Pharmacy Practice

1. Presented by-
Ms.S.J.Kamble
Assistant Professor-Pharmacology
Ashokrao Mane College of Pharmacy,
Peth Vadgaon

3. ACCORDING TO YOU WHAT
IS HOSPITAL??

6. Definition
 Hospital-
‘an institution of community health’
Complex organization
Functions of medical care- prevention, diagnosis, therapy,
rehabilitation, education and research
OR
Complex organization, specialized scientific equipment
Functioning - trained staff
All these are co- ordinated together common purpose- restoration
and maintenance of good health

7.  Modern Hospital-
 Educational and social service institution
 Single purpose- restoration and maintenance of good health .
 Special facilities- accommodation, colleges and day night
medical stores with a trained professional staff.

8. The hospital is a unique institution of man. A WHO Expert
Committee in 1963 proposed the following working definition of a
hospital.
“A hospital is a residential
establishment which provides short-term and long term medical
care consisting of observational, diagnostic, therapeutic and
rehabilitative services for persons suffering or suspected to be
suffering from a disease or injury and for parturient. It may or
may not also provide services for ambulatory patients on an
outpatient basis”

9. WHO expert committee,1956:
The hospital is an integral part of a social and medical
organization, the function of which is to provide for the
population complete healthcare, both curative and preventive,
and whose out- patient services reach out to the family in its
home environment; the hospital is also a centre for the training of
health workers and for bio- social research’.

10. Functions
 Patient care
Diagnosis, treatment to sick & injured
patients
Quality of care , standard of medical
practice
 Public health
Support activities- agencies- by
providing facilities and advice

11. Functions
 Medical research
Developing new methods of
treatment- improving the
hospital services
 Educational training
Medical students, pharmacist,
nursing, physician, laboratory
technicians
General public- lectures and
demonstrations
 Counseling and patient advice

12. Hospital Classification based on Care
Primary Care
Hospital
Secondary Care
Hospital
Tertiary Care
Hospital

13. According to Level of Care:
Primary Care Hospital
Primary care is the day-to-day healthcare given by a health care
provider. Typically this provider acts as the first contact and
principal point of continuing care for patients within a healthcare
system, and coordinates other specialist care that the patient may
need.
Provides mostly basic health care. It is generally regarded as the
‘gateway’ to receiving more specialist care.

14. Secondary Healthcare refers to a second tier of health system, in
which patients from primary health care are referred to specialists
in higher hospitals for treatment. In India, the health centres
for secondary health care include District hospitals and
Community Health Centre at block level.
Secondary care is the health care service provided by medical
specialist and other health professionals who generally do not have
first contact with patient for examples cardiologist, urologist and
dermatologist .
It includes acute necessary treatment for a short period of time for
a brief but serious illness ,injury or other health condition such as
in a hospital emergency department .It also includes skilled
attendance during child birth ,intensive and medical imaging
services.

15. Tertiary care
Tertiary care is a specialized consultative health care ,usually for
in patients and on referral from primary or secondary health
professional , in a facility that as personal and facilities for
advanced medical investigation and treatment, such as tertiary
referral hospital.

16. Quaternary care
The term quaternary care is also used sometimes as a
extension of tertiary care in reference to medicine of
advanced levels which are highly specialised and not widely
accessed.
Experimental medicine and some types of uncommon
diagnostic or surgical procedures are considered
quaternary care
These services are usually only offered in limited number of
regional or national health care canters

17. Classification
 Clinical basis
 Non-clinical basis
 Basis of size
 Basis of cost

18. Clinical Basis
 Basis of major disease
Mental hospital, T.B. hospital, Cancer hospital, Leprosy hospital
 Basis of anatomical specialization-
ENT hospital, Eye hospital, Kidney hospital, Orthopedic hospital
 Basis of age of client-
Paediatric hospital, Maternity hospital
 Basis of system of medicine
Allopathic hospital, Ayurvedic Hospitals, Homeopathic hospitals,
Physiotherapy centers

