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Biomedical subjects

W W Churchill

Publications and source records attributed to W W Churchill.

8 recordsLinked to original sources
PubMed1991

Quality improvement in a hospital pharmacy department.

This article reports the successful implementation of two quality improvement efforts in the central pharmacy of a large tertiary care facility. The authors, who were participants in the project, describe the steps taken and the graphic tools used to document processes and measure improvements. The experience confirms that health care organizations can apply techniques of total quality management taken from other types of organizations.

Medication Systems, Hospital↗
PubMed1988

Source of missing doses in a decentralized unit dose system: a quality assurance review.

Unit dose drug distribution systems have become the prominent drug delivery system in healthcare institutions. Much of the success of the unit-dose concept can be attributed to the increased accountability of medications dispensed and administered. However, as a direct result of this added accountability the problem of "missing doses" has become more evident than under non-unit dose systems. A quality assurance audit was conducted to identify the reasons for missing doses and identify the responsibility for them. A missing dose record was developed through a collaborative effort of the pharmacy and nursing departments. Both staff nurses and pharmacists were invited to review and suggest modifications prior to using the form. All potential reasons for missing dose occurrences were listed on the form. When a missing dose occurred the pharmacist and the nurse completed form jointly to ensure agreement as to the cause. During the 25 day study period the pharmacy dispensed 54,082 doses of medications to patients on the study floors. During that period 227 incidents of missing doses were documented. This resulted in an overall incidence of missing doses of 0.4%. Of the 227 missing doses, a reason for the occurrence was identified for 170 (75%). Nine classes of medications accounted for 62% of all reported missing doses. When responsibility for the missing doses was examined 13.3% were pharmacy generated and 45.8% were nursing generated. The results of the audit generated several suggestions which may decrease the number of missing doses and further improve our drug distribution service.

Boston↗
PubMed1985

Medication carts--are they all the same?

Purchase of unit dose medication carts is one of the major capital expenditures in the development and maintenance of a unit dose distribution system. Critical factors in this selection process are the considerations of product reliability and durability. To develop an assessment of user satisfaction with the various brands of unit dose carts, a national survey of 500 randomly selected hospital pharmacies was developed and mailed. The questionnaire requested information on types of carts used, satisfaction with cart performance, types of repairs needed, frequency of repairs, providers of cart repairs, and frequency of cart maintenance inspections. Two hundred seventy responses (54%) were available for evaluation. Eighty-five percent of cart users have five or more carts. Although 60% of respondents have carts greater than or equal to 4 years old, comparative satisfaction did not decrease as a function of increasing age of carts. There were 11 brands of unit dose carts reported by 214 responders. One hundred and three of these 214 responders (48.1%) used MacBick as compared with 36, 22, 18, and 35 users of Trans Aid, Lionville, Ferno Forge, and seven other brands, respectively. MacBick's users reported less equipment failure rate compared with the other brands, but this difference did not reach statistical significance (p less than 0.2 greater than 0.05). It was also determined that only 29% of hospitals routinely inspect carts to insure proper functioning. Since the most frequent type of equipment failure reported (up to 61% of users) involved cart locking mechanisms, drug security can be compromised without routine inspections.

Attitude of Health Personnel↗
PubMed1985

Cost of implementing and maintaining a hospital-pharmacy-based online literature search system.

The costs of implementing and maintaining an online literature search system are described. The drug information service component of the department of pharmaceutical services pursued computerization to ensure the availability of timely and comprehensive drug information and to provide hands-on experience in computerized literature retrieval for its undergraduate and graduate students. Three major implementation costs were identified: the cost of purchasing the computer hardware, the expense of a training program for the online search program, and the ongoing user's fee for access to the databases. These implementation expenses were covered through nontraditional sources of funding, and no money was required from the hospital. The system received hospital-wide publicity through a number of prominent communication vehicles when it was implemented. In its first year, there were 448 requests requiring computer searches of a total 4150 requests for drug information. Of these 448, 255 originated from physicians, 138 from pharmacists, and 55 from nurses and drug manufacturers. Medline was the most frequently accessed database, accounting for 62.6% of the charges; Toxline accounted for 32.3% and miscellaneous files 5.1%. The average monthly charge (user's fee) was +238, which was within the initial projection for the yearly expense. Because of the success of this program, the system's costs were added to the operating budget of the drug information service.

Boston↗
PubMed1983

Decentralized preparation of short-term prescriptions for discharged patients.

The rationale for and implementation of a decentralized system for filling short-term discharge prescriptions are described. To prevent interruption of drug therapy, orders for three-day supplies of medications were filled in the outpatient pharmacy and returned to patients before discharge. Under the old system, more than 20% of medications ordered were not received by patients. Reasons for this problem were identified, and a new system was designed in which these discharge prescriptions were filled in satellite pharmacies. A follow-up study under the new system showed that only 1.5-3% of discharge medications were not received by patients and that patients' use of the discharge medication program was increased. Implementation of a decentralized discharge prescription program using the existing satellite pharmacies allowed increased efficiency in delivery of medications to patients at the time of their discharge from the hospital.

Boston↗