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Biomedical subjects

E G Nold

Publications and source records attributed to E G Nold.

31 records · Page 2Linked to original sources
PubMed1982

Managing computer systems. Developing the proposal.

The major components of a thorough proposal to computerize pharmaceutical services are described. The components of the proposal are (1) the introduction; (2) description of current and proposed systems; (3) hardware, software, and supplies; (4) vendor selection; (5) implementation; (6) interface; (7) justification of need; (8) risk analysis; (9) contract; (10) summary; and (11) appendices. Special emphasis is given to justifying the pharmacy system on the basis of decreased cost for personnel, drugs, charging for services, and equipment. Additional justification is based on the benefits of increased production, decreased problems, and increased capacity to produce. A life-cycle cost analysis and engineering economy formula is described that can be used to calculate the number of full-time equivalents that must be reduced in order to offset costs of the system through personnel reduction alone. Because the decision to computerize pharmaceutical services constitutes a major and permanent change, it is important that the proposal be logical, factual, thorough, and organized.

Computers↗
PubMed1982

Computer systems planning, development, and impact assessment.

In this final installment of a 12-article series on managing computer systems for the hospital pharmacy department, contemporary issues related to the topic of the series are discussed. Assessment of institutional strategy for acquiring systems and determining the departmental direction is reviewed. The far-reaching impact of computerization on personnel staffing and job functions is discussed. The results of a telephone survey of 23 pharmacy computer system vendors that had at least one installation of a unit dose and i.v. admixture system are also presented. Because of the current and future widespread use of computers, pharmacists must acquire knowledge of computer systems.

Computers↗
PubMed1982

Computerization needs assessment.

The process of assessing needs for a computer application in a hospital pharmacy is described. The variables discussed for which data are needed include hospital-specific characteristics, personnel, data storage, data retrieval, data transmission interfaces, and hardware. By determining these needs, the buyer will be able to know the functions that are necessary and the vendors' abilities to meet the buyer's needs.

Computers↗
PubMed1982

Use of clinical pharmacists to reduce cefamandole, cefoxitin, and ticarcillin costs.

The financial impact of using cefamandole and cefoxitin rather than cefazolin and of using ticarcillin rather than carbenicillin in one institution was assessed; the effectiveness of clinical pharmacists in reducing the costs associated with these drugs also was determined. During Phase 1 (July 1, 1980-March 31, 1981), the numbers of intravenous piggyback cefazolin, cephalothin, cefamandole, cefoxitin, carbenicillin, and ticarcillin doses prepared were recorded. Quarterly purchase data for each drug were determined from invoice records. During Phase 2 (April 1, 1981-September 30, 1981), eight clinical pharmacists reviewed all patient charts for cefamandole, cefoxitin, and ticarcillin orders. If the indication for these orders was missing or considered inappropriate, the pharmacist contacted the prescriber and recommended substituting appropriate doses of cefazolin for cefamandole and cefoxitin and of carbenicillin for ticarcillin. The number of doses prepared and quarterly purchase data were collected as in Phase 1. The projected savings resulting from clinical pharmacist input relating to these drugs was calculated. Based on Phase 1 data, the total theoretical expense resulting from cefamandole and cefoxitin use instead of cefazolin and from ticarcillin use in place of carbenicillin was projected to be $233,448 annually. Cefamandole and cefoxitin accounted for 59.8 and 39.7% of total cephalosporin use in Phases 1 and 2, respectively. Ticarcillin accounted for 77.1% of the total ticarcillin and carbenicillin doses in Phase 1, and 16.6% in Phase 2. A projected annual savings of $156,756 was achieved because of clinical pharmacist input at a cost of $16,000 for time devoted to the effort. Clinical pharmacists were effective in reducing the use of cefamandole, cefoxitin, and ticarcillin in situations where cefazolin or carbenicillin could be substituted.

Anti-Bacterial Agents↗
PubMed1982

Role of the director of pharmacy: the first four months.

Specific goals and tasks that should be addressed during a pharmacy director's first four months of employment are reviewed. Individuals must prepare themselves for the director's role, find the right job, and negotiate an acceptable benefits package. During the first two months as director of pharmacy, an individual should primarily work on gathering facts and assessing the department's operations without making many changes. Interrelationships within the hospital should be studied, and many pharmacy and hospital documents should be reviewed so that the director has an understanding of past history. The director should interview all employees of the department and work as a staff pharmacist for one to two days in each area. During the third and fourth months, the new director will need to determine the extent of authority, develop working relationships with key individuals, assess the pharmacy-management team, develop a data-collection system, learn the processes for making changes, and consolidate authority. A major document, containing a departmental-operations analysis, statement of philosophy, goals, and approach to goal completion, should be the culmination of the four months. The director of pharmacy must meld professional, administrative, and financial activities; the final determinant of success will be the director's ability to implement and follow through with proposed changes.

