Adventist Medical Center College

San Miguel, Iligan City

Department of Pharmacy

Activity 1

THE HOSPITAL PHARMACY ENVIRONMENT

I. OBJECTIVES
A. Describe the vision, mission and goals of the institution and the pharmacy department.
B. Describe the organizational chart of the institution and the pharmacy department. C. Describe
the key management personnel of the pharmacy department, their roles and responsibilities.
D. Demonstrate knowledge of patient profiling, hospital formulary system, and the quality
initiatives of the department.

II. ACTIVITIES:
1. Describe and differentiate the various types of hospitals as to:
a. Ownership
1. Public hospitals: These hospitals are owned and funded by the government or a
public authority. They are usually operated by a board of governors or trustees
appointed by the government. Public hospitals are typically non-profit
organizations that provide healthcare services to the general public, regardless of
their ability to pay.
2. Private hospitals: Private hospitals are owned and operated by private individuals,
organizations, or corporations. They are typically for-profit entities that offer
healthcare services to those who can afford to pay for them. Private hospitals may
also offer specialized services that are not available in public hospitals.
3. Non-profit hospitals: Non-profit hospitals are owned by organizations or groups
that operate for the public benefit. These hospitals may be run by religious
organizations, charities, or foundations. Non-profit hospitals usually operate on a
not-for-profit basis, and any profits they generate are reinvested into the hospital
or used to support charitable causes.

b. Specialization
1. General hospitals: These hospitals provide a broad range of medical and surgical
services to treat a variety of conditions. They typically have an emergency
department and can provide inpatient and outpatient care.
2. Specialized hospitals: These hospitals are focused on treating specific medical
conditions or populations. Examples include cancer hospitals, pediatric hospitals,
and psychiatric hospitals.
3. Rehabilitation hospitals: Rehabilitation hospitals specialize in providing care and
treatment to patients recovering from injuries, illnesses, or surgeries. They may
offer physical therapy, occupational therapy, and other types of rehabilitation
services.
 4. Long-term care hospitals: Long-term care hospitals provide care to patients who
require an extended period of hospitalization. These hospitals are typically
equipped to handle complex medical conditions and offer specialized care to
patients with chronic illnesses or disabilities.

c. Classification
1. Teaching hospitals: These hospitals are affiliated with medical schools and are involved in
training the next generation of healthcare providers. They often have research programs
and offer advanced medical services.
2. Community hospitals: Community hospitals are typically smaller than teaching hospitals
and serve a specific geographic area. They provide a range of medical and surgical services
to meet the needs of the local population.
3. Tertiary care hospitals: Tertiary care hospitals are highly specialized and offer advanced
medical services and procedures. They are often located in major urban centers and serve
as referral centers for patients with complex medical conditions.
4. Rural hospitals: Rural hospitals are located in sparsely populated areas and provide basic
medical services to the local population. They may also provide emergency services and
stabilize patients before transferring them to larger hospitals for further treatment.

2.Describe the role of each institutional setting as to services they offer.

1. Hospitals: Hospitals are large institutions that provide a wide range of medical
services, including emergency care, inpatient and outpatient care, surgery,
diagnostic testing, and rehabilitation. They may also specialize in certain areas of
care, such as cancer treatment, pediatrics, or psychiatric care. Hospitals play a
critical role in the healthcare system by providing care to patients with acute or
chronic illnesses and injuries.
2. Clinics: Clinics are smaller healthcare facilities that typically provide outpatient care
to patients. They may offer primary care services, such as general check-ups and
preventative care, as well as specialized care for specific medical conditions. Clinics
may also provide diagnostic testing, such as blood work or imaging, and may offer
vaccinations or other preventative measures.
3. Urgent Care Centers: Urgent care centers are walk-in medical facilities that offer
treatment for non-life-threatening medical issues. They provide immediate care for
conditions such as minor injuries, infections, and illnesses that require prompt
attention but are not serious enough to require emergency room care.
4. Rehabilitation Centers: Rehabilitation centers provide care and treatment to
patients recovering from injuries, illnesses, or surgeries. They may offer physical
therapy, occupational therapy, and other types of rehabilitation services to help
patients regain strength, mobility, and independence.
5. Nursing Homes: Nursing homes provide long-term care to patients who require
assistance with daily activities, such as bathing, dressing, and eating. They may also
provide medical care and supervision for patients with chronic illnesses or
disabilities.
 6. Hospice Care: Hospice care is a specialized form of care for patients with terminal
illnesses. It focuses on providing comfort and support to patients and their families
during the end-of-life process. Hospice care may be provided in a hospital, nursing
home, or specialized hospice facility.

