2. • Organization of pharmacy service
• Human resource determination and work load analysis
• Dispensing flow
• Responsibilities of staff members
• Roles and responsibilities of stakeholders
• Collective responsibilities
• Indemnity
Outline of presentation
3. • At the end of this session the participant will able to explain
• Organization of pharmacy service
• Human resource determination and work load analysis
• Dispensing flow of pharmaceutical services
• Responsibilities of bin owners
• Roles and responsibilities of stakeholders
• Concepts of collective responsibilities
• Principles of indemnity
Session objectives
4. • Why organization?
To facilitate delivery of quality pharmaceutical services as well
as to minimize the wastage, theft, pilferage and expiry of
medicines
• The pharmacy should first be organized into
Dispensaries:
• Outpatient,
• Inpatient
• Emergency pharmacies and
Pharmacy store,
Organization of pharmacy service
5. • Based on the complexities of health facilities and OPD clinic arrangement OPD
pharmacy may be organized in multiple locations (ART, Chronic care pharmacy, OR,
oncology…)
• Pharmaceutical supply and internal distribution should be coordinated pharmacist (named as
DSM officer)
• The hospital pharmacy should prepare a separate store for supplies and medical equipments
• Each pharmacy unit should have adequate space and human resource
• Hospital pharmacy should establish a drug information service
• Hospital pharmacy should provided a Clinical pharmacy service
• hospital pharmacy should open compounding unit for the preparation products
• dispensing room should be organized in such a way to facilitate counseling, ensure privacy,
reduce waiting time, ensure security and facilitate the billing process
Organization of pharmacy service…
6. • At dispensary Human resource determination is done by using
workload analysis.
• Taking into account the average number of patients served per day
• The health facility can determine the number of pharmacists required for
dispensing activities (using 48 patients per pharmacist per day or 68
counseling service per pharmacist per day).
• Clinical pharmacy services based on bed number
• Work force requirements for managing medicines and supply store,
drug information services and other technical and administrative
activities will be calculated separately.
Human resource determination
7. • Human resource need
• Pharmacy Coordinator
• Drug Supply Manager (DSM officer)
• Store Managers: should be 2 (equipment and supplies, drugs)
• Dispensing heads in each dispensary (1ኛ፣ 2ኛ እና 3ኛ) ተተኪ
• Dispensers/ Bin Owners
• Pharmacy Accountants
• Pharmacists working at Clinical pharmacy, DIS
• Cashiers
• Porters ,
• Guards and Cleaners
Human resource determination…
11. • Responsibilities of bin owners
• Receives medicines issued from the store
• Labels the codes, selling prices and/or retail prices on each package
• Shelves the medicines into the bin location
• Follows the expiry dates of drugs in each bins assigned to him/her
• Monitor availabilities of medicines, report if stock out.
• fill the necessary information in Model 20/መ IFRR
• Follow the movement of stocks (fast moving, slow moving, dead stock, near
expiry, etc…) and report to head of the dispensing unit
Responsibilities Staff Members
12. • Responsibilities of bin owners
• Control the inventory from theft, pilferage and other losses,
• Makes sure that the his/her bin location is adequately stocked and
is accessible to other dispensers all the time
• During inventory, fill-in the inventory sheet and make it ready
for physical inventory
• Have up-to-date information on stock status, price changes,
availability of different choices of medicines
• Report the average monthly consumption of drug in his/her bins to
head of the dispensing unit
Responsibilities Staff Members…
13. • Responsibilities of accountant
• Requests and receives sales ticket pads from the hospital
property administration store
• issues sales ticket pads to service providers after
registering all details on the sales ticket register
• receives used sales ticket pads after checking and
segregating it by used, lost, voided and/ or damaged pages
• Check sales price quoted at model 19/መ by store manager
• Receives copy of received and issued model from store
at every transaction
• Receives copy of daily used sales ticket from casher after
cross check balance with collected money.
• Check correctness of unit sales price, multiplication and
addition in sales ticket, free/credit register
Responsibilities Staff Members…
14. • Responsibilities of accountant
• Check correctness of unit sales price, multiplication
and addition in sales ticket, free/credit register take
intervention immediately.