Administrative Personnel↗
PubMed1981

Managing computer systems.

This paper launches a 12-part series of articles on managing computer systems for the hospital pharmacy department. The series will concentrate on the evaluation, purchase, and implementation of commercial computer systems. Computer hardware and software capabilities will be reviewed, a systematic approach toward the selection of a vendor will be outlined, advice on how to justify a system wil be offered, and important considerations in implementing and managing a computer system will be discussed.

Computers↗
PubMed1979

Cost-effectiveness of clinical pharmaceutical services: a follow-up report.

The cost-effectiveness of pharmacist-conducted training programs for patients self-administering at home antihemophilic factor, calcitonin, cytarabine, injectable analgesics and parenteral nutrients was studied. Records of 35 patients participating in the training programs from September 1976 through August 1978 were reviewed. The benefits of the patient training programs were measured by approximating the days of hospitalization or outpatient visits saved (and their related costs) per patient. For every dollar charged by the pharmacy service for the patient training programs, 1.25 days of hospitalization and $321.90 in hospital charges were saved. The cost-effectiveness ratios demonstrated the benefits of the patient training programs. Third-party reimbursement can be improved by designing comprehensive measures of cost-effectiveness.

Cost-Benefit Analysis↗
PubMed1979

Reimbursable pharmacy teaching program for adrenalectomy patients.

A three-step, pharmacist-taught education program for adrenalectomy patients is described. Twenty-three patients were trained during the two years of the project. Training included: (1) an explanation of the patient's disease state and need for supplementary medication; (2) an explanation of each medication taken; and (3) training on self-administration of an i.m. dose of dexamethasone. Blue Cross agreed to pay the hospital ø25 per patient trained. Thirteen patients were available for interviews designed to evaluate the program. All patients knew the signs and symptoms of adrenal crisis and had excellent recall of information about their medication. Eight patients had increased their oral steroid doses as instructed to avoid adrenal insufficiency during stress. Substantial cost savings resulted from the program. The costs saved by offering the program justified the cost of supplying the service.

Adrenal Cortex Hormones↗
PubMed1979

Developing reimbursable clinical pharmacy programs: pharmacokinetic dosing service.

The development, operation and evaluation of a pharmacy-conducted pharmacokinetic dosing service is described. Pharmacists recommend individualized drug dosing regimens based on pharmacokinetic models and equations clinically tested for accuracy by the pharmacy department. Pharmacokinetic values are determined with the aid of online computer programs developed by the department. Drug assays are provided by the hospital's laboratory. All of the department's pharmacists were trained to provide the 24-hour service. The pharmacy department's $20 pharmacokinetic dosing service fee is reimbursed by Blue Cross. The pharmacokinetic dosing service is the first nonteaching, nonproduct-oriented pharmaceutical service whose cost-effectiveness has been recognized by a third-party payer.

Body Surface Area↗
PubMed1979

Developing reimbursable clinical pharmacy programs: a goal-oriented approach.

Using a goal-oriented approach, a model for achieving third-party reimbursement for clinical pharmaceutical services is proposed. Within the framework of this model, the discussion includes: (1) determination of the hospital pharmacy mission, goals and objectives; (2) classification of clinical services into eight categories to establish the reimbursement potential for each service; (3) development of a clinical service protocol, techniques to establish charges and stages involved in communicating with the parties affected by the clinical services; and (4) methodologies for evaluating program outcome.

Evaluation Studies as Topic↗
PubMed1977

Third-party reimbursement for clinical pharmacy services: philosophy and practice.

A step-by-step approach is outlined for obtaining third-party reimbursement for clinical pharmacy services separate from dispensing fees. The program is based on a patient-care philosophy rather than a cost-conscious philosophy. The steps in implementation of the program were: (1) a total commitment to the patient's health, (2) identification of patient needs that require clinical pharmacy expertise, (3) development of a patient training program, (4) presentation of a written proposal to the hospital administration, (5) presentation of the proposal to third-party agencies, (6) initiation of charges for the services, and (7) preparation of reports on the progress of the program. Third-party reimbursement covers pharmacist instruction of home therapy patients receiving antihemophilic factor, cytarabine, parenteral nutrition, calcitonin-salmon and injectable analgesics. Financial data based on one year's experience with the program show that savings far outweight the charges.

Blue Cross Blue Shield Insurance Plans↗