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Biomedical subjects

D P Vogel

Publications and source records attributed to D P Vogel.

17 recordsLinked to original sources
PubMed1997

Creating synergy to restructure a college of pharmacy's teaching site.

Colleges of pharmacy and clinical teaching sites have a history of collaboration to create teaching and practice innovations. Radical changes in health care delivery have placed a strain on these relationships and may jeopardize the continued success of these programs. Goals of collaborative planning for a renewed model include integrating teaching into the professional culture of the pharmacy department, moving pharmaceutical care resources to the patient care unit, and training all staff in teaching skills. A model that combines these attributes is defined, and development of the model at a university teaching hospital is described. Revising the pharmacy practice and teaching agenda has a positive effect on both care delivery and educational outcomes.

Education, Pharmacy↗
PubMed1993

Patient-focused care.

The trend away from a departmental focus and toward "patient-focused" care in hospitals is described; advantages of and barriers to such a change and its effects on pharmacy are discussed. Patient-focused care is characterized by decentralization of services, cross-training of personnel from different departments to provide basic care, interdisciplinary collaboration, various degrees of organizational restructuring, use of "clinical pathways"--recommended components of care for patients with a particular diagnosis, simplification and redesign of work to eliminate steps and save time (e.g., providing care according to predetermined protocols and charting only exceptions to the protocol), and increased involvement of patients in their own care. Its objectives are to use nonclinical and clinical staff more effectively and to improve patients' perceptions of the quality of care and staff members' job satisfaction. It is unrealistic to expect quick reductions in hospital costs through patient-focused care, and workers will worry about job security if an institution overemphasizes this aspect. A 1993 survey of 311 hospitals found that almost half had or planned to have patient-focused care projects. Adoption of patient-focused care projects may be slowed by workers' fear of new responsibilities and new reporting relationships. However, not all patient-focused care models involve radical organizational changes, and reorganizations can be such that pharmacy staff members are still connected to the pharmacy department even if they are supervised by a nonpharmacist. In some institutions patient-focused care projects have given pharmacy its first opportunity for decentralization.(ABSTRACT TRUNCATED AT 250 WORDS)

Hospital-Patient Relations↗
PubMed1991

A team approach to patient care in the medical intensive care units at Robert Wood Johnson University Hospital.

The MICU offers the pharmacist and the pharmacy technician an exciting opportunity to participate meaningfully in direct patient care. Cost containment will continue to be an important issue in the 1990s. The pharmacist must promote optimal therapeutic decision making and decrease the incidence of adverse drug reactions to get the patient better and out of the unit as quickly as possible. The pharmacist will ensure that patients receive the safest, most cost-effective therapy without compromising the quality of care. The pharmacist and pharmacy technician can collaborate with MICU nurses to create a safe and efficient flow of medications. Time management by nurses becomes much more efficient when they are able to benefit from the interactions of pharmacists and pharmacy technicians as described in this article.

Hospital Bed Capacity, 300 to 499↗
PubMed1991

Creating the optimal nursing-pharmacy interface: a strategic plan for the pharmacy manager.

These strategies certainly do not represent an exhaustive list of the possibilities. They cover some of the major issues and reflect observed elements that exist in institutions that enjoy frequent positive interactions at the pharmacy-nursing interface. Anecdotal observations and comments confirm that in such institutions there exists greater efficiency in the drug-use process, greater job satisfaction, and better patient care than in those institutions where there are strained relationships at the pharmacy-nursing interface. The remaining articles in this issue provide specific examples to document these benefits. The pharmacy manager who makes a concerted, proactive effort to use some of the information in this article and the others to establish a positive, highly interactive pharmacy-nursing interface will experience these same rewards. Progress may occur more slowly in some institutions due to long-standing difficulties. Pharmacy initiatives may be viewed with skepticism. In these situations, actions speak much louder than words; demonstrate change (e.g., decentralization) on a pilot basis without additional resources to generate a groundswell of acceptance at the grassroots level. This will in turn contribute to a much more serious consideration of any proposal that does include increased resources or reallocation of resources (from nursing to pharmacy). No matter how difficult or frustrating it might be to implement these strategies, the potential results are worthy of the efforts.

Clinical Pharmacy Information Systems↗
PubMed1989

Development and implementation of a strategic-planning process at a university hospital.

