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Biomedical subjects

W N Kelly

Publications and source records attributed to W N Kelly.

12 recordsLinked to original sources
PubMed1990

National survey of ethical issues presented to drug information centers.

Whether and how drug information centers respond to calls from the public that involve ethical issues was studied. A survey describing six ethical dilemmas typical of those presented by calls from the public was mailed to pharmacists in 154 drug information centers to see how the questions would be handled. Centers that had written policies governing responses to questions with ethical implications were asked to submit those policies. One hundred twenty-six centers (82%) responded to the survey; of these, 81 (64.3%) answered questions from the public. There were no significant differences in characteristics between centers that did and did not respond to public calls. The case analyses, completed only by pharmacists in centers that responded to public calls, covered such issues as invasion of privacy, social responsibility, personal liability, and interference with the patient-physician relationship. Respondents exercised a wide degree of discretion in determining if they would answer a question; for example, while only 4% would not answer a question concerning the efficacy of a weight-loss diet patch, 77% reported they would not respond to a caller asking for information on drugs that could interfere with the results of a polygraph test. Although respondents often cited institutional policy as the reason for failing to respond to a question, none submitted a copy of such a policy. The pharmacists' responses indicated a high degree of moral and social sensitivity; nonetheless, written policies should be developed to assist drug information center staff members in handling questions that have ethical implications.

Adrenergic beta-Antagonists↗
PubMed1989

Clinical career ladders: Hamot Medical Center.

The clinical career ladder program for pharmacists at Hamot Medical Center (HMC), a 500-bed not-for-profit community teaching hospital, is described. Between 1980 and 1989 a career ladder at HMC evolved from an idea to an established program with parallel administrative, business, and clinical tracks. The development of the career ladder mirrored the growth of clinical programs and the diversification of pharmaceutical services. A formal plan for a clinical ladder was developed when the first satellite pharmacy opened in 1984. An entry-level pharmacist at HMC starts with a six-month period during which he or she learns the drug distribution system and prepares for several certification tests. The employee is then promoted to staff pharmacist. Staff pharmacists are promoted to clinical pharmacist II (CP II) upon meeting requirements for competence in a broad range of clinical skills and knowledge. Candidates for the position of clinical pharmacist specialist (CP I) must have either a minimum of three years of experience as a CP II or a Pharm.D. degree and have established an area of clinical expertise. A CP I can progress to assistant and associate director positions as vacancies occur. The clinical ladder has enhanced job satisfaction and encouraged the development of clinical practitioners who provide improved care. Problems have included time constraints, competition for positions, and management of incentives. A parallel career ladder program with a clinical track has enhanced the growth of pharmacy practice at HMC and improved the quality of pharmaceutical care.

Career Mobility↗
PubMed1986

Cost analysis of a satellite pharmacy.

The cost-effectiveness of a satellite pharmacy that serves 100 beds in a 550-bed community teaching institution was determined. On one day six months before and one day six months after the satellite pharmacy was implemented, 30 patients were randomly selected for study from the 50-bed surgical-trauma unit and the 50-bed medical oncology unit served by the satellite. Data for the cost analysis were collected from the medical charts of these 60 patients; each patient's entire hospital stay was used for all calculations. Data collected included costs per patient day for drugs, i.v. therapy, and laboratory tests; total hospital costs per patient day; number of doses per patient day; and length of hospital stay. There were no significant differences in patient age or sex, length of hospital stay, or patient mix among patients studied before and after the satellite pharmacy was implemented. The cost per patient day for drugs was significantly less after the satellite pharmacy was implemented. A cost analysis based on this decrease in drug costs per patient day of $5.77 showed that an annual savings of $134,927 could be realized as a result of satellite pharmacy implementation. Implementation of a pharmacy satellite proved to be cost-effective, largely because of decreased drug costs.

Cost-Benefit Analysis↗
PubMed1986

Strategic planning for clinical services: Hamot Medical Center.

As a result of a two-day strategic-planning program, a hospital pharmacy department developed a five-year plan for addressing seven critical issues facing the department. The pharmacy department at a large nonprofit community hospital began a formal planning process in 1981 after concluding that the existing clinical services had been implemented in a haphazard fashion and had mixed results. The planning process began with a two-day planning program aimed at identifying issues facing the department, followed by the development of consensus about the most important issues and the development of action plans for dealing with these. The planning program consisted of four parts: presentations by hospital administrators, nurses, and the medical staff on future directions in their respective areas and pharmacy's potential input; presentations on the future of pharmacy from the perspectives of the pharmacy director and the responsible hospital administrator; preliminary recommendations related to drug distribution services and clinical services by two pharmacy consultants; and discussions of departmental management issues and key points identified in previous sessions. The department's progress in addressing each of the seven critical issues is described; most of the action plan has been completed. The consensus-building planning process allowed the department to focus on the most important issues, identify support and possible conflicts from others, and obtain administrative approval of the department's focus on patient-oriented services.

Cost-Benefit Analysis↗
PubMed1986

Strategic planning for clinical services: panel discussion.

A panel of hospital pharmacy managers representing three institutions discussed issues related to planning for patient-oriented pharmacy services. The panelists discussed organizational benefits of strategic planning, ways to gain momentum for change among pharmacy staff members and from others within the institution, the need for setting realistic goals, and problems in differentiating roles for pharmacy staff. They also discussed the funding of strategic-planning programs. The panelists advocated an integrated approach to providing drug distribution and clinical services. Management must provide whatever support is necessary for integrating patient-oriented services into the daily activities of all pharmacists. That support may be in the form of additional personnel, better use of supportive personnel, staff development programs, or automation. Pharmacists, too, must recognize their combined responsibilities for drug distribution and clinical services. Only by having all pharmacists clinically trained can a department provide clinical services when needed. The experiences of these panelists may be useful to other institutions planning patient-oriented pharmacy services.

Medication Systems, Hospital↗
PubMed1975

Drug usage review in a community hospital.

A simple and effective manual drug usage review program in a community hospital is described. Fifteen randomly selected charts are screened each month by a drug information pharmacist. Charts demonstrating questionable drug therapy are forwarded to a physician member of the pharmacy and therapeutics committee; those showing questionable drug administration practices are referred to the nurse member of the committee. These committee members screen the questionable charts and refer to the entire committee those cases which require further follow-up. The committee categorizes the problems and communicates its recommendations to the individual practitioners involved. Recommendations focus on the legal ramifications of FDA-unapproved drug usage. During the first two years of the program, 341 charts were screened for drug usage; 62 of these were referred to the pharmacy and therapeutics committee for further review. In 20 cases, the committee sent a letter to the prescribing physician or his department chairman; in 16 cases, letters were sent to nursing administration.

Drug Utilization↗