Automated medication distribution systems and compliance with Joint Commission standards.

One health care institution's experience with an automated medication distribution (AMD) system is described, along with how the system met standards of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). AMD units were implemented in nearly 50 patient care locations in a medical center with the goal of providing cartless distribution for over 90% of all medications. Planning for the system began in the fall of 1998; the system was fully implemented by mid-2000. In compliance with JCAHO requirements, the system provided medications in unit dose or single unit-of-use packaging, supplied drugs in a ready-to-administer form, ensured that drugs were available only near the time of administration, created a patient-specific medication profile, allowed for pharmacist review of medication orders before dispensing, provided proper storage conditions, prevented unauthorized use, allowed for access in emergencies, and met federal and state regulations. Implementation of the system improved drug distribution at the medical center and saved nursing and pharmacy time. Challenges included waits by nurses trying to access the AMD units and the extensive, ongoing education and training required for users of the system. An AMD system should be fully integrated with the health care institution's medication-use process and comply with applicable JCAHO standards.

Effects of age, sex, race, diagnosis-related group, and hospital setting on lipid management in patients with coronary artery disease.

Among 1,211 patients hospitalized with documented CAD at either a university hospital or a large suburban community hospital, 36% failed to receive appropriate evaluation and treatment for dyslipidemia. Younger patients, those admitted to a university hospital, and those undergoing percutaneous coronary intervention were substantially more likely to receive appropriate lipid management than other subgroups.

A process for interpreting data on adverse drug events: determining optimal target levels.

The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) primarily accredits health care organizations against broad-based standards of performance. However, it has a role in postmarketing drug surveillance, specifically in terms of how health care organizations accredited by the Joint Commission review and respond to significant adverse drug events (ADEs) that occur in their organization. This paper discusses the role of the Joint Commission in reducing the incidence and severity of ADEs.

On accreditation of healthcare organizations. Determining eligibility for Accreditation of Home Pharmaceutical Services.

Many misperceptions exist in the health care community about the Joint Commission's accreditation of home pharmaceutical services, primarily related to when pharmacy services are considered home care and which patients or services are eligible for survey. This article concentrates on eligibility for survey and accreditation of just one of the six eligible home care services-home pharmaceutical services. The concept of home care and pharmaceutical services is difficult for most people to understand. Unlike other home care services, pharmacy services cannot be provided directly in the patient's home. Pharmacy laws prohibit pharmacists from compounding and dispensing directly in the patient's home. The pharmacists must do these activities in a licensed pharmacy. Also, most patients who receive medications from pharmacies take their own medications in their homes. So the differences between home care pharmacy and ambulatory or retail pharmacy are much less clear-cut than the delivery of more traditional home care services such as nursing or home health aide services.