Staffing levels: how do you compare?
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Biomedical subjects
Publications and source records attributed to R P Hoffmann.
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Through efficient staff scheduling our 481-bed community teaching hospital has been able to expand its pharmacy services. This paper describes how a clinical pharmacy service program for cardiology and cardiac surgery patients was developed and defines the service components. After over two years of experience with the cardiology program, we have found this pharmacy service area to be very successful and well received. Various forms and proposals are provided to assist other pharmacists interested in expanding into this area of practice.
The results of a comprehensive statewide survey of hospital pharmacy technicians are presented. Although this was only a statewide survey, its findings should be of interest to technicians and pharmacists everywhere since very few data of this type are available. In addition, Michigan is a very progressive pharmacy state and has recently implemented a formal technician certification process (described in an appendix) via the Michigan Pharmacists' Association. The survey instrument was mailed to the Directors of Pharmacy at 252 Michigan hospitals. The response rate was 68.7% (173) hospitals). The survey pointed out that Michigan hospitals employ on the average one technician for each pharmacist. Most hospitals required high school graduation and typing skills as a minimum for hiring of a technician. Numerous technician work responsibilities were identified, including the admixture of sterile products. Technicians in this survey had a variable work schedule, and the future job market appeared to be healthy. Most of the technicians were females under the age of 30. Average hourly wages for regular technician position ranged from $5.05 to $6.25 (June 1981). Numerous categories of technicians were noted, and about 20% of the technicians were unionized. Many of the hospitals utilized a formal on-the-job technician training program. The performance of the majority of technicians was evaluated annually, and many opportunities existed for continuing education. The concept of technician certification appeared to be looked upon favorably by most of the pharmacy directors.
Seventeen community hospitals within the 16 division of the Sisters of Mercy Health Corporation cooperatively participated in a medication allergy audit program. Initial and follow-up audits were conducted at each hospital to determine whether allergy information for penicillin- or aspirin-sensitive patients was appropriately communicated to the pharmacist. A total of 483 patient records were reviewed during each audit which corresponded to 12% of each hospital's average patient census. In the initial audit, the overall acceptance rate for the combined hospitals was 62.3%. Following the first audit, each hospital undertook corrective follow-up measures in an attempt to improve its results. In the second audit, the overall acceptance rate improved significantly to 78.9%. It is concluded that this auditing process followed by corrective follow-up measures was an effective mechanism for improving the communication of patient allergy information and is a means to quality assurance. Future audits will be necessary to determine whether the beneficial effects produced will be sustained or improved.
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Seven community hospitals have worked cooperatively for 18 months to develop an initial hospital pharmacy quality assurance program. Auditing criteria were developed for nine service areas corresponding to the model program developed by the American Society of Hospital Pharmacists. Current plans are to implement and modify this program as required at each participating hospital. Follow-up programs will also be essential to a functional, ongoing program, and these will be developed in the future.
Methods utilized to expand pharmaceutical services in hospitals without additional personnel are of prime concern in light of the numerous cost containment constraints. Our hospital was able to expand its services through the development of a standardized staff pharmacist schedule. This schedule rotates every eight-week period and divides work responsibilities equally during this period. In addition, all staff pharmacists are given the opportunity to participate in expanded drug information and clinical services for a two-month period as the schedule progresses. This article describes how this schedule was developed and summarizes the expanded services made possible by its implementation.
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The PAS system, subscribed to by many hospitals, is readily adaptable to drug usage review. Useful for this purpose are PAS data on drug usage according to (1) drug type, (2) diagnosis, and (3) information supplied at patient admission. The PAS system also permits "special coding," or "targeting," of other data for review. Whatever the drug utilization system used, pharmacist input into the process is highly important.
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