• Prepare daily summery for type of transactions (cash,
credit, free)
• Prepare monthly, quarter and year summery and report
Responsibilities Staff Members…
15. • Responsibilities of cashier
• The cashier ensures that the serial number of sales ticket, delivered for
payment is consecutive and inform to the respective dispenser
• The cashier checks the price (unit/sum) and collects the right amount of
money from the respective clients.
• Then, she/he signs the sales tickets, delivers the original to the client
and retains the second copy.
• The cashier transcribes the serial number of the sales ticket on the
prescription, signs and stamps so that the dispenser will be sure that the
patient has paid accordingly.
• The cashier inform the client to please collect his/her drug at the
dispensing counter
Responsibilities Staff Members…
16. • Responsibilities of auditor
• The findings of this performance audit have to be presented
to the management of the health facilities
• Auditing of a supplier manager, a store manager, a cashier,
a bin owner, biller/evaluator, counselor, an accountant,
overall pharmacy coordinator and health facility
• Conduct regular financial auditing of the health facilities
• Conduct regular service performance auditing
Responsibilities Staff Members
17. • Health Facility
• Collect a baseline data that shows the overall status of
pharmaceutical transactions and services
• Develop detailed plan of action that guides the
implementation of APTS within the health facility
• Provide training and orientation to relevant staff in the
health facility
• Ensure the continuous printing and availability of the
necessary vouchers, sales tickets, forms and registers
• Conduct continuous supervision to ensure proper
implementation of APTS
• Prepare regular report and submit to the next level of
authority
Roles and Responsibilities of Stakeholders
18. • RHB/Zonal and Woreda Health office
• Develop and facilitate the endorsement of policies and legal framework
• Provide continuous and all rounded follow-up and support to health facilities
• Provide support to health facilities in the printing of vouchers, sales tickets and
registers
• Allocate appropriate budget and resources to support implementation of the
system
• organize and conduct training in collaboration with relevant stakeholders
• Organize experience sharing events between implementing health facilities and
stakeholders
• Prepare regular report and submit to the next level of authority
Roles and Responsibilities of Stakeholders …
19. • Federal Ministry of Health
• Develop and facilitate the endorsement of policies and legal framework
• Provide continuous and all rounded follow-up and support to health facilities
• Provide support to health facilities in the printing of vouchers, sales tickets
and registers
• Allocate appropriate budget and resources to support implementation of the
system
• organize and conduct training in collaboration with relevant stakeholders
• Organize experience sharing events between implementing health facilities
and stakeholders
Roles and Responsibilities of Stakeholders…
20. • Partners
• Provide ongoing technical support to RHB and facilities on the implementation of
APTS
• Provide ongoing financial support to RHB and facilities on the implementation of
APTS
• Participate on National, Regional and Hospital level monitoring and evaluation of
APTS implementation
• Participate on National, Regional and Hospital level supervision of APTS
implementation
Roles and Responsibilities of Stakeholders …
21. • The management of medicines transactions and services involves multiple
professionals especially at dispensing outlets
• The provision of continuous services to clients requires the concerted effort and
coordination of all professionals
• This requires accepting collective or shared responsibility amongst the
professionals
• In order to ensure transparency and accountability for medicine transactions
taking place at dispensing outlets, shelves are categorized by bin locations
which are in turn assigned to different owners
Collective Responsibility
22. • In order to facilitate the process, there has to be a common understanding
amongst all dispensers to hold a collective responsibility in order to:
• Avoid the locking of bin locations during absence of a dispenser
• Take shared accountability for shortages and losses of medicines received
from the pharmacy store
Collective Responsibility…
23. • The basic purpose of indemnity is risk sharing
• In the course of managing the transactions of these products, unavoidable human
errors may occur
• There are various opportunities for making unintentional errors.
• These errors will make pharmacists, pharmacy technicians and cashiers at risk of
being responsible to cover losses and shortages.
• The regional health bureau should develop and issue appropriate indemnity policy
based on the volume and value of transactions that are prone to deserve indemnity
coverage.
• Health facilities should implement this policy to effectively implement APTS
Indemnity
