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PubMed1982

Developing the request for proposal.

The development of a request for proposal (RFP) to computer hardware and software vendors is described. The RFP functions as a planning document, facilitating communication with a selection of vendors, contract negotiations, and development of acceptance criteria. Development of the pharmacy specifications for the RFP involves evaluating and collecting statistics on the existing manual system, planning future services to be provided by the pharmacy and the hospital, evaluating any computer systems already within the hospital, and assessing the impact of pharmacy's interaction with other departments. This information is translated into descriptions of exactly what is to be provided by computerization. The resulting RFP should include a description of the current manual or electronic data processing system. The priority of each function requested, requests for vendor-specific data, contract information, and instructions for the vendor to use in submitting a proposal. Because the RFP's purpose is to communicate unique system needs, the less specific it is written, the greater the opportunity for misinterpretation.

Computers↗
PubMed1982

Establishing priorities and distributing the request for proposal.

The process of establishing priorities for a prospective hospital pharmacy computer system and distributing the Request for Proposal (RFP) to computer vendors is described. Priorities are established through the creation of three documents: (1) a priority list, (2) a categorized RFP, and (3) a categorized RFP extension. The priority list outlines important elements in the selection of a vendor; quality of software, reliability of software and hardware, vendor stability, costs, site requirements, expansion capability, vendor support, and system performance. The categorized RFP ranks each specific RFP item as mandatory, highly important, important, or "luxury." The categorized RFP extension ranks the nonimplementation items and is used to grade vendors on items not addressed by the RFP. Each potential vendor should be called and asked the same set of questions in order to quickly eliminate those with unacceptable products. The RFP is then distributed to vendors that qualify. This process helps determine if the system being considered has all the required functions, has reliable software and hardware, and whether the vendor is stable and capable of providing assistance during implementation and throughout the life of the product.

Computers↗
PubMed1979

Who makes decisions about new technology in hospitals?

Three top managers from different kinds of hospitals explain how decisions to buy expensive new technology are made in their institutions. Financial feasibility, competition with other hospitals, and the advantages of new equipment to patients and members of the medical staff are all considerations administrators must keep in mind when buying new equipment.

Costs and Cost Analysis↗
PubMed1995

Lessons learned from Hurricane Andrew: recommendations for care of the elderly in long-term care facilities.

We report on the experience of a 500-bed, long-term care facility in Miami, Fla, which provides housing and nursing care units for patients--ranging from those who are independently ambulatory to those who are acutely ill and feeble--in preparing for, during, and in the immediate aftermath of Hurricane Andrew, which struck on August 24, 1992. The problems encountered included a massive influx of evacuated elderly to the facility, facility isolation, loss of electrical power, loss of running water, special dietary needs, and limited professional staffing due to personal property losses or loss of transportation. Overwhelmed county emergency medical services, limited access to hospitals and patient care, and difficulty in procuring supplies exacerbated the already complicated situation resulting from the storm. As a result of these catastrophic conditions, a number of challenges specific to the care of the elderly were identified. In conjunction with the Florida Department of Elder Affairs, we drafted a comprehensive blueprint that could serve as a disaster plan for other long-term care facilities facing a similar threat during the hurricane season.

Aged↗
PubMed1994

ASHP national survey of pharmaceutical services in federal hospitals--1993.

The results of a national mail survey of pharmaceutical services in federal hospitals conducted by ASHP from May to July 1993 are reported. Mailing lists were compiled of all Air Force, Army, Navy, Public Health Service, and Department of Veterans Affairs (VA) hospitals, as well as some federal prison hospitals. Questionnaires were mailed to each chief of pharmacy. The adjusted gross population size was 326. The net response rate was 76%. Complete unit dose drug distribution was offered by 85% of respondents, and 83% offered complete, comprehensive i.v. admixture programs. About half of the pharmacies provided decentralized services. Over 99% provided services to ambulatory care patients. A computerized pharmacy system was present in 99% of the departments. More than 95% of hospitals participated in adverse drug reaction, medication error management, and drug-use-evaluation programs. A total of 93% provided drug therapy monitoring, and 89% provided patient education. About 70% provided written documentation of pharmacist interventions in the medical records, and 57% participated in drug research. A total of 42% provided pharmacist-managed drug clinics, 41% participated in drug management of medical emergencies, 30% provided written medication histories, and 30% provided drug therapy management planning. Pharmacokinetic consultations were provided by 64% of departments. About 90% had a well-controlled formulary system and prescribing restrictions. Therapeutic interchange was practiced by 64%. Diversified pharmaceutical services included telephone or mail-in refill services (80%), mail-out pharmaceutical services (58%), and services to long-term-care facilities (49%). A total of 70% of the hospitals were affiliated with a pharmacy school. The first ASHP national survey of pharmaceutical services in federal hospitals showed that comprehensive distributive and clinical services were offered by most of the facilities.

Drug Information Services↗
PubMed1993

Reusable laparoscopic instruments: continuous quality improvement.

Proactive management of processing activities is cost effective, fulfills the requirements of the Joint Commission for the Accreditation of Healthcare Organizations, and meets professional recommended practices. Controlling the variables is the key to producing an acceptable product each and every time. It may not be possible to completely eliminate variations, but they can be reduced to an acceptable level with product testing; simple, illustrated procedures with measurable outcomes; employee education; and adequate inventory. A cost-effective system approach can be developed to provide a high level of assurance that rigid laparoscopic instruments are clean, functional, and sterile each time they are used.

Humans↗