. Undertake program in product development.
4. Maintain a unit dose program.
• Sterile Products Division
1. Produce small volume parenterals.
2. Manufacture sterile ophthalmologic, irrigating solutions
etc.
3. Prepare aseptic dilution of lyophilize and other "unstable"
sterile injections for administration to patients.

27. • Radiopharmaceutical Services division
1. Centralize the procurement, storage and
dispensing of radioisotopes used in clinical
practice
• Intravenous Admixture Division
1. Centralize the preparation of intravenous
solution admixture.
2. Review each I.V. admixture for physio-chemical
incompatibilities.