Hospital Organization & Hospital Pharmacy

Organization of hospitals, structure, staff responsibilities & Hospital Pharmacy Layouts

1. UNIT-1 Organization of Hospital and Structure 1 Agra Public Pharmacy College, Artoni , Agra, UP, India

2. Introduction: Definition- A hospital is a health care institution providing patient treatment with specialized medical and nursing staff and medical equipment. It also provides facilities for diagnosis , therapy, prevention, education and research. Organization structure refers to levels of management within a hospital. Function’s of Hospital- Hospital can provided health service to patients in following terms- The main function of a hospital is to provide the population with complete health care; it also functions as the centre for the training of health workers. Provide medical care, which involves the treatment and management of patients through the staff of physicians. Provide teaching- Vocational, Undergraduate, Postgraduate, Continuing education. To maintain research facilities- Basic research, Clinical research, Health services research, Educational research. 2 Agra Public Pharmacy College, Artoni , Agra, UP, India

3. Classification of Hospitals: In the large hospitals have complex organizational structures, but Smaller hospitals tend to have much simpler organizational structures. It can be divided in to following way’s- Primary Hospital’s : focuses on general care for overall patient education and wellness. Secondary & Tertiary Hospitals : treat more severe conditions that require specialized knowledge and more intensive health monitoring. Furthermore, the classification of hospitals can be on the basis of clinical & non-clinical- Clinical Basis: On the based on specific diagnostic or treatment services, like- Medicine: General medicine; T.B., Surgery: ENT, Orthopedic, Maternity: Long term, short term etc. Non-Clinical basis: Based on governing body/trust form, like- Government : Army hospital, AIIMS, PGI, Non-Government : Private hospitals, Community hospitals, charitable hospitals etc. 3 Agra Public Pharmacy College, Artoni, Agra, UP, India

4. Other criteria's of classification like- On the basis of size : Ex. Large (>1000 beds) & small (between 50-100 beds) hospitals. On the basis of cost : Ex. Elite hospitals ( Expensive / five star), Budget hospitals ( Moderate budget & low budget). On the basis of system of medicine : Ex. Allopathic, Ayurvedic, Homeopathic hospitals. Organization of Hospitals- Organizational structure varies from hospital to hospital. Hospital departments are grouped in order to promote efficiency of facility. Grouping is generally done according to similarity of duties. 4 Agra Public Pharmacy College, Artoni, Agra, UP, India

5. Common Categorical Grouping: Administrative Services . Informational Services . Therapeutic Services . Diagnostic Services . Support Services 5 Agra Public Pharmacy College, Artoni, Agra, UP, India

6. Typical Chart for Organization of Hospital 6 Agra Public Pharmacy College, Artoni, Agra, UP, India

7. Responsibilities of Medical Staffs Involved in the Hospital: Governing body/trust - It is a one of the most essential part of any hospital. In this following peoples are grouped together as follow; Vice President(s), Executive Assistants, Department Heads Business people who “run the hospital” Oversee budgeting and finance . Establish hospital policies and procedures . Often perform public relation duties . Informational Services- To keep maintain document and process information; Admissions . Billing & Collection . Medical Records . Computer Information Systems . Health Education . Human Resources . 7 Agra Public Pharmacy College, Artoni, Agra, UP, India

8. Therapeutic Services- Important division of any hospital, which Provides treatment to patients . Therapeutic services may organize include further departments as follow; Physical Therapy - treatment to improve large muscle mobility. Occupational Therapy - treatment goal is to help patient regain fine motor skills. Speech/Language Pathology -identify, evaluate , treat speech / language disorders. Respiratory Therapy - treat patients with heart & lung disease . Medical Psychology - concerned with mental well-being of patients . Social Services - connect patients with community resources(financial aid etc.) Pharmacy – It also called hospital pharmacy , which controls the pharmacy operation in any hospitals. This department fills prescription & dispense medications . Furthermore, it is include begin purchasing of drug and finishes with the drug distribution to out patients and in patients . Dietary - maintain nutritionally sound diets for patients . Sports Medicine - provide rehabilitative services to athletes . Nursing - provide care for patients . 8 Agra Public Pharmacy College, Artoni, Agra, UP, India

