This document discusses the management of hospital pharmacies. It outlines the responsibilities of hospital staff like pharmacists and supply managers. It describes how hospital pharmacy services are organized with sections for storage, dispensing, and production. It discusses the hospital drug and therapeutics committee which establishes medication policies. The committee membership includes representatives from medical, pharmacy, nursing and administration. The document also summarizes inpatient medication management systems, formulary management, and proper disposal of pharmaceutical waste.

1. Hospital Pharmacy
Management
Pravindas Vaishnav
M.Pharm
Goa college of pharmacy
Pharmacology Dept.

2. Contents
 Responsibilities of hospital staffs
 Organization of hospital pharmacy services
 Hospital drugs and therapeutic committee
 Inpatient medication management
 Small scale hospital pharmaceutical production
 Pharmaceutical disposal
 Controlling leakage and drug abuse

3. Responsibilities of hospital staffs
Hospital pharmacist- expert
on medicines who advises
on
prescribing,administering,
monitoring
Supply manager-ensures that
medicines are available
through
procurement,storage,distri
bution,inventory control,&
quality control,assurance.

4. Responsibilities of hospital staffs
• The responsibility for establishing policies & procedures realated to
medication selection , procu , distri & use often lies with DTC
• The medicine process is multidisciplinary,the committee should
include representatives from all functional areas involved;
• Medical staff
• Pharmacy
• Quality assurance coordinator
• Hosp administrator
• Nursing
 Subcommittees are often formed for in-depth analysis of particular
issues

5. Purchasing and stock management
• In some hospitl a separate dept manages all
hosptl purchasing
• This dept called- medical stores or material
management
• In such cases chief pharmacist prepares an
annual budget request for pharmaceutical
purchases and places orders for medicines
through the medical stores
• Pharmacy dept manages pharmaceutical
purchasing
• Designated committee review & approve all
purchases
• DTC may manage

6. Medication
use
The medication-use
process can be divided into 4 components-
1. Prescribing
2. Preparation and dispensing
3. Medication administration
4. Monitoring the effects of medications on the
patient & ordering appro changes in therapy
• Govt agencies and licensing boards regulate
medications through laws and professional practice
standards

7. Organization of hospital pharmacy
In organizing hospital pharmacy services , both
the way in which the staff is organized and the
physical layouts of the building must be
considered-
Personnel
Can be divided into
3 major categories;
Management
Professional staff
Support staff

8. Physical organization
 Extent of pharmacy’s physical facility - the size of the hospt &
service provided.
 Large pharmacy dept -- sections within one physical space or in
separate locations throughout the hospt-
 Administrative offices
 Bulk storage
 Narcotics or dangerous drug lockers
 Manufacturing & repackaging
 IV soln compounding
 Inpatient and outpatient dispensing
 Medicine info resource center
 After –hours pharmacy
 Emergency medical storage

9. Hospital Drug & therapeutics
committee(DTC)
• DTC is responsible foe developing policies &
procedures to promote rational medicine use
• Its functions include-
• Management of the approved medicine list &
hospital formulary
• Ongoing drug use review
• Adverse drug event reporting & implementation
of safe medication practices

10. DTC membership
 An effective DTC requires that members
participate in meetings and assist with other
committee activities
 Members –representative from:-
 Medical staff ( from each dept)
 Pharmacy (chief pharmacist often serves as
the secretary)
 Nursing
 Hospital administration
 Quality assurance staff
 8-15 members
 Invite specialist to make
presentation
or provide advice on
particular issue

13. Hospital formulary management
• Cornerstone of medication management
• Should be the principal concern of the DTC
• Issues related to medication selection

14. Guidelines for the hospital setting
• Limit the formulary list to conserve resources-stocking all
medicines on the national formulary is usually not
necessary
• Eliminate generic duplication-only one brand or label of
each generic medicine should be routinely stocked
• Minimize the number of strengths stocked can be same
medication;multiples of lower strengths can be used for
frequently needed higher strengths
• Select medications for the formulary based on disease and
conditions treated at the facility
• Include second-line alternatives to medicines of choice as
needed,but minimize therapeutic duplication
• Ensure that the hospital formulary corresponds with any
national or regional standard treatment guidelines that
have been formally approved by the health system

15. • In addition to the basic formulary process,
many hospitals add two more features —
therapeutic substitution and use restrictions
for certain medication in the formulary

17. Inpatient medication management
Medication distribution systems
Medication distribution has long been the
primary function of hospital pharmacy services
4 basic types of medication distribution systems
exist—
1. Bulk ward stock replenishment
2. Individual medication order system
3. Unit-dose system
4. Automated medication dispensing

19. Patient medication profiles
Patient medication profile are necessary if hospital
pharmacists are to monitor inpatient medication
therapy
Each profile contains data on the patient’s current
& recent pharmaceutical therapy, allergies ,
diagnosis,height,weight,age,sex
Profile allows the pharmacist to review all
medications that a patient is taking before
dispensing the first dose and with each new
medication order
Problems with pharmaceutical therapy can be
detected and avoided or corrected

20. Medication treatment record

22. Small scale hospital pharmaceutical
production
• Include secondary production from existing raw
material imported packaging or repackaging
of finished goods into smaller dispensing packs &
course-of-therapy(COT) packages (tertiary
production)
• SSP divided into
sterile &
non-sterile production
or compounding

24. Pharmaceutical disposal
Hospitals ,health-care—
generates
Expired goods,
Damaged pharmaceuticals
Improper disposal—
>contaminate water
supplies,resale poor quality
of medicine,air pollution
from improper
incineration

25. • Hospital- return products to the facility from
where they were obtained
• If this option is not available then,
• Proper disposal plan & regularly monitored
• Depending on property –pharmaceutical
waste incineration, land disposal,
inertization(product is mixed with cement)

26. Special care must taken—
 Narcotics
 Toxic drugs
 Anticancer medicines
Before disposal technique is
instituted any govt laws &
regulations relevant to
health care waste
management and
environmental protection
should reviewed

27. Controlling leakage and drug abuse
• Systematic approaches for detecting,analyzing &
preventing pharmaceutical losses caused by
theft,bribery and fraud
• Applicable to hospitals and healthcare facilities
• The control of narcotics – concerns in hospital
because it may be the only type of institution
regularly stocking,dispensing,administering them
• Drug addiction among
physician,pharmacists,nurses is quite common

28. To avoid drug abuse and prevent leakage
• Be alert to changes in
performance,injuries,mood
swings in workers
• Ensure double-witness &
double-signature procedures
for wastage of narcotics
• Limit access to narcotic
storage areas
• Check patient charts & medication administration
records for patterns of consumption; be suspicious if
patients receive noticeably more narcotics during a

29. • Ask patients if they received medications
• Use locked boxes or wire cages to ensure security for
medication moved from the pharmacy to the wards
• Issue individual narcotics boxes to each
anesthesiologists daily,and make sure that the box is
returned to the pharmacy at the end of the day with a
written record of quantities used for each patient
• Count narcoti stocks daily and reconcile with
inventory records
• Sometims –for antibiotics
• Antiretroviral to treat HIV/AIDS

30. THANK
YOU