TERMS.
Almshouses – for the sick poor
Asylums – for the care and confinement of
orphans and the mentally ill
Hospices – for terminally ill
Infirmaries – for short-term acute care
Aesculapius – Greek God of medicine
Temple of Aesculapius – existed in 1134 BC
Hippocrates – Father of Western Medicine born
about 460 BC
Fabiola-a wealthy Roman woman; donated her
palace for the care of the sick
Bishops – required to provide a shelter for the
care of the sick in each diocese
Maimonides – famous rabbi, influenced health
care by his teachings and works
Monks – primary health care practitioners
during the middle ages.
The Black Plague – killed almost one-third of
the inhabitants in Europe
Hotel Dieu – one of the finest hospitals in
Europe during the Black Plague
Hospital of the Holy Spirit – founded in 717
- Major site for the education of lay
physicians
Hospital of the Immaculate Conception – first
hospital on the American Continent built by the
Spaniards in 1524
- Name changed to The Hospital of Jesus
of Nazareth in 1663
Philadelphia General Hospital – started in 1713
as an almshouse to give relief to the sick
Jonathan Roberts – first American hospital
pharmacist
Pennsylvania Hospital – established in 1751
- First incorporated hospital in the United
States through the efforts of Dr.
Thomas Bond
Massachusetts General Hospital – first hospital
to use general anesthesia in surgery
Dr. Crawford Long – performed the first
operation with anesthesia
Chloroform and ether – standard anesthetic
agents
Union Hospital – poor sanitation and
depressing environment
Louisa May Alcott – described the Union
Hospital in her published book Hospital
Sketches
Saint Dymphna – patron saint for mental
disorders
- May 15
Benjamin Rush – Father of American Psychiatry
- Introduced new method of treatment
for psychiatric patients based on moral
principles
Deinstitutionalization – large number of
persons were discharged to communicate
World War I
 Major trauma, burns, poison gas &
infections of all kinds
 Hospital designs
 Floating hospitals
World War II
 Major advances in trauma surgery
 systemic sulfonamides, penicillin
 wide use of blood & plasma transfusion
 Volume of injured increased
  Cadet nurse corps
 PT’s and OT’s came into being
Abraham Flexner – American educator
Florence Nightingale – Lady with the Lamp
Congress of the Hospital Survey and
Construction Act – Hill-Burton program
- This act provided federal funds for
hospital construction on a matching
basis with local communities
Social Security Amendments of 1965 – had a
long range impact on the development and
expansion of hospitals
Hospital – has become a necessary instrument
for providing the fourth basic element of
survival—health.
Health care – a right for all, rather than a luxury
for few
Hospital – an institution where the ill or injured
may receive medical, surgical, or psychiatric
treatment, nursing care, food and lodging
- Function is to provide patient services,
diagnostic and therapeutic
Institution – a significant and persistent
element (as a practice, a relationship, an
organization) in the life of a culture
Hospital Pharmacy- practice of pharmacy in
hospital settings and includes the
organizationally related facilities and services
- Division of hospital wherein the
procurement, storage, compounding,
etc, are performed by legally, qualified,
professionally competent pharmacists
and assistants
The Administrator – highest hospital
administrative position; implements policies,
delegates authority, and passes on
responsibility to department leaders
Department Leaders – carry out the patient
care, teaching research and public health
objectives of the hospital
The Business and Finance Department –
handles the financial affairs
The Building Services Department – provides
the essential maintenance, housekeeping, and
security functions
The Human Resources Department –
implements personnel policies
The Clinical Laboratory Department – performs
a multitude of patient laboratory tests and
services
The Nursing Service – provides continuous care
Accreditation Agencies – exerts their influence
on professional standards of practice as they
affect patient care
Licensing Agencies – exert their legal influences
on hospital operations
The Federal Government – imposes standards
and regulation in hospitals
Third-party Agencies – exerts their influence on
the methods by which hospitals may be
reimbursed for services rendered to patients
Social Agencies and Governmental Welfare
Agencies – exert their influences over the
policies, objectives and philosophies of hospital
operation and services
Governing Board and Public Opinion – exert
their influences over the policies, objectives and
philosophies of hospital operation and practice
National Hospital Week – (August 6-12, 2010)
DOH: “Ospital na ligtas, handang magbigay
lunas.”
General Hospital – provide patient services,
diagnostic and therapeutic, for a variety of
medical conditions
Special Hospitals –for patients who have
specified medical conditions, both surgical and
nonsurgical
Rehabilitation and Chronic Disease Hospitals –
for handicapped or disabled individuals
requiring restorative and adjustive services
Psychiatric Hospitals - for patients who have
psychiatric-related illnesses
Short-term – less than 30 days
Long-term – 30 days or longer
Federal – owned and operated by various
branches of the federal government
State – owned by the state and controlled by a
board of control or division of the state
government
County – owned by the county and financed
and controlled similarly to state hospitals, only
on county level
City – owned, financed and controlled by the
city government
Non-profit – fees from paying patients or by
contributions from the several religious orders
or churches
Patient Care – involves the diagnosis and
treatment of illness or injury, preventive
medicine, rehabilitation, covalescent care, and
personalized services
Education of the medical and allied health
professions – includes formal programs; in-
service training programs
Education of the patient – includes providing
general education for children confined to long-
term hospitalization; special education in the
area of rehabilitation
1988 – JCAH  JCAHO
2007 – JCAHO TJC
JCAHO – Independent, voluntary agency and its
actions are not subjected to ratification by the
organizations represented by its component
members
- Operates voluntary accreditation
programs for hospitals
- Private sector, US based
1956 – Pharmacy department was included
among the essential services of the hospital
Governing Body – has total accountability with
organization’s structure
CEO – lead organization and make
recommendations to the board
Administrator/s – assists the CEO; appoints
leader to each department
Department Leaders – operate departments
effectively and properly
Open Staff – certain physicians other than those
attending or active medical staff are allowed to
use the facilities
- Courtesy medical staff
Closed Staff – all professional services, private
and charity, are provided and controlled by the
attending or active medical staff
Honorary Medical Staff – physicians who have
been active in the hospital but who are retired
and those whom it is desired to honor because
of outstanding contributions
Consulting Medical Staff – specialists who are
recognized as such by right of passing specialty
boards or belonging to the national organization
of their specialty
Active or Attending Medical Staff – concerned
with regular patient care
- Most actively involved in the hospital
Associate Medical Staff – junior or less-
experienced medical staff
Courtesy Medical Staff – physicians who desire
the privilege of attending private patients, but
those who do not desire active staff
membership
Resident Medical Staff – residents, who are full-
time employees of the hospital
- Persons who provide specific services in
the care of a patient
Pharmaceutical Care
- Responsible provision of drug therapy
for the purpose of achieving definite
outcomes that improve a patient
quality of life.
- Monitoring the regimen’s effect
Separation of Pharmacy to Medicine – took
place in charitable institutions
Hospital Pharmacist – first recognized
practitioner
Materia Medica – drug and medicinal remedies
Myrrh – a remedy used as an appetite
stimulant, carminative, skin protective; with
healing properties
Olibanum (frankincense) –oleogum resin
Ebers Papyrus (1500 BC) – Found in Egypt by
George Ebers
- One of the 11 medical scrolls that
preserve the knowledge of early
Egyptian medicine
- 700 drugs w/ formulas for over 800
remedies
- Use of mortars & pestles, hand mills,
mills, sieves & weighing scale
AHFS – comprehensive unbiased source of
information on drugs provided on a
supplemented basis annually
Institutes – a continuing education program
served to help the hospital pharmacy
practitioner keep up with current trends of
professional service
1910 – End result system of hospital
accreditation
Medical Malpractice – improper, negligent
treatment of a patient by a health care
professional
ASHP – formed during clinical years
- Patient as the focal point for existence
of pharmacy practice
IPA – provides extensive coverage of the
pharmaceutical literature
 ACRONYMS.
SSA – Social Security Amendments

