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PubMed2005

[The benefits of computerized anticancer drug distribution].

Medication errors can lead to treatment failure and adverse drug reactions with potentially life-threatening consequences, especially when the patient is fragile or the drug is highly toxic. Both these latter factors are frequent in the cancer setting. Computers can be used to securitize the prescription (through validated protocols), preparation and administration of anticancer drugs, including experimental drugs, as they can store a wealth of information on both the individual patient and the product. We report our experience at Hotel-Dieu Hospital in Paris, where a computerized anticancer drug distribution system has increased treatment safety, provided major cost savings, and allowed nurses to spend more time with their patients.

Antineoplastic Agents↗
PubMed1978

Clinical pharmacy services in a community hospital.

An example is given of the implementation of clinical pharmacy service program in a community hospital. The need for establishing an efficient drug distribution system is discussed, and the feasibility of utilizing clinically motivated staff pharmacists is presented. A method of limiting the number of patients admitted to the clinical pharmacy service program is also given.

Aged↗
PubMed1999

[Hospital information systems or data processing in gynecology? Strategic reflections towards a comprehensive information concept].

Hospital information systems are essential tools for efficient hospital management and improvement of medical procedures. Structural differences between the management of hospital information systems and the management of other huge, distributed and heterologous information systems cannot be found. However, there are differences concerning special tasks in patient care and medical research with high demands in data protection and modularity. The management of information processing has to be performed systematically.

Electronic Data Processing↗
PubMed1994

Accuracy of technicians and pharmacists in identifying dispensing errors.

The accuracies with which pharmacists and technicians checked medications in a unit dose distribution system were compared. The study was conducted at three large hospitals in Washington State. From August through October 1991, technicians filled unit dose medication drawers and pharmacists verified the accuracy of each fill (pharmacist verification period). From November 1991 through January 1992, technicians who had undergone special training verified the accuracy with which medication drawers were filled by other technicians (technician verification period). For each study period, two error rates were estimated: the frequency with which the pharmacists or technicians identified dispensing errors and the frequency of verification errors identified by the investigators in a final independent check. A total of 143,952 unit doses were dispensed during the pharmacist verification period, of which 49,718 were randomly analyzed for accuracy. A total of 151,721 doses were dispensed during the technician intervention period, of which 55,470 were assessed. The mean +/- S.E. daily rates of dispensing-error identification by pharmacists (0.0125 +/- 0.0069%) and technicians (0.0119 +/- 0.0001) did not differ significantly. While pharmacists overlooked more errors (107) than technicians (50), the percentage of such missed errors classified as potentially serious did not differ significantly between the groups (25.2% versus 32.0%, respectively). Pharmacy technicians who underwent special training were able to verify medications in a unit dose distribution system without compromising the accuracy of dispensing.

Education, Pharmacy↗
PubMed1981

Staffing for comprehensive pharmaceutical services in a small hospital.

The use of licensed practical nurses as medication administration personnel under the administrative authority of the pharmacy department in a 140-bed hospital is described. The pharmacy department assumed responsibility for medication administration in its efforts to expand the scope and quality of its services and to control drug distribution more completely. A medication administration team (MAT) was developed that involves licensed practical nurses and technicians. The MAT members are trained through programmed instruction, on-the-job experiences, and a 32-hour pharmacology course taught by staff pharmacists. This medication administration team gives the pharmacy department control of the entire drug distribution system.

Drug Therapy↗
PubMed1996

Automatic alerts for methicillin-resistant Staphylococcus aureus surveillance and control: role of a hospital information system.

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is an escalating problem in hospitals worldwide. The hospital reservoir for MRSA includes recognized and unrecognized colonized or infected patients, as well as previously colonized or infected patients readmitted to the hospital. Early and appropriate infection control measures (ICM) are key elements to reduce MRSA transmission and to control the hospital reservoir. OBJECTIVE: To describe the role of an expert system applied to the control of MRSA at a large medical center (1,600 beds) with high endemic rates. METHODS: The University Hospital of Geneva has an extended hospital information system (HIS), DIOGENE, structured with an open distributed architecture. It includes administrative, medical, nursing, and laboratory applications with their relational databases. Among available patient databases, clinical microbiology laboratory and admission-discharge-transfer (ADT) databases are used to generate computer alerts. A laboratory alert (lab alert) is printed daily in the Infection Control Program (ICP) offices, listing all patients with cultures positive for MRSA detected within the preceding 24 hours. Patients might be either newly detected patients colonized or infected with MRSA, or previously recognized MRSA patients having surveillance cultures. The ICP nurses subsequently go to the ward or call the ward personnel to implement ICM. A second alert, the "readmission alert," detects readmission to the hospital of any patient previously colonized or infected with MRSA by periodic queries (q 1 min) to the ADT database. The readmission alert is printed in the ICP offices, but also forwarded with added guidelines to the emergency room. RESULTS: During the first 12 months of application (July 1994 to June 1995), the lab alert detected an average of 4.6 isolates per day, corresponding to 314 hospital admissions (248 patients); the use of this alert saved time for the ICP nurses by improving work organization. There were 438 readmission alerts (1.2 alerts per day) over the study period; of 347 patients screened immediately upon readmission, 114 (33%) were positive for MRSA carriage. Delayed recognition of readmitted MRSA carriers decreased significantly after the implantation of this alert; the proportion of MRSA patients recognized at the time of admission to the hospital increased from 13% in 1993 to 40% in 1995 (P < .001). CONCLUSIONS: Hospital information system-based alerts can play an important role in the surveillance and early prevention of MRSA transmission, and it can help to recognize patterns of colonization and transmission.

