Technical expertise, work quality and efficiency
Infrastructure and equipment
Functions and duties : Hospital is a scientific unit with high medical expertise.
KT Management
Medical examination and treatment
Staff training
International Cooperation
HOSPITAL
H Research
Disease prevention
Line direction
Figure 1.5. Functions and tasks of the hospital
In addition to the most important task of examining, treating and taking care of patients, hospitals also have other important functions and tasks. Depending on the level, the priority of functions and tasks is different. For some hospitals with their own characteristics, different tasks can be added or removed, however, the first and most important task of a hospital is: examining and treating patients.
Each general and specialized hospital of different levels will have different organizational scales to both unify according to general regulations and ensure proper and complete implementation of its functions and tasks.
Friendship Hospital:
Friendship Hospital is a grade I general hospital under the Ministry of Health, organized according to the following general diagram:
Drug and therapeutics committee | |
Deputy Directors | |
Maybe you are interested!
-
Survey of drug interactions in outpatient prescriptions at Hue University of Medicine and Pharmacy Hospital - 1 -
Operating Model of Pharmacy Department, Samsung Hospital, Korea -
Statistics By Job Position At Viet Duc Friendship Hospital -
Study on microbiological characteristics of foot ulcers in diabetic patients at the Department of Endocrinology - Diabetes, Bach Mai Hospital in 2021 - 11 -
Motives for drug trafficking of prisoners at Z30D prison - Department V26 - Ministry of Public Security - 1
General clinic
2 outpatient clinics A,B
3 hospital rooms
outpatient for senior staff
8 departments
21 clinical departments
8 paraclinical departments
Board of Directors
Functional departments
Clinical Departments
Paraclinical departments
Figure 1.6: Friendship Hospital organization
1.2.2. Overview of the Department of Pharmacy, Drug and Therapeutics Council
1.2.2.1. Position, functions and tasks of the pharmacy department
The hospital pharmacy department is a specialized department under the management and administration of the hospital director. In the hospital, the pharmacy department is the highest organization that undertakes all pharmaceutical work, not only purely as a specialty, but also as a management department to contribute to improving efficiency and ensuring safety in medical examination and treatment, especially in the use of drugs. The pharmacy department is part of the paraclinical block and is the place to implement national drug policies. [3], [5], [21].
Functions and tasks of the hospital pharmacy department:
The Pharmacy Department is a specialized department under the direct leadership of the Hospital Director. The Pharmacy Department has the function of managing and advising the Hospital Director on all pharmacy work in the hospital to ensure timely and adequate supply of quality drugs and to advise and supervise the implementation of safe and appropriate use of drugs. [5]
The hospital Pharmacy Department has the following tasks [21][28];[54]:
Plan, provide and ensure the quantity and quality of common and specialized drugs, chemicals, and medical consumables: cotton, bandages, alcohol, and gauze for inpatient and outpatient treatment, meeting reasonable treatment requirements.
Prepare some medicines for hospital use
Check and monitor the safe and rational use of drugs throughout the hospital. The head of the pharmacy department and authorized pharmacists have the right to replace drugs of the same type.
Participate in drug cost management, implement savings to achieve high efficiency in serving patients.
Is a practice facility of medical universities, medical faculties in universities and medical high schools.
Participate in scientific research and drug information.
1.2.2.2. Operational model of hospital pharmacy department
Main pharmaceutical statistics group
The organization of the pharmacy department requires to be compact, reasonable, and to fully promote the capabilities and knowledge of the staff, following the clinical orientation. The head of the pharmacy department needs to arrange for university or postgraduate pharmacists with training in clinical pharmacy and management qualifications. The head of the department also participates in hospital advisory councils: Vice Chairman of the Drug and Treatment Council, member of the hospital's scientific council. Currently, the pharmacy department model in most hospitals is organized according to the following online structure - functions [ 3]:[5]; [54] :
CHIEF
PHARMACEUTICAL FLOWERS
Bartending team
Warehouse and distribution team
Oriental medicine (if any)
DLS Team,
Drug information
( If any)
Pharmacy (May belong to the Pharmacy Department)
Main Warehouse
Main medicine
Pharmaceutical Accounting
Inpatient allocation
Outpatient dispensing
Figure 1.7: Organizational model of hospital pharmacy department
In this model, when a decision is accepted, the head of the Pharmacy Department will issue it, the functional departments only have the task of guiding their own professional part. All purposes are to complete the functions and tasks of the Pharmacy Department in the hospital.
1.2.2.3. Human resources and management of the hospital pharmacy department
Along with the expansion of training of universities and colleges of Pharmacy; the attention of all levels and society, in recent years, the human resources of Pharmacy have increased significantly, partly compensating for the shortage of human resources in the Pharmacy industry.
