Hospital Pharmacy

Definition of Hospital

The hospital is a complex organization utilizing a combination of intricate, specialized scientific equipment, and functioning through a corps of trained people educated in the problem of modern medical science. These are all welded together for the common purpose of restoration and maintenance of good health

Definition of Hospital Pharmacy

The department or service in a hospital which is under the direction of a professionally competent, legally qualified pharmacist, and from which all medications are supplied to the nursing units and other services, where special prescriptions are filled for patients in the hospital, where prescriptions are filled for ambulatory patients and out-patients, where pharmaceuticals are manufactured in bulk, where narcotic and other prescribed drugs are dispensed, where injectable preparations should be prepared and sterilized, and where professional supplies are often stocked and dispensed.

The computerization of the pharmacy department makes it possible for the staff to participate in patient education programs, poison control center activities, preparation of patient drug use profiles, parenteral nutrition program participation, cooperating in the teaching and research programs of the hospital, communicating new product information to nursing service and other hospital personnel and dispensing radiopharmaceuticals.

Goals for Hospital Pharmacy

Just as any organization must have long-range goals toward which its daily activities are directed, so must a profession, its members, and their representative societies. For example, the American Society of Hospital Pharmacists, in its Constitution and Bylaws, sets forth the following objectives:

1. To provide the benefits of a qualified hospital pharmacist to patients and health care institutions, to the allied health professions, and to the profession of pharmacy.
2. To assist in providing an adequate supply of such qualified hospital pharmacists.
3. To assure a high quality of professional practice through the establishment and maintenance of standards of professional ethics, education, and attainments and through the promotion of economic welfare.
4. To promote research in hospital pharmacy practices and in the pharmaceutical sciences in general.
5. To disseminate pharmaceutical knowledge by providing for the interchange of information among hospital pharmacists and with members of allied specialties and professions.

More broadly, Society's primary purpose is the advancement of rational, patient-oriented drug therapy in hospitals and other organized health care settings.

To the preceding can be added the following objectives:

• To expand and strengthen institutional pharmacists' abilities to:

1. Effectively manage an organized pharmaceutical service.
2. Develop and provide clinical services.
3. Conduct and participate in clinical and pharmaceutical research
4. Conduct and participate in educational programs for health practitioners, students, and the public.

• To increase the knowledge and understanding of contemporary institutional pharmacy practice by the public, government, pharmaceutical industry, and other health care professionals.
• To promote compensation and benefits commensurate with pharmacists responsibilities and contributions to patient care.
• To help provide an adequate supply of qualified supportive personnel for institutional pharmacy services.
• To help ensure that health care reimbursement and payment systems do not inhibit the implementation of innovative pharmaceutical services or adversely reflect on institutional pharmacy practice.
• To assist in the development and advancement of the pharmacy profession.

The foregoing serves as a collective statement of the goals of the Society and its constituency. Transforming these goals into realities will require the dedicated efforts of all institutional pharmacists, both as individuals and as members of society.

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Minimum Standard for Hospital Pharmacy

Pharmaceutical services in institutions have numerous components, the most prominent being

1. The procurement, distribution, and control of all pharmaceuticals used within the facility.
2. The evaluation and dissemination of comprehensive information about drugs and their use to the institution's staff and patients.
3. The monitoring, evaluation, and assurance of the quality of drug use.

These functions are carried out in cooperation with other institutional departments and programs.

The primary function of this article is to serve as a guide for the development and provision of pharmaceutical services in institutions. It will also be useful in evaluating the scope and quality of these services. It does not, however, provide detailed instructions for operating a pharmacy—other Society publications serve this function.

Standard 1: Administration

The pharmaceutical service shall be directed by a professionally competent, legally qualified pharmacist. He or she must be on the same level within the institution's administrative structure as directors of other clinical services. The director of pharmaceutical services is responsible for:

1. Setting the long- and short-range goals of the pharmacy based on developments and trends in health care and institutional pharmacy practice and the specific needs of the institution.
2. Developing a plan and schedule for achieving these goals.
3. Supervising the implementation of the plan and the day-to-day activities associated with it.
4. Determining if the goals and schedule are being met and instituting corrective actions where necessary.

The director of pharmaceutical services, in carrying out these tasks, shall employ an adequate number of competent and qualified personnel

Standard II: Facilities

There shall be adequate space, equipment, and supplies for the professional and administrative functions of the pharmacy.

• The pharmacy shall be located in an area (or areas) that facilitate (s) the provision of services to patients. It must be integrated with the facility's communication and transportation systems.
• Space and equipment, in an amount and type to provide secure, environmentally controlled storage of drugs, shall be available.
• There shall be designated space and equipment suitable for the preparation of sterile products and other drug compounding and packaging operations.
• The pharmacy should have a private area for pharmacist-patient consultations. The director of pharmaceutical services should also have a private office or area.
• Current drug information resources must be available. These should include appropriate pharmacy and medical journals and texts and drug literature search and retrieval resources.

Standard III: Drug Distribution and Control

• The pharmacy shall be responsible for the procurement, distribution, and control of all drugs used within the institution. This responsibility extends to drugs and related services provided to ambulatory patients. 
• Policies and procedures governing these functions shall be developed by the pharmacist with input from others involved in hospital staff (e.g. nurses) and committees (pharmacy and therapeutics committee, patient-care committee, etc.). 
• In doing so, it is essential that the pharmacist routinely be present in all patient-care areas, establish rapport with the personnel, and become familiar with and contribute to medical and nursing procedures relating to drugs.

Standard IV: Drug Information

The pharmacy is responsible for providing the institution's staff and patients with accurate, comprehensive information about drugs and their use and shall serve as its center for drug information.

Standard V: Assuring Rational Drug Therapy

An important aspect of pharmaceutical services is that of maximizing rational drug use. In this regard, the pharmacist, in concert with the medical staff, must develop policies and procedures to ensure the quality of drug therapy.

Standard VI: Research

The pharmacist should conduct, participate in, and support medical and pharmaceutical research appropriate to the goals, objectives, and resources of the pharmacy and the institution.

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