HECO U1- Application

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Application inPHARMACY PRACTICE

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INPUTRESOURCES

OUTPUTGoods

And

Services

NEEDSWANT 

DEMANDS

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INPUTRESOURCES

OUTPUTGoods

And

Services

OUTCOMES

transformation

Pharmacy operations

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Processes

• Goods and services offered by thebusiness

• Outputs

prescription medications patient counselling

immunization

OTC medications

Durable medical equipment Disease state management

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Processes

• Outputs (consumable offerings) drivepatients perceptions of your pharmacy

• Outputs influence outcomes in patients

• Keep in mind.....

patients develop perceptions of yourbusiness based on the outputs and

outcomes

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Processes

• Goods and services GOODS

compounded prescription

durable medical equipment

OTC medicationsRx medications

SERVICES

refill reminders

patient counselling

disease state management

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PROCESSES

• Service Typologyservices can be viewed in terms ofspecificity and intensity

Specificity

customer service

product service

service as a product

Intensitytactic

strategic

cultural

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processesService specificity

• Customer service-general quality ofinteractions

• Product services – support of products(distribution, technicalassistance)

• Service as a product – independent ofcompany’s goods 

Organizational intensity

• Tactic – actions withinthe marketing mix

• Strategic – adds a key

competency• Cultural – reshapes themission

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tactic strategic cultural

CustomerService

24 houremergency

Delivery Customersalways right

ProductService

Refillreminder

Onlinerefills

Counseleverypatient

ServiceProduct

RefillingcompetitorRx

DSM Diabeteseducationonly

S

PECIFIC

IT y

I n t e n s i t y

PROCESSES

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INPUT  RX MEDSTransformation

Initialpatientinteract

-ion

RxProce-ssing

RxFilling

RxHandling

fordelivery

to patient

Secondary

PatientInter-action

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Ingredients, both active and inactive

Container

Computer that creates the label the

Insurance company

Fee charged to verify and fill the

Rx over the phone lineBag that Rx is place

Cost of electricity

Rent on the facility

Salary and benefits who compound

the prescription

PR

ODUT 

INPUT 

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processes

• All of the resources needed tocreate the output

• Examples of INPUTS (Rx Meds)

stock medicationspharmacists

technicians

labels utilities

containers computers

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processes

• OUTCOMES the result of patient behaviours

can be measured (although not alwayseasy)

 can be influenced by the pharmacy’soutputs

can be monitored

outcomes can occur along a continuum

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Filling the prescription medication

Compounding the prescription

OTC medication

Nutritional supplements

Offering and fitting durable medical

equipmentInformation about Rx drugs

Information about OTC drugs

Health and beauty aids

Greeting cards

Counseling in prescription drug use

Screening for drug interactionsSpecial convenience packaging

PROFIT 

Typical Community Pharmacy Output

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Filling the prescription medicationCompounding

Preparation of IV and solutions

Delivery of medication to floors

Collection of order from hospital

floors

Drug event monitoring

Formulary management

Therapeutic management

Prescription medication counseling

Filling of Rx medication carts

Drug information to physicians

TPN and enteral nutritions

PR

OFIT 

TYPICAL HOSPITAL PHARMACY OUTPUT 

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Factors Affecting the Drug Delivery of PharmacyProduct and Services

1.Patient Demographic

a. Aging population

b. Females as decision-makers

c. Ethnic composition of patient

2.Attitudes and Belief system

a. Belief about disease, sick role, medication

takingb. Trust in health care delivery system

c. Direct-to- consumer advertising ofRx drug

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Factors Affecting the Drug Delivery of PharmacyProduct and Services

3. Third party payers

a. Complexity/differences among payerspolicies

b. Formularies

c. Limited networks

d. Limited access for some patients

e. Lack of knowledge by patients

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Factors Affecting the Drug Delivery ofPharmacy Product and Services