General pharmaceutical human resource indicators [9], [34]
Table .: Pharmaceutical human resources nationwide in the period 2000-2005
N m
Total number of employees | DS Number | DS ratio % | PhD | Master | Specialty II | Specialty I | Total number of subscribers | Rate of SDH % | University of Applied Sciences | Percentage | |
2000 | 175497 | 2164 | 1.2 | 5 | 9 | 18 | 498 | 530 | 24.5 | 1634 | 75.5 |
2005 | 195112 | 1953 | 1.0 | 3 | 51 | 8 | 473 | 535 | 27.4 | 1418 | 72.6 |
However, there is still a shortage of hospital pharmacists, especially in remote provinces and districts.
In hospitals, not only in the Pharmacy department, but in any department, the human factor is the decisive factor in determining operational efficiency. The targets for Pharmacy human resources in hospitals in the past were always insufficient to meet the hospital's Pharmacy activities. Nowadays, although the quantity and quality have increased, there is still a need for additional training and education [8].
Some indicators of hospital human resources (2006)[34]
Table .2: Classification structure of occupational groups in hospitals
Occupation group
Total | % | Staffing | % | Contract | % | |
Group Y | 29,107 | 24.6 | 26,157 | 22.1 | 2,950 | 2.5 |
Pharmaceutical Group | 6.185 | 5.2 | 5.166 | 4.4 | 1,069 | 0.9 |
DD, HS | 48,080 | 40.7 | 39,883 | 33.8 | 8.204 | 6.9 |
KTV Group | 7,559 | 6.4 | 6.313 | 5.9 | 1,146 | 1.0 |
Nurse, Medical | 11,619 | 9.8 | 6,958 | 5.9 | 1,146 | 1.0 |
Other | 15,656 | 13.3 | 10,034 | 8.5 | 5,622 | 4.7 |
Total | 118,113 | 100.00 | 94,416 | 80.0 | 23,652 | 20.0 |
Figure 1.: Classification structure of occupational groups in hospitals.
According to the summary report of the Department of Treatment - Ministry of Health in 2006, the pharmaceutical staff in the hospital accounted for 5.2% of the total number of staff in the hospital. According to previous studies, the pharmaceutical staff usually accounted for 5-7% of the total number of staff in the entire hospital.
The human resource structure of the Pharmacy Department includes: 1 head of department, 1-2 deputy heads of department, the rest are university pharmacists (DS §H ), secondary pharmacists (DSTH), accountants and statistics, and pharmaceutical workers. The job titles specified in terms of duties and responsibilities in the 1997 hospital regulations are Head of Pharmacy Department, pharmacist in charge of warehouse, pharmacist in charge of drug preparation . The ratio between DSDH/DSTH and pharmacist assistant is 1/5 or 1/6 [4].
Table .3: Professional qualifications of pharmacists at central hospitals in 2005 (2/3 central hospitals)[19]
Professional qualifications
SL | % | Professional qualifications | SL | % | |
Associate Professor | 1 | 0.6 | CKI | 42 | 24.4 |
PhD | 4 | 2.3 | CKII | 0 | 0 |
Master | 21 | 12.2 | University | 104 | 60.5 |
Total | 172 | 100% | |||
Depending on the specific capabilities and situation of each hospital, DSĐH is often needed in the following departments:
Pharmaceutical business
Warehouse and inpatient and outpatient distribution.
Pharmaceutical statistics
Clinical pharmacy, drug information
Drug preparation, testing, and drug quality control.
Manage professional activities of the hospital pharmacy
However, the current number of Pharmacy staff in general or university pharmacists in particular is not suitable for the work and functions of the Pharmacy Department. In addition, the distribution to the levels and levels also has many shortcomings.
With the requirements for developing comprehensive patient care, the pharmacy department has increased clinical pharmacy activities, drug information, and drug use instructions, but the number of staff and quality of human resources are not guaranteed. The pharmacy department has not changed its staff over many years, but the demand for drugs is constantly growing. Pharmacists at hospitals have not received specialized training in hospital pharmacy work such as clinical pharmacy, hospital pharmacy management, etc. , so they face many difficulties in professional development. These are urgent issues that need to be resolved [43].
1.2.2.4. Facilities
Typically, today's pharmaceutical departments have the following facilities:
a. Drug storage system
Including the main warehouse, retail dispensing counters ensure adequate equipment for storing and preserving drugs [1], [48].
Pharmaceutical flower
The main warehouse includes :
-Warehouse of addictive drugs, psychotropic drugs.
