Institutional Pharmacy Practice

8/19/2019 Institutional Pharmacy Practice

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Institutional PharmacyPractice

Chapter 1


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Institutional Pharmacy Practice

• Provision of distributional and clinical pharmacy services at a broad institutional settings including hospitals, long-term care, hospice, corfacilities and others


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Integrated Health Systems

• Integrate all care under the umbrella of a central organization

• Often include:

• inpatient/acute care

•primary care/outpatient care

• long term care

• home care


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Hospitals

• Traditionally focused on providing care to acutely ill patients that reqconstant care by a team of highly skilled professionals

• Biggest component of institutional practice

•

Differentiated by these factors:• Location

• Size

• Specialization


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Types of Hospitals

• COMMUNITY HOSPITAL

• Most common type

• Deal with an assortment of diseases and injury

• Treat a broad group of medical conditions

• SPECIALIZED HOSPITAL

• Particular disease

• Specific organ

• Type of patient


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Types of Hospitals

• TEACHING HOSPITAL

• Training future health-care professionals

• PROFIT HOSPITAL

•

Owned by corporation or private investors

• NON-PROFIT HOSPITAL

• do not seek a return on investment for owners


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Types of Hospitals

• GOVERNMENT HOSPITAL

• Owned or heavily supported by federal , state, country or other governmenta


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Evolution of Hospital Nomenclatu

AO no. 68-A s.1989

AO no. 70-A s.2002

AO no. 147 s.2004

AO no. 2005-0029

A.O.

Primary Infirmary Infirmary Level 1 Othefa

Secondary 1st level ReferralHospital

Primary CareHospital

Level 2 Le

Tertiary (Non-Teaching)

2nd levelReferral Hospital

SecondaryCare Hospital

Level 3 Le

Tertiary(Teaching)

3rd level ReferralHospital

Tertiary CareHospital

Level 4 Le


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Legal Basis for Defining Hospital

(R.A. 4226)• Beds/cribs for 24 hours use or longer (sec 2)

• Must have Minimum Standards and Construction of a Hospital (sec

Bed space OPD

Laboratory DR

OR Isolation

X-ray Morgue

Pharmacy


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Legal Basis for Defining Hospital

(R.A. 4226)• “Classify” hospitals as to: (sec. 16)

• General or Special

• Service capacity

• Size or bed capacity

• Training or not


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“NEW Classification of Hospitals and ot

Facilities”

A.O. no. 2012 – 0012DOH Bureau of Health Facilities and Servic


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CLASSIFICATION OF HOSPITA

• According to Ownership:

• A. Government

• Created by law

•

Maybe under DOH, DND, DOJ, PNP, LGU, SUCs, GOCC and others• B. Private

• Single proprietorship, Partnership, Corporation, Cooperative, Foundation, ReNGO


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• According to Functional ca pacity:

• A. General Hospital

• Clinical services

• Emergency services

• Outpatient services

• Ancillary and Support services


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• According to Functional ca pacity:

• B. Specialty Hospital

Particular disease – e.g. National Orthopedic Hospital, NationaCenter for Mental Health, San Lazaro Hospital

Particular organ(s) –

Lung Center, Phil. Heart Center, NKTI Particular Group of Patients – PCMC, NCH, DJFMH


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• According to Trauma Capability

• A. Trauma – Capable Facility

DOH licensed hospital designated as a trauma center

• B. Trauma –

Receiving Facility

Receives trauma patients for transport to trauma center


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New Classification of General Hospi

C L I N I C A

L S E R V I C E S A N D

F A C I L I T I E S F O R

I N - P A T I E N T S

LEVEL 1 LEVEL 2 LEVEL 3

Medicine

PediatricsOB-GYNESurgery

Level 1 plus all: Level 2 plus all:

Departmentalized ClinicalServices

Teaching/training with

Accredited residencyprogram in the 4 majorclinical services

Emergency and OPD Respiratory Unit Physical Medicine andRehabilitation unit

Isolation Facilities General ICU Ambulatory Surgical Clinic

Surgical/ MaternityFacilities

High Risk Pregnancy Unit Dialysis Clinic

Dental Clinic NICU Tertiary lab withhistopathology

A N C I L L A R Y

S E R V I C E S

Secondary ClinicalLaboratory

Tertiary Clinical Laboratory Blood bank

Blood Station Blood station 3rd level X-ray

1 st level X-ray 2nd level X-ray with mobileunit

Pharmacy


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New Classification of other Health FacA B C D

Primary Care Facility Custodial Care Facility Diagnostic/ Therapeutic

Facility

Specialized Out-Pa

FacilityWith In-patient Beds:

Infirmary

Birthing Home

Psychiatry Care Facility Laboratories:

Clinical Lab/HIV

Blood service

facilities

Drug Test lab

NBS

Water lab

Dialysis Clinic

Ambulatory Surgical

Without Beds:

Medical Out-patient

clinics

OFW clinics

Dental clinics

Drug Abuse Treatment

and Rehabilitation Center

(DATRC)

Ionizing machines:

X-ray, CT scan,

Mammography, etc

In-Vitro Fertilization

Centers

Sanitarium/ Leprosarium Non-Ionizing machines:

Ultrasound, MRI and

others

Radiation Oncology

Facility

Nursing Home Nuclear medicine Oncology center/ cl

Documents

Institutional Pharmacy Practice