Cross Infection↗
PubMed1986

Strategic planning for clinical services: St. Joseph Hospital and Health Care Center.

A pharmacy department at a 340-bed community hospital based its strategic plan for developing patient-oriented services on a sound drug distribution system, a credible work-measurement program, and fiscal responsibility. In 1982 the department of pharmacy and i.v. therapy implemented a strategic plan for improving pharmaceutical services. The plan involved developing goals and objectives for the department; marketing the department's services and fiscal management to hospital administrators, medical staff, and nursing staff; building teamwork among the pharmacy staff; and improving the drug distribution system before instituting clinical services. Hiring of additional pharmacy staff was justified on the basis of work-measurement data. By adjusting staffing levels every two weeks based on work-measurement data, the department increased the efficiency of drug distribution activities; the pharmacy also implemented cost-saving programs like selection of therapeutic alternates and formulary restrictions. The savings were then reinvested in labor-intensive patient-oriented pharmaceutical services. A staff development program using staff pharmacists as preceptors expanded the breadth and depth of pharmacists' clinical skills. The planning efforts were successful because the needs of hospital administrators, the pharmacy department, and staff members were addressed.

Hospital Bed Capacity, 300 to 499↗
PubMed1989

PharmaTrend as a management tool: experience with the program.

A hospital's experiences with two pharmacy workload measurement systems, PharmaTrend and the pharmacy productivity unit (PPU) system it replaced at the institution, are compared. In 1976 a 352-bed general acute-care hospital implemented the locally developed PPU system. Typical drug distribution-related activities were defined and were assigned standard times per work unit; miscellaneous activities were assigned constant times per month. The PPU system served the institution well but had three important limitation: (1) new pharmaceutical services were not adequately represented, (2) the data collected had to be manually manipulated in order to calculate indicators, and (3) it was not possible to compare the data with those of similar institutions. In January 1988 the hospital implemented PharmaTrend. PharmaTrend was found to be a useful management tool because of the relative ease of data collection and the system's report-generation capabilities. By combining pharmacy workload data (including non-drug-distribution-related components) with data on finance, personnel hours, and patient admissions, PharmaTrend calculated indicators that were used for determining staffing and other needs and for financial reporting. The limitations of the PPU system were eliminated, except that it was still not possible to make valid comparisons with other hospitals because of the small number of participating hospitals that consistently report data to the PharmaTrend database. PharmaTrend offers advantages over previous pharmacy workload-monitoring systems by allowing for the expanded analysis and application of data.

Colorado↗
PubMed2004

Caseview_HUN: easy DRG overview.

Several hospital management tools are currently used by the DRG financial system. Each case is classified into a DRG group, so it is necessary to know the distribution of hospital or departmental cases into DRG groups, and to follow the variances of this distribution. The DRG's properties include the income and expenses related to each case. There are differences in the profitability of the cases, depending on their DRG. It is important to know own expenses and the recuperated costs for every case. There are several systems for data collecting and analysis in hospitals, depending on existing hospital information systems and management. We can, however, be sure, that a DRG data collection system works in every department, because it is the basis of assessing income. The tool, which is shown in this article, facilitates an overview of the DRG, presenting the hospital's or other healthcare provider's own data. These services are supported by a platform-independent, accessible Internet application.

Diagnosis-Related Groups↗
PubMed1969

[Drug distribution].

Explore the source record for details and available documents.

Medication Systems, Hospital↗
PubMed1991

Checking of unit dose cassettes by pharmacy technicians at three Minnesota hospitals.

A pilot project in which pharmacy technicians were trained to check unit dose cassettes filled by other technicians is described. With the approval of the state board of pharmacy, the Minnesota Society of Hospital Pharmacists (MSHP) conducted the nine-month project in three hospitals with different types of unit dose drug distribution systems. Twenty-seven technicians underwent didactic and practical training and were then validated as checkers if they scored 99.8% accuracy in checking carts into which errors had been deliberately introduced by the pharmacist auditor. The performance of validated technicians was audited monthly, and failed audits had to be repeated. Participating technicians did not check the preparation of first doses or extemporaneously prepared doses. In 100,000 doses audited, 60 errors by the validated checkers were identified. Of six technicians who failed a monthly audit, five passed a repeat audit. Pharmacists at the participating hospitals documented time they spent on clinical activities that would have been spent checking cassettes. In December 1990 a one-year extension of the project, expanded to 10 hospitals, began. With strict quality control measures, specially selected and trained pharmacy technicians performed unit dose cassette checking with an accuracy of at least 99.94%.

Humans↗
PubMedDate not supplied

Computer simulation as a basis for pharmacy reengineering.

Using computer simulation can enhance the management decision-making process. Simulations can predict the effects on cost and quality of services. This article discusses the use of computer simulation to assist in planning the reengineering process to change a hospital's drug distribution from a decentralized pharmacy satellite system to a centralized robotic drug dispensing system. Because computer simulation was based on a fixed set of circumstances, circumstances changed before system implemented. Nursing and pharmacy staff and line managers were involved in the review, planning, and implementation that resulted in positive economic and quality outcomes for this project. For organizations to achieve successful change, administrators must play an active and essential part.

Computer Simulation↗