Decentralization of pharmaceutical services in a large hospital complex.

The decentralization of pharmaceutical services to two patient-care areas remote from the central pharmacy in a large hospital complex is described. The addition of a fifth building to a large hospital complex led to problems with drug distribution and interprofessional communication, since the pharmacy that provided services to the 120 beds in the new building was located in a building some distance away. Decentralization of pharmaceutical services to a 24-bed surgical intensive-care unit and a 48-bed surgical patient-care unit in the new building was accomplished through a satellite pharmacy located on the intensive-care unit with support from a mobile medication cart located on the surgical unit. The satellite is staffed from 0700 to 2200 each day by one pharmacist and one technician per eight-hour shift. Evaluations of medication turnaround time, number of interactions with nurses and physicians, efficiency of the drug distribution system, quantity of floor stock maintained on the units, and productivity performed before and after the implementation of decentralized services indicated improvements in all areas. A survey of the nursing staff indicated that nurses were very satisfied with the improvements in pharmaceutical services. The implementation of decentralized pharmaceutical services in two patient-care areas remote from the central pharmacy was successful in improving services to these areas.

Computer-based system for maintaining and printing a hospital formulary.

Use of a pharmacy department personal computer (PC) with database management and word processing (WP) systems to maintain a hospital formulary is described. Data input and formatting were accomplished with IBM-PC/XT-compatible equipment, the Nutshell (Leading Edge) database management system, and the Wordperfect (WordPerfect Corporation) WP system. Computer-generated pages were photocopied and placed in loose-leaf binders; reduced copies were made for pocket-size binders. The cost of an outside printing service was eliminated, and the loose-leaf format made it possible to replace only the pages with revisions. The large binders were prominently placed and clearly marked to encourage use by physicians; the number of copies needed was reduced because individual copies were no longer provided to each physician. Excluding first-year one-time costs, the annual formulary maintenance cost (for 250 copies) was projected to be approximately one sixth the cost incurred previously, when 1300 bound formularies were printed annually. Maintaining and printing the hospital formulary on a PC facilitated the updating of the formulary and reduced printing costs.