pharm admin & pharm Econ exam 1 Flashcards
Types of Change
Waves or shifts
- Education or workforce
Professional Identity
- How we see ourselves and how other healthcare professionals view us
Healthcare
- A change within healthcare that ripples over to pharmacy
Early 20th Century (Before 1940)
Pharmacist
- Education – apprenticeship
- Role – manufacturer, wholesaler, distributor, and business owner
—Management of inventory of bulk chemicals and supplies, product dispensing, accounting, and multi-tasking
—-Take raw materials and produce a remedy
—- Prescriptions not required for the remedies - Not considered a healthcare worker
What did pharmacy management look like?
The push for change
Flexner Report 1915
- Conducted by the US government to assess the roles of healthcare workers, pharmacist included
- Report critical of educational requirements of healthcare workers, including pharmacists
- American Association of College of Pharmacy (AACP) conducts a second study on just pharmacists
Lead to a push for pharmacists to complete a
4 year Bachelor’s degree
Middle 20th Century (1940-1960)
Era of Expansion
- Hospital Survey and Construction (Hill-Burton) Act of 1946
—- Funding to renovate and expand hospitals in underserved areas – inner-city and rural areas
- Durham-Humphrey Amendment to the Food, Drug, and Cosmetic Act
—–Created a prescription drug, “legend” category, pharmacist must now have an order from a licensed prescriber in order to dispense to patients
—- Demand by patients for uniform medications
Lead to mass production of medication
How did these surveys/acts affect pharmacy management?
The Diminishing Pharmacist
During this time period we saw changes to the role of the pharmacist, what about pharmacy management?
Role
- Dispenser of mass-produced products
- Less need for the pharmacist to compound medications
- Business ownership
- Movement from business owner to employee begins to happen
Code of Ethics
The pharmacist could not discuss drug therapy with patients
Changes to pharmacy curriculum
The pharmacy curriculum became more technical, scientific and content-driven
Pharmacology, pharmaceutics, and physical chemistry matured as disciplines
Courses in the business aspect of pharmacy took a secondary role
Education in patient care (communications and therapeutics) was non-existent
Late 20th Century (After 1960’s)
Health Maintenance Act (1973)
- Lead to the development of HMO’s due to the big rise in healthcare expenses
Two Reports:
- Millis Commission
- Mirror to Hospital Pharmacy
What did these studies demonstrate?
How did they affect pharmacy management?
Millis Commission Report in 1975
Suggested pharmacists were inadequately prepared in systems analysis and management skills
Suggested pharmacists were deficient in communication skills with patients, physicians and other healthcare workers
Subsequent report suggested including behavioral and social sciences in pharmacy curricula
Mirror to Hospital Pharmacy
Published by ASHP
Suggested that pharmacy had lost its purpose
Suggested that pharmacy was not enduring the changes to healthcare
The clinical pharmacy movement
Evolved in the 1970’s
Promoted the pharmacist’s role as therapeutic advisor
Eventually led to pharmacy curricula moving to 6 years with the final year being devoted to therapeutics and disease-oriented courses and educational experiences
Led to the standardization of care using evidence-based medicine and protocols, treatment algorithms, and clinical pathways
Pharmaceutical Care
Developed as a practice philosophy in the 1990s
Not a list of clinically-oriented activities
A new mission and way of thinking taking advantage of pharmacists’ accessibility
Encouraged the pharmacist to take responsibility for managing pharmacotherapy to resolve current and prevent future medication-related issues
How did the movement toward the provision of pharmaceutical care change the role of the pharmacy manager?
Pharmaceutical Care Domains
Developed through a nationwide panel of experts identifying standards of practice for the provision of pharmaceutical care
- Risk Management
- Patient Advocacy
- Disease Management
- Pharmaceutical Care Services Marketing
- Business Management
From pharmaceutical care to MTM
Why is the term pharmaceutical care not enough?
Medication Therapy Management (MTM)
An approach to help patients maximize drug benefits through
- Improving patient compliance
- Educating the patients
- Providing wellness checks
- Providing disease management and monitoring
Management
Medicare Prescription Drug, Improvement and Modernization Act of 2003
—-Allows for payment for MTM services to providers who supply the service
All Pharmacist are Managers
Managing
- Technicians and staff
- Drug delivery/distribution
- Medication safety
- Budgets
- Medication therapies
Managing successfully is an expectation
- Decrease stress
- Increased job satisfaction
- Decrease career burnout
- Decrease in alcohol and drug abuse
Drug Delivery
Safe and efficient drug delivery is the primary goal of every pharmacy manager
Factors affecting drug delivery
- Patient demographics
- Attitudes and belief systems
- Third-party payers and coverage issues
- Competitive markets
- Technology
Some of these can be managed and others cannot
Managerial Sciences in Pharmacy
Accounting
- Keeping the books, record transactions
Finance
Determine need, operational budget
Economics
Determine ratio labor to capital, optimize output
Human Resources Management
Job analysis, personnel – hire, fire, reward, review
Marketing
Identify your niche, strategic promotion of goods and services
Operations Management
Design workflow, inventory control -day to day
What is a Manager?
Manager:
- People who perform management activities
- These are the people who we think of as the boss
- Those with administrative appointments within an organization
- Anyone who has a task to accomplish or a goal to achieve is a manager as well