Pharm. admin exam 1 Flashcards
Inputs and Outputs
Inputs = resources
Outputs = goods and services
Customers pay for the outputs
The process of creating goods and services = operations
The activities of the operation transform resources into valued, profit-generating goods and services
Managing these activities = operations management
The link between operations and profitability
There are many costs associated with creating a product that is then sold or delivered to a patient or customer.
Exercises:
- List costs associated with creating prescription products in a community pharmacy setting
- List costs associated with providing pharmacy services in a hospital pharmacy setting
The link between operations and profitability
Profit = Output – input
After deducting all the costs associated with operating and creating goods and services that are sold, the money left over = profit.
Maximizing efficiency in the creation of the goods and services requires planning, analysis and management.
Non-tangible inputs or resources
Pharmacists’ knowledge
Customer service skills
Efficiency
Interpersonal skills
Others?
May be more important than some of the tangible inputs and resources
Suggested decisions under the purview (scope of influence) of pharmacy operations management
Designing goods and services
Process strategies
Managing quality
Location strategies
Layout strategies
Human resources
Scheduling
Supply-chain management
Inventory management
Maintenance
Designing goods and services
Goods are tangible
Services are non-tangible
Design of the goods is influenced by the manufacturer
MTM provides opportunities to design innovative and creative services
Scheduling
pharmaceutically elegant
Process strategies
The operations process involves many steps
The steps influence efficiency as well as the quality of goods and services
The capacity for each person in the process to produce work imposes limitations to the process
A flowchart of the process can be used to identify and evaluate the capacities of each element of the process and areas that can be improved
Managing quality
Quality of goods and services is essential
Quality of goods can be based on objective, measurable standards - so quality of goods is objectives
Quality of services is determined by subjective standards - quality of services is subjective
There are costs associated with maintaining quality and there are costs associated with providing poor quality
Internal failures occur before the customer receives goods or services
External failures are errors that reach the consumer
Location
Determines how easily and efficiently the inputs can be acquired (including wholesalers, qualified staff) as well as customers
Determines how easily outputs can be available to consumers
Determines what outputs need to be offered by the business (i.e. ethnicity of patient population)
The pharmacy manager may not influence the location of the actual pharmacy
Scheduling
A critical aspect of managing
Must meet regulatory requirements
Should be driven by the demand for goods and services
Involves the collection of data and charting or graphing to determine the demand for staff
Overspending on staff results in decreased profitability
Chase strategy vs level scheduling
Supply-chain management
The chain of businesses that supply pharmacies with the necessary inputs
Important to form strong relationships and agreements
Includes wholesalers, both primary and secondary
Who else could it possibly include?
Inventory Management
Inventory is the largest expense in both community and hospital pharmacy
Too much inventory = money sitting on the shelves, inability to pay bills
Too little inventory = inability to meet demand for goods and services, customers look elsewhere, inability to pay bills
Too much, too little = unsuccessful business
Maintenance of resources
Not managing resources necessary to provide goods and services = risk of resource failure
Includes maintenance of technology, physical facilities, staff, relationships, customers
Technology
Technology is used with a systematic approach to support pharmacy operations
Technology is defined as anything that replaces routine or repetitive tasks that were previously performed by people or which extends or enhances the capacity to do their work.
Technology includes automated compounders, counting machines, unit dosing machines, baker cells
Automation
Refers to any technology, device or machine that is linked to or controlled by a computer and used to actually do work that was previously done by humans
Includes computer systems (order entry, maintains profiles), automated dispensing systems
Point of care devices
Allow healthcare professionals to be more effective and efficient in everyday practice
Should include patient-oriented drug information as well as a mixture of primary, secondary, and tertiary literature like lexicomp
Must be updated frequently
May provide information from several software programs
Internet information
Things to consider when evaluating the credibility of internet websites include
- Site ownership
- Authors of the material
- The review process
- Updates
- Believable claims
- Support for the information
- References
Other technology
Surescripts: a pharmacy health information exchange network linking electronic communications between pharmacies and physicians allowing the electronic exchange of prescription information
Computerized Physician Order Entry (CPOE)
- instead of handwriting everything is done electronically
Telehealth: employs telecommunications and information technology combining practices, products, and services to deliver healthcare and information to any location
Telepharmacy: provision of pharmaceutical care through telecommunications at patients at a distance
What is quality?
Quality can be defined as a degree of excellence
Quality in pharmacy can be defined as accuracy, efficiency and lack of error
Quality of medical care is evaluation of the performance of medical providers according to the degree to which the process of care increases the probability of outcomes desired by patients and reduces the probability of undesired outcomes, given the state of medical knowledge
Quality in Pharmacy Practice
Represents a degree of excellence
Increases the probability of positive outcomes
Decreases the probability of negative outcomes
Corresponds with current medical knowledge
Offers the customer/patient what they want and expect
Provides the patient with what they need
How is quality measured?
By assessing its:
- Structure: the raw materials needed for production. Includes the number of pharmacists per shift, counter space, credentials and licensing, pharmacy square footage, references, stock, counseling facilities
- Process: the method or procedure used. Includes all phases of the medication use process (prescribing, transcription (verification)dispensing, administration and monitoring)
How is quality measured?
Outcomes: the end result:
Includes patients’ control of medical conditions
Decreased use of medical resources
Increasing patient knowledge of conditions, treatments and medications
Increasing adherence and compliance
Increasing patients’ satisfaction with their care
Cost efficiency
Improving patients’ quality of life
Improved morbidity and mortality rates
Decreased adverse event rates
Methods for ensuring quality in pharmacy practice
Quality Assurance: the systematic monitoring and evaluation of the various aspects of a project, service or facility to ensure that standards of quality are being met.
Quality Control: an aggregate of activities designed to ensure adequate quality.
Continuous Quality Improvement (CQI): a philosophy of continual improvement of the processes associated with providing a good or service that meets or exceeds customer expectations.
CQI models
FOCUS PDCA
- Find an opportunity for improvement
- Organize a team
- Clarify current knowledge of the process
- Understand the causes of process variation
- Select the process improvement
- Plan
- Do
- Check (or Study)
- Act
oooh its an acronym
FOCUS PDCA
Plan Do Check Act
What can pharmacists do to improve quality and decrease adverse events?
Promote a systems view culture personally and within their organization
Focus on high-level systems changes to promote medication safety
Implement small changes in short cycles
Implement interventions that have worked elsewhere (learn from best practices)
Exercise
You are the manager of record in a community pharmacy. Several times over the last 6 months the wrong med has reached the patient because it was in their bag but was for a different patient.
Work through a CQI plan for this quality issue.
Exercise
You work as a pharmacy supervisor in a community hospital. There have been several medication error reports filed by nursing in which an IV medication was delivered to the patient at the wrong rate.
- Work through a CQI plan for this quality issue.
team: nurses, quality members, pharmacy members
