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Hospital pharmacy in the US

Hospital pharmacy in the US
As you may know, the United States has played a leading role in pharmacy practice. The experience gained from the development history of the US can be a good learning model for Asian countries. It was not until 1930s that hospital leaders explicitly recognized the need for pharmacy services. In the late 1950s, fewer than 40% hospital had the service of full time pharmacist. What are the major themes of change for hospital over the 50 years in the US?
There are three major themes: the first is the hospitals have recognized universally that pharmacists must be in charge of drug product acquisition, distribution, and control. Second, hospitals pharmacy departments have assumed a major role in patient safety and in promoting rational drug therapy. And finally, hospitals pharmacy departments have come to see their mission as fostering optimal patient outcomes from medication use. Taken together, these changes signify that pharmacy practice in the US hospitals over the past 50 years has become more intensive in its professional staffing, more directly focused on patient care, and more directly influential on the quality and outcomes of patient care.
In short, hospital pharmacy transformed from a marginal, optional activity into a vital profession contributing immensely to the health and well-being of patients and to the stability of the institution that employ them. Pharmacists become essential role in the medical team and modern hospital. There are five internal factors have played a large role in transforming U.S.
hospital pharmacy over the past 50 years: The first is the visionary leadership, if you read any of the early literature of hospital pharmacy in the US, you will be impressed by the clear articulation of an exciting, uplifting vision by that era’s practice leaders. Hospital pharmacy has not always been the way it is now. It was built by pharmacists who led change in practice. The second is “ A strong professional society”. In the US., American society of health system pharmacists, ASHP established in 1942 as an independent organization affiliated with American Pharmacy Association. There are two essential things that ASHP has done for the advancement of hospital pharmacy.
One is to serve as a vehicle for the nurturing, expression, and actualization of the professional ideals and aspirations of hospital pharmacists. The second essential act of ASHP has been its creation of resources to assist practitioners in fostering the development of hospital pharmacy practice. One of the reasons for ASHP’s success has been its clarity about objectives and its concentrated focus on a limited number of goals. The third force for the transformation is “the reforms in pharmacy education”. Over the past 20 years, pharmacy education in the US has been transformed completely from teaching primarily about the science of drug products to teaching primarily about the science of drug therapy.
Transformation of hospital pharmacy practice from a product oriented to a patient orientation could not be occurred without the change in education.
The fourth force is postgraduate residency education and training. Stemming from its early concerns about the inadequacy of pharmacy education for hospital practice, ASHP leaders advocated internships in hospitals and worked for years to establish standards for such training. There are more than 10 thousands pharmacists in practice who have completed accredited residency training. Residency training is the height if mentorship in professionalism in American pharmacy. Dreams are fostered in residency training of the profession becoming an ever more vital force in health care. The last but not the least force is “the practice standards”. Numerous legal or almost legal requirements affect hospital pharmacy practice.
For example, in the US, federal law governing drug products and state practice acts governing how the pharmacist behaves and how pharmacists are operated. On the other hand, the voluntary practice standards promulgated by organizations such as ASHP. ASHP practice standards have been used effectively over the years as a lever of raising the quality of hospital pharmacy services. The common element among these forces has been dissatisfaction with the status quo and burning desire to bring hospital pharmacy in better alignment with the needs of patients and the needs of physicians, nurses, other health professionals, and administrators in hospitals. What we have learned from the transformation? The first is fundamental change of complex efforts requires leadership and time.
Hospital pharmacists are sometimes frustrated by the slow pace of change. Acknowledge of the developmental history might help practitioners dissolve that discouragement. The second, It is important to engage as many practitioners as possible in assessing hospital pharmacy`s problems and identifying solutions, so that a large number of individuals identifying with the final plan and are committed to pursuing it. Thirdly, it is critical to recognize and capitalize on changes in the environment that may make conditions more favorable to the advancement of hospital pharmacy. The fourth is, It is important to regularly and honestly assess progress and start on a new approach if the existing plan for constructive change is not working or has run its course.
This requires open- mindedness and a good sense of timing. Todays challenges in hospital pharmacy are more daunting than those that faced hospital pharmacy’s leaders and innovators in the past. Fortunately, hospital pharmacy is imbued with a culture of taking shock, setting goals,making and executing plans, measuring results, and refining plans. If hospital pharmacy sticks to the time-tested formula, it will continue to be a beacon for the profession as a whole.

What are the major themes of change for hospital over the 50 years in the US?

In this video, Director Chang will explain the three major themes:

  • Pharmacists must be in charge of drug product acquisition, distribution, and control.

  • Pharmacists play major role in patient safety and in promoting rational drug therapy.

  • The mission of hospitals pharmacy departments become fostering optimal patient outcomes from medication use.

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Essentials of Good Pharmacy Practice: The Basics

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