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Biomedical subjects

D A Kvancz

Publications and source records attributed to D A Kvancz.

4 recordsLinked to original sources

Implementation and pharmacoeconomic analysis of a clinical staff pharmacist practice model.

The implementation and pharmacoeconomic analysis of a clinical staff pharmacist (CSP) practice model are described. Staff pharmacists at a large, tertiary care, academic medical center were selected and trained to perform clinical pharmacy services under the direction of clinical pharmacy specialist mentors. Clinical interventions by these CSP practitioners were evaluated in terms of direct cost savings (the difference in actual acquisition costs between therapies) and cost avoidance (the dollar value of adverse drug events [ADEs] avoided). The CSPs performed a total of 4959 interventions during a 12-month period. The interventions provided direct cost savings of $92,076 and an estimated cost avoidance of $488,436. Comparing cost savings and cost avoidance with the expenses of providing these services indicated a net economic benefit of $392,660. A new model of pharmacy practice that integrates staff pharmacists into existing clinical practice has the potential to minimize the risks, decrease the costs, and improve the outcomes associated with drug therapy.

Cost Savings↗

Implementation of mobile decentralized pharmaceutical services in a community teaching hospital.

Administrative strategies that were used to justify mobile decentralized pharmaceutical services in a community teaching hospital are discussed. The report describes the problems prompting the pharmacy's review of its centralized unit dose drug distribution and i.v. admixture services, the evaluation of alternative solutions, the proposal submitted to hospital administrators, the implementation process, and an analysis of fiscal impact. A decentralized system using mobile medication carts was considered the best alternative because it integrated distributive and clinical functions and offered efficiencies in drug distribution; anticipated capital expenditure costs and personnel costs were also lower than the costs of alternatives. The conversion to the new system increased the pharmacy personnel budget by $174,455 annually, representing the addition of 13.8 full-time equivalent (FTE) pharmacists and elimination of 10.4 FTE technicians and interns. The increased personnel budget was offset in fiscal year (FY) 1982-83 by documented savings of $47,000 from pharmacists' clinical activities and by calculated savings of $132,400 in nursing time. Excluding capital expenditures of $19,800 for the medication carts, implementing mobile decentralized services saved the hospital $4945 in FY 1982-83. Mobile decentralized services is a cost-effective approach for providing integrated drug distribution and clinical pharmacy services.

Costs and Cost Analysis↗

Evaluation of mobile decentralized pharmaceutical services in a community teaching hospital.

Mobile decentralized pharmaceutical services were compared with the previous centralized unit dose drug distribution services in a community teaching hospital. Medication order turnaround time, pharmacist workload activities, number of drug information requests, dose-activity index, and quality of drug distribution and drug administration record keeping were compared under the two systems. The number of drug therapy problems identified and resolved by decentralized pharmacists also was determined. Medication order turnaround time decreased from a mean of 198 minutes to 64 minutes in the centralized and decentralized systems, respectively. The number of drug information requests increased from 0.0055 to 0.05 requests per patient day. The percentage of requests related to adverse drug reactions, drug interactions, therapeutics, pharmacokinetics, and pharmacology increased in the decentralized system. The dose-activity index was 63.5% and 56.9% for centralized and decentralized systems, respectively, with the mean number of doses handled per patient day at 14.4 and 10.7. Decentralized pharmacists spent substantially more time than centralized pharmacists performing educational, therapy-related, and dispensing activities and less time performing clerical and verification activities. Decentralized pharmacists detected a large number of drug therapy problems that probably would have gone undetected in the previous system. The decentralized system met 31 of the 32 quality assurance standards, compared with 20 standards met for the centralized system. The implementation of mobile decentralized services provided greater opportunities for use of the pharmacists' clinical skills and reduced the time allocated to traditional functions.

Drug Information Services↗