AHA – American Hospital Association

PHA – Philippine Hospital Association

DOH – Department of Health

CEO – Chief Executive Officer

PRC – Professional Regulation Commission

SALAD – Sound Alike Look Alike Drugs

HAM – High Alert Medications

ACS – American College of Surgeons

JCAH – Joint Commission on Accreditation of Hospitals

JCAHO- Joint Commission on Accreditation of Health Care Organizations

UDDDS – Unit Dose Drug Distribution System

ASHP – American Society of Hospital Pharmacists (1942)

- American Society of Health-System Pharmacists

AJHP – American Journal of Hospital Pharmacy

IPA – International Pharmaceutical Abstract

AHFS – American Hospital Formulary Service

TJC – The Joint Commission

JCI – Joint Commission International

ACCP – American College of Clinical Pharmacists

AACP – American Association of Colleges of Pharmacy

APhA – American Pharmacists Association

ACCP – Asian Conference on Clinical Pharmacy

FAPA – Federation of Asian Pharmaceutical Association

PPRC – Philippine Pharmaceutical Research Congress

 ENUMERATION.
Internal forces:  Service capability

 Organizational structure of a hospital Type of service:

 There is a physician – pharmacist –
 General
nurse – patient relationship in the
hospital  Special
 Rehabilitation and Chronic Disease
Organizational Structure:  Psychiatric

 The Administrator Length of Stay:

