Focus on the future: ASHP 2000. American Society of Health-System Pharmacists.
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Forecasting↗
Biomedical subjects
B E Scott
Publications and source records attributed to B E Scott.
Pharmaceutical services for a homeless population.
Participation of pharmacist volunteers in the medication program of a countrywide health care program for homeless persons is described. Pharmacist volunteers were brought in to manage medications for a health care program serving homeless persons in Ramsey County, Minnesota. After the pharmacy program was structured, volunteers were recruited from the community. Pharmacists duties initially focused on product management but were expanded to include establishing and monitoring the program formulary; reviewing patient records and prescriptions for allergies, potential drug interactions, and appropriate dosage; counseling patients on medication use; and consulting with other members of the health care team. The pharmacists' efforts led to improvements in monitoring and stocking of necessary medications. The cost of the pharmacy program decreased from $1800 a month to as little as $300 a month. The value of donated supplies and medications increased from $8,600 in 1991 to over $122,000 in 1994. Pharmacist volunteers helped to improve the cost-effectiveness and quality of medication use in a homeless population.
Community Pharmacy Services↗
Influence of water run training on the maintenance of aerobic performance.
The purpose of this study was to examine the effect of a 6-wk deep water running program on the maintenance of cardiorespiratory performance (VO2max, ventilatory threshold, running economy); metabolic measurements of blood glucose, blood lactate, and plasma norepinephrine; and body composition. Sixteen trained male runners (VO2max = 58.6 +/- 3.6 ml.kg-1.min-1) were assigned to one of two groups matched by VO2max, treadmill run (R) or water run (WR). Subjects participated in their respective training programs, which consisted of workouts of a) 30 min at 90-100% VO2max and b) 60 min at 70-75% VO2max alternated daily for 5 d.wk-1. Following 6 wk of workouts, no significant intra- or intergroup differences were observed for treadmill VO2max for R (pre = 58.4 +/- 2.3, post = 60.1 +/- 3.6 ml.kg-1.min) and WR (pre = 58.7 +/- 4.7, post = 59.6 +/- 5.4 ml.kg-1.min-1). Similarly, ventilatory threshold was unaltered in R (pre = 47.5 +/- 1.8, post = 48.2 +/- 3.3 ml.kg-1.min-1) and WR (pre = 46.5 +/- 6.4, post = 47.4 +/- 6.7 ml.kg-1.min-1), nor were there any changes in running economy in R (pre = 48.4 +/- 2.3, post = 48.9 +/- 2.0 ml.kg-1.min-1 at 255 m.min-1) and WR (pre = 51.8 +/- 2.0, post = 48.9 +/- 2.2 ml.kg-1.min-1 at 255 m.min-1). No significant differences were observed within or between groups for maximal blood glucose, blood lactate, and plasma norepinephrine concentration as well as for body composition indices. It was concluded that deep water running may serve as an effective training alternative to landbased running for the maintenance of aerobic performance for up to 6 wk in trained endurance athletes.
Analysis of Variance↗
Factors that influence residency applicants in the selection of a specific program.
The relative importance of factors that influenced residency applicants in the selection of a specific program was determined through a national survey. A four-page questionnaire was developed through a series of focus groups with current and former pharmacy residents. A total of 370 questionnaires were mailed to the preceptors of all residencies participating in the 1987 ASHP Resident Matching Program; the preceptors were instructed to forward the questionnaires to all first-year residents in their programs. Respondents were asked to provide demographic information and to rate (using a seven-point Likert scale) the importance of 19 factors that might have influenced their choice of residency program. The respondents also were asked to list which 4 of the 19 factors had been most important to them in their choice. Most of the 243 respondents had entered the residency programs with little or no postgraduate pharmacy experience. The average residency candidate applied to 2.8 programs; approximately half of the respondents had accepted a residency position in the state in which they currently lived. The reputation of the residency program as a good learning program was rated most important by all groups. ASHP accreditation was rated slightly higher by residents in general programs, whereas the type of medical services provided by the hospital and the university teaching affiliation were rated slightly higher by respondents in clinical and specialty programs. Factors with low importance ratings included desirable climate and total number of residency hours worked. Residency preceptors can use the results of this study to focus their marketing and recruiting strategies.
Internship, Nonmedical↗
Management consultant review of three departments of pharmacy to identify cost-reduction opportunities.
A review by a management consulting firm to identify cost-reduction opportunities at three hospital pharmacy departments is described. A multihospital corporation hired a management consulting firm to review the operating procedures of several departments, including pharmacy, and recommend measures for reducing costs. A team approach was adopted to enable the pharmacy department managers and the consultants to freely contribute their expertise; input was also solicited from staff members. A review of each pharmacy department's operating costs showed that drugs and i.v. supplies consumed 60-67% of the expenses, and salaries and wages 27-36%. Estimates of the full-time equivalents allocated to inpatient, clinical, support, and ambulatory and outside contract service activities were compared. The relative costs of personnel allocated to all inpatient drug distribution activities were also compared. Cost-reduction recommendations were divided into short- and long-term measures. Short-term measures involved decreasing drug expenditures, decreasing the number of personnel, and limiting decentralized services in one of the departments; savings of $500,000 were projected. Long-term recommendations involved increasing the use of technology, expanding the use of technicians, and consolidating the management staffs among the hospitals. Management consultants, in cooperation with pharmacy department managers and staff members, can identify cost-reduction opportunities without compromising patient care.
Centralized Hospital Services↗
Evaluation of computer-assisted instruction versus traditional new-employee training.