3. Design/Construct a floor plan of a pharmacy setting in a hospital

4. Differentiate the regulatory and operational requirements for hospital pharmacy and for each
personnel.
-Regulatory requirements for hospital pharmacy may include licensing, accreditation, and
compliance with laws and regulations related to pharmaceutical care. For example, in the United
States, hospital pharmacies are regulated by state boards of pharmacy and must comply with
federal regulations such as the Drug Enforcement Administration (DEA) regulations. In the
Philippines, hospital pharmacies must comply with the minimum standards for hospital
pharmacy established by the Department of Health.
Operational requirements for hospital pharmacy and its personnel, on the other hand, may
include medication dispensing, drug utilization review, drug therapy monitoring, and patient
counseling. Hospital pharmacists are responsible for managing drug inventories, compounding
and dispensing medications, providing drug information to healthcare providers, and ensuring
that medications are used safely and effectively. Pharmacy technicians, on the other hand, may
be responsible for assisting pharmacists in medication dispensing, inventory management, and
other operational tasks.
In terms of personnel, regulatory requirements may include education and training
requirements, certification, and licensure. For example, in the United States, hospital pharmacists
must have a Doctor of Pharmacy degree and be licensed by the state in which they practice.
 Pharmacy technicians may be required to have a high school diploma and complete a formal
training program or be certified by a national certification board.

Instructions:
● Read the ASHP Guidelines: Minimum Standards for Pharmacies in Hospital. Differentiate the
ASHP guidelines with that of the minimum standards for hospital pharmacy in the Philippines.
Explain the advantages of these guidelines.

ASHP PHILIPPINES
Organization The ASHP emphasize the The minimum standards for
importance of having a clearly hospital pharmacy in the
defined organizational Philippines also emphasize
structure for the pharmacy the need for a well-organized
department, with specific pharmacy department, with
roles and responsibilities clear lines of authority and
assigned to each member of accountability. However, the
the pharmacy team. Philippines' standards also
require the establishment of a
Pharmacy and Therapeutics
(P&T) Committee, which is
responsible for reviewing and
approving hospital formulary
policies and medication use
protocols.
Policies and Procedures The ASHP provide detailed They also emphasize the
guidance on the development importance of developing
of policies and procedures and implementing written
related to medication policies and procedures for
ordering, dispensing, and pharmacy operations.
administration, as well as However, the Philippines'
medication safety and standards require the
security. establishment of a
Medication Error Reduction
Program (MERP) to help
prevent and respond to
medication errors.
Personnel Recommends that hospital Requires adequate staffing
pharmacy departments have levels, but they also mandate
a sufficient number of that all pharmacy personnel
qualified pharmacists and have the necessary education,
pharmacy technicians to training, and licensure to
provide safe and effective perform their assigned duties.
medication therapy. In addition, the Philippines'
standards require the
appointment of a licensed
 pharmacist as the head of the
pharmacy department.
Facilities The ASHP guidelines provide Require that pharmacy
guidance on the design and departments have a
layout of the pharmacy designated area for
department, as well as the compounding sterile
need for appropriate storage preparations.
and security measures for
medications.

5. Identify and describe the different pharmacy services in the Host Training Establishment (HTE).
1. Medication dispensing: This involves the preparation and distribution of
prescription medications to patients. In an HTE, medication dispensing may be
done through an outpatient pharmacy or a centralized pharmacy that serves the
entire institution.
2. Medication therapy management: This involves the review and management of
patients' medication regimens to ensure that they are safe and effective. In an HTE,
pharmacists may work collaboratively with other members of the healthcare team
to provide medication therapy management services, such as medication
reconciliation and medication therapy review.
3. Medication education and counseling: This involves providing patients with
information about their medications, including how to take them properly,
potential side effects, and drug interactions. In an HTE, pharmacists may provide
medication education and counseling to patients directly, or they may train other
healthcare providers to do so.
4. Medication-related policy and procedure development: This involves developing
and updating policies and procedures related to medication use in the HTE. In an
HTE, pharmacists may be responsible for developing and implementing policies
related to medication ordering, dispensing, administration, and storage.
5. Medication safety monitoring: This involves monitoring medication-related
adverse events and implementing measures to prevent future occurrences. In an
HTE, pharmacists may participate in medication safety initiatives, such as
medication error reporting and analysis, and the development of strategies to
prevent medication errors.
6. Clinical pharmacy services: This involves providing direct patient care services in
collaboration with other members of the healthcare team. In an HTE, pharmacists
may provide clinical pharmacy services, such as medication therapy management,
pharmacokinetic dosing, and antimicrobial stewardship.