-Regular medicine warehouse (injections, pills)
Chemical and consumable warehouse
Single medicine warehouse.
Warehouse of medicinal materials and finished medicinal products (if any)
Oriental Medicine Dispensing Room
outpatient retail
inpatient retail
cough of the mixing department
Figure 1.9: Warehouse system in Pharmacy department
Warehouses and drug dispensing counters must ensure facilities such as high warehouse location, convenient for import, export, storage, and dispensing of drugs. Ensure implementation of 5 anti-: Confusion, expired, theft, disaster, termites, rats, cockroaches.
Medicines must be stored in a warehouse with all necessary conditions. Each medicine has different storage conditions and must be stored according to the storage conditions stated on the label. Addictive and psychotropic drugs must be stored according to relevant regulations. Medicines are arranged in the warehouse according to the principle of dosage form (injections, tablets), by pharmacological group, in alphabetical order, in order of expiry date: FIFO... to ensure the best management of medicine quality and quantity.
b. Drug dispensing counter for inpatients and outpatients
There is a suitable area for storing medicine, a place for retailing and packaging medicine, and a place for patients and medical staff to wait for medicine.
c. Department of preparation of oriental and modern medicine
Ensure adequate equipment for drug preparation and hygiene.
d. Department of statistics, pharmacy, clinical pharmacy :
Checking the implementation of pharmaceutical regulations in hospitals: Appendix 2.
There are documents for drug information work, online information search.
Pharmaceutical management system using information technology: Currently, most pharmaceutical departments are only connected to the management network at the department level. The information management system connected to the entire hospital is only being initially applied in some hospitals. The requirements for a standard software are not yet available, so there are still many shortcomings.
With hospitals applying hospital-wide management software, doctors prescribe to patients online. After the prescription is approved, data will be transferred to the pharmacy department, and the medicine will be automatically deducted from the pharmacy warehouse when the pharmacy staff completes the dispensing procedures. This reduces errors and confusion in management. Medicines are strictly managed from the pharmacy department to the user in terms of quantity, origin, production batch, expiry date, etc.
e. Pharmacy
Currently, according to the regulations of the Ministry of Health, hospital pharmacies are under the responsibility of the hospital director and are mostly managed by the pharmacy department in terms of expertise. The pharmacy department is responsible to the director so that the pharmacy can provide drugs that ensure quality and reasonable prices, and comply with management regulations. [23]. According to the regulations of the Ministry of Health, hospital pharmacies in large cities such as Hanoi and Ho Chi Minh City from January 1, 2009 are required to meet GPP standards to be allowed to operate.
Therefore, the pharmacy department has the additional task of ensuring drug supply at hospital pharmacies.
1.2.2.5. Inh ph for purchasing medicine
Funds for purchasing drugs usually come from the state budget and hospital fees. The amount of funds spent on purchasing drugs accounts for a large proportion of the total hospital budget.
According to the report of the Treatment Department in 2005: The total amount of medicine costs of 661 hospitals (25 central hospitals, 162 provincial hospitals, 445 district hospitals, 30 industry hospitals) is specifically as follows [26], [37]:
Revenue for medical examination and treatment activities (Treatment Department)
Table .4: Drug costs in hospitals in 2005-2006
(Unit: thousand dong)
Expenses
2005 | 2006 | Rate 200/2005(%) | |
State budget | 3,064,025,761 | 3,549,521,784 | 115.8 |
Total cost of medicine purchased in hospital | 2,753,313,162 | 3,973,035,576 | 144.1 |
Foreign medicine money | 1,826,265,091 | 2,626,635,420 | 143.8 |
Domestic drug costs | 921.704.069 | 1,308,436,209 | 142.0 |
Health insurance medicine money | 1,381,073,592 | 2,271,836,679 | 164.5 |
Hospital fees | 1,327,658,036 | 1,454,554,357 | 109.6 |
Total revenue from operations KCB movement | 8,947,000,000 | 11,010,000,000 | |
Drug cost/total cost ratio (%) | 30.77% | 36.09% |
Table .5: Hospital costs in 2000 - 2009 (unit: billion VND)[38]
Expenses
2008 | 2009 | Rate2009/2008(%) | |
State budget | 25,269.0 | 32,012.5 | 126.7 |
Total hospital fees collected | 17,257,176.1 | 22,525,595.4 | 130.5 |
Total cost of medicine in hospital institute | 7,955.0 | 10,791.3 | 135.7 |
Health insurance medicine money | 4,572.3 | 6,574.0 | 143.8 |
Hospital fees | 2,674.2 | 3,351.8 | 125.3 |
Ratio of drug cost/total hospital fee (%) | 46.1% | 47.9% |