4.Competitive market

a. Diminished margins

b. Diversity in the types of providers offeringproducts and services

5.Technology

a. Software

b. Automated dispensing technology

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Pharmacoeconomics

1.Determine optimal mix of labor andcapital

2.Determine optimal output

3.Determine optimal hours of businessoperation

4.Determine levels of investment intorisk management

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10 Decisions under the purview 

of Management

• Designing goodsand services

• Managing quality• Process strategies

• Location strategies

• Lay out strategies

• Human resource

• Scheduling strategies

• Supply chain strategies• Inventory management

• Maintenance

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1.Designing Goods and Services

@ needs and wants of consumers

@ require analysis and planning@ tangible or not tangible

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 2. Managing Quality

CompoundPrescription Quality Product

2 Types of Costs

1.Cost maintaining qualitya. Prevention cost

b. Appraisal cost

2.Cost associated with poor qualitya. Internal failure

b. External failure

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3. Process Strategies

STEPSPerformed

DuringOperations

EfficiencyGood

ServicesProfitability

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4. Location Strategy

1.How can easily and efficiently theinput for operations can berequired?

2.How easily the outputs operationcan be transferred to theconsumers of those outputs?

3.Which outputs are chosen to beoffered by a given business?

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5. Pharmacy Layout

Pharmacy needs to bedesigned to maximize the

efficiency of the processconducted to create the goodsand services

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6. Human Resource

@ most important resources in apharmacy

@ goods and services offered aretransferred using personnel

@ efficiency and ability to interact

with patient

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7. Scheduling Strategy

@ scheduling with personnel is a critical aspect ofoperation

@ pharmacist must be present when the pharmacy isopen

@ CHASE Strategy – chase the demand havingpersonnel available = great demand

@ LEVEL Scheduling – to provide amount ofproduction so that a constant workforce can beemployed to handle the demand day after day,and week after week

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8. Supply chain management

@ chain of business that supplypharmacies with necessary

inputs@ build relationship and

agreements with othercompanies

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9.Inventory management

@ largest expense that a pharmacyhas

@ too much inventory is seen asmoney sitting on the shelf

@ too little causes inefficiency inthe system

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10. Maintenance Strategy

INEFFICIENT PRODUCTIONOF

GOODSSERVICES

P

ROFIT 

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Ensuring Quality in PharmacyOperations

Quality of Care “ is the degree towhich health services for individuals

and populations increase thelikelihood of desired healthoutcomes and care consistent withcurrent professional knowledge” 

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Quality in Pharmacy Practice

1.Represent degree of excellence

2.Increases the probability of positive outcomes

3.Decreases the probability of negative

outcomes4.Corresponds with current medical knowledge

5.Offers the patient what he wants

6.Provides the patients with what he needs

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How is Quality Measured

1.Structure = refers to the rawmaterials needed for production

2.Process = method and procedure used

3.Outcomes = end result

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Different Ways to LookOutcomes

ECHO Model

3 Basic Types of Outcomes

a. Economical Outcomes

b. Clinical Outcomes

c. Humanistic outcomes

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A.Economical Outcomes

@ include direct costs andconsequences

@ include indirect cost andconsequences

@ both medical and nonmedical

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B.Clinical Outcomes

@ include morbidity andmortality, event rates, andsymptoms resolution

C. Humanistic Outcomes

@ measures of the “human”

aspects of care - HRQoL

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Methods for Ensuring Quality

in Pharmacy Practice1.Quality Assurance (QA)

“The systemic monitoring andevaluation of the various aspect ofa project, service, or facility toensure that standards of qualityare being met” 

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Methods for Ensuring Qualityin Pharmacy Practice

2. Quality Control (QC)

“ an aggregate of activitiesdesigned to ensure adequatequality ” 

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Methods for Ensuring Qualityin Pharmacy Practice

3.Continuous QualityImprovement (CQI)

“ a philosophy of continualimprovement of the processesassociated with providing a good

or service that meets or exceedscustomer expectations ”

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2 Important Ideas that

Trascend QA and QC1.CQI represents total systemperspective concerning quality (all

works are interconnected)2.CQI demands that the qualityimprovement process is continuous

(never ending)