 Department Leaders
 The Business and Finance Department  Short-term
 The Building Services Department  Long-term
 The Human Resources Department Ownership:
 The Clinical Laboratory Department
 The Nursing Service  Governmental
 Other Federal
State
External Forces: a. County
b. City
 Accreditation Agencies
c. City-county
 Licensing Agencies
 Nongovernmental
 The Federal Government
Nonprofit
 Third-party Agencies
For profit
 Social Agencies and Governmental
a. Individual
Welfare Agencies
b. Partnership
 Governing Board and Public Opinion
c. Corporation
Mission:
Bed Capacity:
 Lead
 Large (above 1000)
 Enable
 Medium (between 500-1000)
 Assist
 Small (between 100-500)
 Protect
 Very Small (less than 100)
Hospitals towards quality service
Service Capability
Classification of Hospitals
 Primary Care Hospital
 Type of service
 Secondary Care Hospital
 Length of stay
 Tertiary Care Hospital
 Ownership
 Bed capacity
 PRIMARY SECONDARY TERTIARY
Non-departmentalized hospital Departmentalized hospital that Teaching and training hospital that
that provides clinical care and provides clinical care and provides clinical care and
management on the prevalent management on the prevalent management on the prevalent
diseases in the locality diseases in the locality, as well as diseases in the locality, as well as
particular forms of treatment, specialized and sub-specialized forms
surgical procedures and intensive of treatment, surgical procedure and
care intensive care
Clinical services include:
 General medicine Clinical services provided in Clinical services provided in Secondary
 Pediatrics Primary care, as well as Specialty Care, as well as sub-specialty clinical
 Obstetrics and Clinical Care care
Gynecology
 Surgery
 Anesthesia

Provides appropriate Provides appropriate Provides appropriate administrative

administrative and ancillary
services (clinical, laboratory,
radiology and pharmacy)
Provides nursing care for
patients who require
intermediate, moderate and
partial category of supervised
care for 24 hrs or longer
administrative and ancillary
services (clinical, laboratory,
radiology and pharmacy)
Nursing care provided in Primary
Care, as well as total and intensive
skilled care
and ancillary services (clinical,
laboratory, radiology and pharmacy)
Nursing care provided in Secondary
Care, as well as continuous and highly
specialized critical care

Fundamental functions of Hospitals:

 Patient Care
 Education
 Research
 Public Health

Major purposes of Research:

 Advancement of medical knowledge against disease

 Improvement of hospital services
2 groups of
services

Internal organization of Governing Board:  Professional Care

 Business Management
 President/Chairman
 Vice-Chairman Types of Hospital Staff:
 Secretary
 Open Staff
 Treasurer
 Closed Staff
Committees appointed:
Categories of the Medical Staff:
 Executive committee
 Honorary
 Hospital committee
 Consulting
 Finance committee
 Active/Attending
 Committee on Public Relations
 Associate
Responsibilities of CEO:  Courtesy
 Resident
 Selection of Competent Personnel
 Control of funds Sources of Income:
 Supervision of the physical plant
 Patients
Groups of Hospital Staff:  Government
 Third-party Hospitalization Insurance
  Voluntary Contributions  Psychiatric
 Endowment funds and Investments  Geriatric
 Drug Information
 Oncology
Traditional Functions of Pharmacists:  Primary Care
 Critical Care
 Procurement  Intensive Care
 Packaging
 Storage
 Controlling
 Distribution
 Compounding
 Assaying
NOT INCLUDED IN THIS REVIEWER:
 Monitoring of Medication
 Manufacturing  Administrative Structure of the
 Dispensing Hospital Pharmacy
 ASHP Guidelines: Minimum
Standards for Pharmacies in
Hospitals
Developed Minimum Standards for Hospitals:
 ((Ewan ko na)) :D
 Dr. Ernest Codman, MD
 Dr. Franklin Martin

Objective:
~~~GoodLuck!~~~
 Health Care
-Kim Manlangit :)
 Provide safe and effective care of the
highest quality and value

Significant Contributions of ASHP:

 Development of standards of practice

 Continuing education
 Various publications to support
practices
 Standard for residency training
 Residency accreditation services

Residency Training Programs:

 Nuclear
 Community
 Pediatric
 COMPUTATIONS:
DP = cost of drug + % markup

DP = cost of drug + professional/dispensing fee

DP = cost of drug + % markup + cost of supplies

Amoxicillin 10 mg = P9.50 from manufacturer

DP = 9.50 + (9.50 x 0.50)

= 9.50 + 4.75
= P14.25 / capsule

A prescription calls for Cefalexin 500mg capsules (1 cap 3x a day fow 1 week). The acquisitor cost of
Cefalexin 500mg/cap is P17.75. The % markup is 25%. Compute for the DP to complete the medication.

DP = 17.75 + (17.75 x 0.25)

= 17.75 + 4.4375
= P22.19 / capsule x 21
= P465.94

RX
Drug A 325mg/pptab
Dispense (1 pptab 3x a day) pptabs good for 3 weeks
Commercially available: Drug A 625mg tab
Acquisitor cost: P15.75 / tablet
PE/pptab: P3.50 (ANO YUNG PE?????)

Total Amount of Drug A

3x day x 21 days = 63 pptabs
325 mg drug : 1 pptab = x : 63 pptab
X= 20,475 mg drug A

625 mg : 1 tablet = 20,475 mg : x

X = 33 tablets
33 tablets x P15.75 = P519.75

DP = P519.75 + (63 + 3.50)

DP = P740.25