The development and implementation of a long-range strategic plan for the pharmacy department at a university hospital is described. Because of rapidly occurring changes in health-care delivery, financing, and education, the pharmacy department at the University of Illinois Hospitals decided to create a strategic plan that would stimulate growth, be responsive to a changing health-care environment, and emphasize the department's philosophy of striving for professional leadership in education, research, and innovation. Actual strategy development was done during a three-day administrative retreat, which was conducted according to a structured agenda that facilitated extensive brainstorming and discussion. As a result, the department developed eight major strategies that have been directing its growth and development over the last four years. Each strategy had an implementation plan that included substrategies with statements of specific results that were expected, an action plan (a list of specific tasks to be accomplished), and a general statement summarizing the benefits of each substrategy. Annual meetings were held to review the continued appropriateness of these strategies. Implementation of the strategic plan has resulted in major improvements in drug cost containment, improved ambulatory-care pharmaceutical services, a results-oriented performance-appraisal system, more support for clinical education programs, and a substantial increase in support for research. The strategic plan has allowed the department to constructively participate in two downsizing events within the hospital without major adverse effects on its own services and programs. Use of the strategic-planning process should be considered by other hospital pharmacy departments as a means of responding to the external and internal forces of change that currently affect most hospitals.

Chicago↗
PubMed1987

Pharmacist participation in the management of incidents involving hazardous materials.

The role of the pharmacist as a hazardous materials consultant is described. Pharmacists in a university-affiliated teaching hospital are contacted by either emergency medical services or the emergency department to assist in the management of incidents involving toxic hazardous materials. These incidents can range from major chemical spills or leaks to long-term exposures involving generalized, nonspecific symptoms. An advanced pharmacy resident in emergency medicine is the primary pharmacy contact for hazardous materials consults. The services provided by the clinical pharmacist include identification of the hazardous materials involved, initiation of special precautions for rescue-squad and hospital-based personnel, clinical assessment of the toxicologic problem, and formulation of therapeutic recommendations. Teaching programs have been developed for pharmacy, nursing, and medical students, hospital employees, and emergency-response agencies. Pharmacy participation in the management of hazardous materials incidents has been well received by emergency department physicians and nurses, as well as by rescue personnel. During the period between January 1 and July 1, 1986, the pharmacy was consulted on 66 hazardous materials incidents. Since pharmacists have traditionally been used as information resources for clinical toxicology questions, it follows that their participation can extend into the field of environmental toxicology, specifically involving hazardous materials. The pharmacist's input as a hazardous materials consultant in our institution has been well received, and we believe that pharmacy departments can play an important role in the management of incidents involving hazardous materials.

Consultants↗
PubMed1986

A model for inpatient clinical pharmacy practice and reimbursement.

The development and expansion of clinical pharmacy over the past 15 years have resulted in several debates. One debate that was very lively in the late 1970s concerned proper reimbursement for clinical pharmacy services. Although this debate is less heated now, its importance is even more significant with today's major changes in health care reimbursement. This article reviews the key reasons for the original debate and discusses how recent changes have increased and added direction to the debate. A model is presented that the authors believe represents the key to the increasing acceptance of the pharmacist's clinical role.

Models, Theoretical↗
PubMed1985

Decision analysis applied to the purchase of frozen premixed intravenous admixtures.

A structured decision-analysis model was used to evaluate frozen premixed cefazolin admixtures. Decision analysis is a process of stating the desired outcome, establishing and weighting evaluation criteria, identifying options for reaching the outcome, evaluating and numerically ranking each option for each criterion, multiplying the ranking by the weight for each criterion, and calculating total points for each option. It was used to compare objectively frozen premixed cefazolin admixtures with batch reconstitution from vials and reconstitution of lyophilized, ready-to-mix containers. In this institution the model numerically demonstrated a distinct preference for the premixed frozen admixture over these other alternatives. A comparison of these results with the total cost impact of each option resulted in a decision to purchase the frozen premixed solution. The advantages of the frozen premixed solution that contributed most to this decision were decreased waste and personnel time. The latter was especially important since it allowed for the reallocation of personnel resources to other potentially cost-reducing clinical functions. Decision analysis proved to be an effective tool for formalizing the process of selecting among various alternatives to reach a desired outcome in this hospital pharmacy.

Cefazolin↗
PubMed1980

Pharmacy unit devises quality assurance plan.

As the basis for a total quality assurance program, a hospital's pharmacy department developed minimum standards of practice and a compliance audit procedure.

Hospital Bed Capacity, 500 and over↗