Biomedical subjects

H F Catania

Publications and source records attributed to H F Catania.

6 recordsLinked to original sources

PubMed1995

Developing a comprehensive medication reaction reporting system.

A step-by-step method for developing a comprehensive medication reaction reporting system is reported. The program was developed from information obtained by literature review, from the existing programs of other hospitals, and the authors' ideas. The following steps were developed and implemented after approval by the Pharmacy and Therapeutics Committee. The name of the program was changed from the Adverse Drug Reporting Program to the Medication Reaction Reporting Program. A voice mail system was installed, the medication reaction reporting form was revised, a suspected medication reaction sticker was developed, the peer review mechanism was revised, and a system for positive feedback to reporters was developed. After implementation of the revised program, the number of reported medication reactions increased by 144%, from an average of 12.7 reports per month to 31 reports per month. The revised program has increased medication reaction reporting from 1.2% to 2.7% of discharged patients. Program revision has also increased the quality of the reports, increased the number of cases for peer review, and has aided the medical center in identifying medication related problems which has resulted in closer monitoring to reduce future problems.

Adverse Drug Reaction Reporting Systems↗

PubMed1992

The next step in clinical intervention programs.

Pharmacists should incorporate and modify existing clinical intervention programs to document pharmacists' effects on patient care and quality drug-therapy management. We have already demonstrated the pharmacist's role in drug cost savings through the intervention programs, and now QIP can assist us in taking the next step in providing quality patient care. If we endorse the principles of pharmaceutical care, we must assume the responsibility for documenting our value as pharmacists in managing drug therapy in patients. The clinical intervention programs will deemphasize the value of drug cost analysis and emphasize effects on patient-care outcome. We believe that facilitating positive patient outcomes will decrease overall health care costs. As managers, we must assist our pharmacists in endorsing this concept by developing our programs to show the maximum benefit of their efforts in the patient-care arena.

California↗

PubMed1990

Four years' experience with a clinical intervention program: cost avoidance and impact of a clinical coordinator.

Four years of data are reported on the drug cost avoidance and the net cost savings associated with a clinical pharmacy intervention program. In 1986 the pharmacy department at a 324-bed nonprofit community medical center began a clinical intervention program by adding one full-time equivalent for providing clinical services. A new clinical pharmacist position was created in 1988. A reorganization in 1989 resulted in further increases in staffing, including the creation of a clinical coordinator position to oversee the intervention program, and in administrative time. Staff pharmacists self-report a broad range of interventions on a clinical documentation form. During the period 1986-1989, monthly data on the number of types of interventions recommended, the percentage of recommendations accepted by the medical staff, and drug cost avoidance were tabulated. Cost avoidance was calculated by subtracting the cost of therapy ordered by the physician from the cost of therapy initiated as a result of the intervention. Net drug cost savings were calculated by subtracting from cost avoidance the cost of pharmacist time required for performing the interventions. The average number of interventions per month ranged from 170 in 1986 to 292 in 1990. During an 18-month period before the clinical coordinator was added, average monthly cost avoidance and net savings were $4932 and $3739, respectively. Average monthly cost avoidance increased to $6244 and savings to $4644 in a 12-month period after the clinical coordinator was added. A four-year study of a clinical intervention program showed that the dollar value and impact outlasted the initial success expected for such programs.

Administrative Personnel↗

PubMed1988

Using clinical interventions to cost-justify additional pharmacy staff.

This paper reports on the use of clinical interventions in cost justifying an additional pharmacist in a 316 bed hospital. Data were collected during a 5 month period in 1986 related to clinical interventions by satellite pharmacists. To justify to the hospital administration the permanent hiring of an additional pharmacist, a 10% return on the hospital's investment in salary and fringe benefits was required. The effect of clinical interventions on the cost of drug use was viewed as the only way to demonstrate the administration's mandated return on investment. Actual drug cost savings were $30,657, which resulted in a total estimated annual savings of $73,572 or a 54% return on the hospital's investment in the salary of the additional full time equivalent pharmacist. The 855 interventions resulted in an average savings of $35.88 per intervention. The study successfully demonstrated the use of clinical interventions to cost-justify additional pharmacy staff.

California↗

PubMed1985

Using DRG data to justify additional clinical pharmacy staff.

The administrative process used to justify additional clinical pharmacy staff is described. A combination of Diagnosis Related Group (DRG) financial data and clinical information was used to justify adding a full-time DRG clinical pharmacist to the 22.6 full-time pharmacy staff in a 316-bed, nonprofit community hospital. A seven-step process was used successfully to gain approval for the new position. A novel strategy was incorporated into the proposal that used a justification based on cost-containment and quality-of-care issues rather than on increased revenues. Also included in the proposal was an evaluation of the DRG clinical pharmacist position at 6 months and after 1 year, based on reducing costs as well as improving patient care. The position was described as an investment by the hospital that would provide a return at least equal to the cost of providing the position.

Diagnosis-Related Groups↗

PubMed1984

Analyzing pharmacy charges using DRGs.

Pharmacy charges at a 316-bed community hospital were analyzed using diagnosis-related groups (DRGs). All patients admitted to the hospital between January 1, 1983, and August 31, 1983, were retrospectively categorized by DRG. For the 20 most expensive DRGs for the pharmacy department in terms of pharmacy charges, the following data were compiled: number of patients, total pharmacy charges, mean hospital and pharmacy charges per patient, mean length of stay, pharmacy charges as a percentage of hospital charges, and DRG distribution and total pharmacy charges by major diagnostic category ( MDC ). A total of 10,550 patients were assigned to 390 DRGs. For the 20 most expensive DRGs, the mean total pharmacy charges and number of patients per DRG were $83,457 and 140, respectively. DRG 107 (coronary bypass) and MDC 5 (diseases and disorders of the circulatory system) had the highest pharmacy charges in the respective DRG and MDC categories. Pharmacy charges as a percentage of hospital charges ranged from 4.1% to 32% for the 20 most expensive DRGs. While there appeared to be a direct relationship between high hospital charges and length of stay for the most expensive DRGs, there did not appear to be a direct relationship between these two measures and high pharmacy charges. Until hospitals have data on actual cost per case and on cost per DRG for each department, analysis of pharmacy charge data by DRG for establishing pharmacy priorities may be a reasonable approach.

California↗