9. Diagnostic Services- Determines the cause (s) of illness or injury . It has involved in the diagnostic of pathological condition for patients through different pathological tests, it include following departments work together;- Medical Laboratory - studies body tissues . Medical Imaging - radiology, MRI, Ultra Sound . Emergency Medicine - provides emergency diagnoses & treatment . Other include like- Sonography , X-ray, ECG, CT scan etc. Support Services- Provides support for entire hospital. It include; Central Supply - orders, receives, stocks & distributes equipment & supplies . Biomedical Technology - design, build repair, medical equipment . Housekeeping & Maintenance - maintain safe, clean environment . Others may also include like- laundary, transport, mortuary, library etc. 9 Agra Public Pharmacy College, Artoni, Agra, UP, India

10. HOSPITAL PHARMACY: Hospital Pharmacy is an area of a hospital where pharmacists distribute prescription medicine to patients. Hospital Pharmacy may also be defined as a department in which the drugs are procured, preserved, stored, compounded, assayed, manufactured, dispensed, packaged and distributed to inpatients and outpatients by professionally competent and legally qualified pharmacists. Functions of hospital Pharmacy- Managing various activities of stores such as purchase of drugs, proper storage conditions and maintenance of records. Practicing pharmacy in a professional and ethical manner. Promoting and contributing to the rational use of medicines. Dispensing drugs as per the prescription of the medical staff of the hospital. Providing counseling services while dispensing drugs especially for outpatients. Inspecting all pharmaceutical supplies. 10 Agra Public Pharmacy College, Artoni, Agra, UP, India

11. The practice of hospital pharmacy started in India 1941 but became a respectable discipline only in sixties. Organization of hospital pharmacy 11 Agra Public Pharmacy College, Artoni, Agra, UP, India

12. Location & Layout of hospital pharmacy- The pharmacy should be located in the hospital premises so that patients and staff can easily approach it. The pharmacy of a hospital, should be preferable located on the ground floor especially the dispensing unit. OPD’s pharmacy should give a pleasant appearance and must have enough space for seating of patients who have to wait for medicines. The IPD’s pharmacy are served to medicines from nursing stations who receive their materials from the pharmacy. Space must be provided for routine manufacturing of stock solution, bulk powders, ointments etc. The manufacturing room should be adjacent to the pharmacy. Medical store of a pharmacy should be adjacent to the pharmacy itself or should be directly connected the pharmacy. 12 Agra Public Pharmacy College, Artoni, Agra, UP, India

13. 13 Agra Public Pharmacy College, Artoni, Agra, UP, India Lay out of hospital Pharmacy

14. Flow chart for OPD’s pharmacy 14 Agra Public Pharmacy College, Artoni, Agra, UP, India

15. Flow chart for In-patients 15 Agra Public Pharmacy College, Artoni, Agra, UP, India

16. Facilities required in hospital pharmacy- In Smaller hospital with one pharmacist , only one room is required for pharmacy having a combination of dispensing, manufacturing, administrative and all other sections of complete pharmaceutical service. In Larger hospital with 200 or more beds, departmentalization of pharmacy activity is required. For sterile products, there should be a separate room or area. A Separate area is required for- Inpatient services and unit dose dispensing. Outpatient service. An Office for the chief pharmacist. A Compounding room. Prepacking and Labelling room. A Store room. Sterile products room. 16 Agra Public Pharmacy College, Artoni, Agra, UP, India

17. Responsibilities of Hospital Pharmacist Hathi committee has recommended that the head of hospital pharmacy department should be a post graduate in pharmacy and assisted by B.pharm and D.pharm holders. 17 Agra Public Pharmacy College, Artoni, Agra, UP, India

18. Flow chart for Requirements of a Hospital Pharmacist 18 Agra Public Pharmacy College, Artoni, Agra, UP, India

19. Abilities required to hospital pharmacist- 19 Agra Public Pharmacy College, Artoni, Agra, UP, India

20. THANK YOU Reference – Khar & Nand ; “A text book of hospital & clinical pharmacy”; Page No- 1-19. 20 Agra Public Pharmacy College, Artoni, Agra, UP, India