Personnel time and costs associated with computer-assisted instruction (CAI) and traditional "one-on-one" instruction in basic computer drug-order entry procedures were compared. Both programs consisted of an introduction to the training session, familiarization of users with the computer hardware and keyboard, and step-by-step instructions in unit dose and intravenous admixture order-entry procedures. The CAI module was developed by a pharmacist with no prior programming experience. It was designed to be used side-by-side with the actual inpatient pharmacy computer system. Fifth-year pharmacy students in their clinical clerkship rotation served as the study population. The personnel (both subject and pharmacy supervisor) time and costs associated with each method were evaluated for significant differences by a two-tailed Student's t test. Of 21 subjects who participated in this study, 11 received CAI and 10 received traditional instruction. CAI was associated with significantly less mean total personnel time (99.64 +/- 18.78 minutes) than one-on-one instruction (133.60 +/- 22.89 minutes). Mean total salary expense was significantly lower for CAI ($13.03 +/- 2.15) than for one-on-one instruction ($28.79 +/- 4.91). Program development time for the CAI module was 18.5 hours longer than that for the one-on-one program. The CAI module cost $1577.77 more to develop than the one-on-one program; however, 24 new employees would be required to offset development costs if the hardware were already available and 100 new employees if hardware had to be purchased. Computer-assisted instruction of new employees in computer order-entry procedures can be a cost-effective alternative to traditional training methods.(ABSTRACT TRUNCATED AT 250 WORDS)
Computer User Training↗
Quality assurance: ensuring pharmacy personnel follow procedures for handling cytotoxic drugs.
The development of a quality assurance activity for the handling of cytotoxic drugs in a hospital pharmacy department is explained. The exposure of hospital pharmacy personnel to cytotoxic drugs even in small amounts may present a health hazard. A method was developed to periodically evaluate and verify pharmacy staff adherence to procedures for the safe handling of cytotoxic drugs. The program development included the development of checklists to audit IV admixture and satellite clinics, outpatient and pharmacy production area, and pharmacy receiving and storage area. The basis for development of these checklists was the ASHP Technical Assistance Bulletin on Handling Cytotoxic Drugs in the Hospital and OSHA Guidelines.
Accident Prevention↗
A comparison of computer-assisted instruction and printed information as methods of pharmacy continuing education.
A continuing education (CE) program was developed to teach hospital pharmacists parameters for monitoring adult total parenteral nutrition (TPN) patients. The effectiveness of a computer-assisted instruction (CAI) module as a method of CE was compared with that of printed information (PI). The computer program was developed using an Apple IIe personal computer and Apple Pilot. Forty-nine hospital pharmacists were given a pretest, the CAI or PI program, a posttest immediately after the instruction, and a retention test 2 weeks later. The CAI group (n = 23) had mean test scores of 53.3% for the pretest, 87.7% for the posttest, and 81.9% for the retention test. The PI group (n = 26) had mean test scores of 54.2% for the pretest, 84.7% for the posttest, and 78.2% for the retention test. Both methods were effective CE programs based on increases in mean test scores from pretest to posttest. Retention-test scores showed a statistically significant drop from posttest scores for each group. A comparison of mean retention-test scores with mean pretest scores for each group demonstrated that participants in each group had retained a statistically significant amount of material from baseline knowledge. When differences in mean pretest, posttest, and retention-test scores were compared between the two groups, no statistically significant differences were found. CAI and PI were equally effective methods of continuing education.
Computer-Assisted Instruction↗
Who gets hired and who gets promoted?
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Career Mobility↗
Stability of 5-aminosalicylic acid suspension.
The stability of 5-aminosalicylic acid in a suspension prepared extemporaneously for administration by enema was studied. The suspension was prepared (tragacanth was the suspending agent) and then placed in 3-ounce amber glass prescription bottles; five bottles were stored at room temperature and five were refrigerated for 90 days. Using samples from each bottle, concentrations of 5-aminosalicylic acid were determined in triplicate by high-performance liquid chromatography at 0, 30, 60, and 90 days. Throughout the study period, all samples retained more than 90% of the day 0 concentration of 5-aminosalicylic acid. At each storage time, concentrations in samples stored at either room temperature or under refrigeration were not significantly different. In this extemporaneously prepared suspension, 5-aminosalicylic acid was stable for 90 days at room temperature and under refrigeration.
Aminosalicylic Acids↗
Working effectively with your boss.
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Humans↗
Progressive discipline.
A structured, stepwise approach to employee discipline is described in which penalties increase in severity if problems are not corrected. Managers should apply all disciplinary measures consistently and should comply with hospital, union, or personnel department procedures where applicable. The steps of progressive discipline include oral counseling, written warning notices, suspension without pay, and termination of employment. Disciplinary sessions should be documented and follow-up sessions should be held to evaluate progress. An oral counseling session should be held immediately after a problem appears and should include a specific description of the problem and its implications by the supervisor, an explanation and suggestions for correction by the employee, and agreement on a specific plan of action. If the problem persists, the manager should give a written warning notice and again discuss the problem and a specific plan of action. One or more suspensions for three or five days may be used, depending on policy and the manager's judgment. When firing an employee, the manager should review previous disciplinary measures and explain the institution's appeal process. If all disciplinary steps have been followed, the appeal should be denied. Use of the progressive discipline process encourages satisfactory employee performance. The specific steps ensure that employees are treated fairly, and documentation of the process supports the manager's action when an employee must be fired.
Counseling↗