6. Explain the functions and responsibilities of the pharmacist assigned in the various areas.
1. Inpatient Pharmacy: Pharmacists working in an inpatient pharmacy are responsible for
ensuring the safe and effective use of medications for hospitalized patients. Their
responsibilities may include:
 a. Reviewing medication orders for appropriateness and accuracy
b. Dispensing medications to patients
c. Monitoring patients' medication therapy and making recommendations to the
healthcare team as needed
d. Conducting medication reconciliation to ensure that patients are receiving the
correct medications
e. Providing education to patients and healthcare providers about medication
therapy and medication-related issues

2. Outpatient Pharmacy: Pharmacists working in an outpatient pharmacy are responsible

for ensuring the safe and effective use of medications for patients who receive care on
an outpatient basis. Their responsibilities may include:
a. Reviewing medication orders for appropriateness and accuracy
b. Dispensing medications to patients
c. Providing education to patients about medication therapy and medication-
related issues
d. Counseling patients on the proper use and administration of medications
e. Collaborating with other healthcare providers to optimize patients' medication
therapy

3. Clinical Pharmacy: Pharmacists working in a clinical pharmacy role are responsible for
providing direct patient care services in collaboration with other healthcare providers.
Their responsibilities may include:
a. Conducting medication therapy management and monitoring patients'
medication therapy
b. Making recommendations to the healthcare team about medication therapy
c. Providing education to patients and healthcare providers about medication
therapy and medication-related issues
d. Conducting pharmacokinetic dosing and monitoring of medications
e. Participating in antimicrobial stewardship initiatives to optimize the use of
antibiotics
4. Sterile Compounding: Pharmacists working in a sterile compounding area are
responsible for preparing and dispensing sterile medications. Their responsibilities
may include:
a. Following strict aseptic techniques to prepare sterile medications
b. Maintaining a clean and sterile environment in the compounding area
c. Monitoring the quality of compounded medications and ensuring that they are
safe and effective for patients
d. Following regulatory guidelines and standards related to sterile compounding
practices
e. Providing education to healthcare providers about sterile compounding
practices and medication safety

7.Compare and contrast the different pharmacy services provided by HTE.

1. Inpatient Pharmacy Services:
 a. Medication order review and verification
b. Dispensing of medications
c. Monitoring of patients' medication therapy
d. Medication reconciliation and patient education
2. Outpatient Pharmacy Services:
a. Medication dispensing and counseling
b. Medication therapy management
c. Patient education on medication therapy and adherence
d. Collaborative care with other healthcare providers
3. Clinical Pharmacy Services:
a. Medication therapy management
b. Clinical pharmacy consultations
c. Antimicrobial stewardship
d. Pharmacokinetic dosing and monitoring
4. Sterile Compounding Services:
a. Preparation of sterile medications
b. Quality control and assurance
c. Compliance with regulatory guidelines
d. Education on sterile compounding practices

8. Provide at least five (5) strategic approaches that you think are essential in improving the
culture of safety in hospital pharmacy.
I. Implementing a Reporting System: Hospitals should establish a reporting system
that encourages pharmacy staff to report medication errors, near misses, and other
incidents related to medication management. The reporting system should also
ensure anonymity and confidentiality to promote a blame-free environment. This
will help identify the root cause of the problem and implement strategies to
prevent future errors.
II. Providing Continuous Education: Regular training and education programs should
be provided to pharmacy staff to improve their knowledge and skills in medication
management. This will help in keeping them updated with the latest trends,
regulations, and best practices related to pharmacy practice.
III. Promoting Teamwork and Collaboration: Pharmacy staff should be encouraged to
work as a team and collaborate with other healthcare providers to ensure safe and
effective medication management. This will help in identifying potential errors and
implementing preventive measures.
IV. Establishing Standard Operating Procedures: Standard Operating Procedures
(SOPs) should be established and implemented for all pharmacy processes,
including medication ordering, dispensing, and administration. This will ensure
consistency and accuracy in medication management.
V. Encouraging Patient Participation: Patients should be encouraged to actively
participate in their medication therapy, including verifying the medications they
are receiving, asking questions, and reporting any adverse reactions or side effects.
 This will help in identifying potential errors and ensuring safe and effective
medication therapy.

Submission: HERE
Deadline: April 7, 2023