19. Non-clinical basis
 Basis of ownership- Public and Private ownership
 Public ownership (Governmental hospitals)
 Central Gov.Hospitals- Army hospitals, Railway hospitals, AIIMS New Delhi
 State Gov.Hospitals- PHC, Civil hospitals
 Local Self-Gov. Hospital- Corporation hospitals
 Private ownership-
 Trusts- Krishna Charitable Trust Hospital
 Religious bodies- Christian mission hospitals, Ram Krishna Mission Hospital
 Company hospitals- Apollo Hospitals

20. Basis of size
 Large hospitals (Beds- 1000 & above)
J.J.Hospital, KEM hospital
 Medium hospitals (Beds- 500-1000)
Bombay hospital,
 Small hospitals (Beds-100-500)
Hinduja hospital, Breach candy hospital
 Very small hospitals (Beds less than 100)
Private hospitals

21. Basis of cost
 Elite hospitals-
 High tech hospitals
 Hospital rates between Rs. 300 to 1200 per day
 Rooms equipped with all necessary materials
 Five star hospitals
 25 -30 % reservation – poor sections
 Budget hospitals-
 Moderate or low budget hospitals

22. Organisation of Hospital
 Governing body-
 Highest decision making body
 Establishing objectives of hospitals
 Approving all major plans and programmes of hospital
 Reviewing administrative policies of hospital
 Appointing administrator
 Managing hospital finance
 Approval of hospital budget

23. Governing Body (GB) or Board
of Directors
Administrator
Head:
Clinical
Service
Head:
Pharmacy
Head:
Nursing
Head:
Admin &
Accounts
Head:
Maintenance

24. Organization Structure of a Hospital

26. Administrator
 Link between GB & medical staff
 Implements or frames policies, procedure & guidelines - approval from
management
 Attend meetings of GB and all medical staff
 Co-ordinates works of various section
 Incharge- admission & discharge of the patient
 Prepare- Budget
 Training facility
 Functioning of the OPD
 Provide facilities, equipment- improve quality of patient care
 Consults with various dept
 Modify internal organization - current condition

27. Services provided by Hospital
 Clinical service-
General physician, General surgery, Orthopedic, ENT, Dental,
Cardiology, neurology, dermatology, Communicable diseases , OPD
 Supportive service-
 Anesthesia service
 Blood bank
 Central sterile supply
 Pathology and clinical laboratory services
 Pharmacy services
 Dietary services
 Nursing services
 Medical record services
 Radiology

28. Medical record services
 Compilation of all records of patient
 Helpful in emergency conditions
 Purpose-
• Planning of patient care
• Evaluation of hospital performance and service
• Medical education
• Administrative planning and control
 It consists of
 Family history and current illness
 Physical examination data
 Laboratory test report & Diagnostic reports
 Current treatment
 Condition during discharge
 Surgery data

29. Nursing services
 Largest department of hospital
 Functions- 24 hrs
 Special nursing skills required- to manage different situations
 General assistance to OPD, IPD and wards
 Assistance - labor wards and Operation Theater.
 Assistance- Pediatric care
 Detect and report any abnormality during treatment
 Coordination - all other departments of the hospital
 Maintaining- Nursing records - quality of service
 Training programs
 Responsible for- health education and promotion, patients care
 Respect -dignity and rights of every person regardless of race,
colour and social and economical status.

31. Health Delivery System in India
 3 Levels of healthcare
1.Primary/ Essential- provided by PHC
2. Secondary- Community health centers or district hospitals
3.Tertiary- Specialized hospitals, more facilities
 At central
Union Ministry of Health and Family Welfare
 At state
Ministry of Health

32. Union Ministry of Health and Family Welfare
Minister of state for Health
Secretary
Joint Secretary
Dy.Secretary
DGHS
DHS for
Medical
care &
Hospital
DHS
Public
Health
DHS
Gen.Admin
Minister of Health and Family
Welfare
Secretary
Commissioner
Two
Dy.commissioner
Joint
Secretary
Dy.Secretary
Regional
Directors

33. Health Minister
Ministry of Health
Deputy Minister
Health Secretary
Dy Secretary
Director of Health Services
Dy.Director of Health Service
Additional Dy.Director of Health
Service (ADHS)
Medical
Education
Nursing
Family
Welfare
Nutrition
School
Health
Health
Education