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American Journal of Pharmaceutical Education
Introduction to Hospital and Health-System Pharmacy Practice.
David A. Holdford and Thomas R. Brown
American Journal of Pharmaceutical Education 2011; 75 (2) Article 31.406
Introduction to Hospital and Health-System Pharmacy Practice provides a review of the practice of pharmacy in health systems in the United States. While it may be considered an overview, the level of detail that is provided makes this work suitable not only for students, but also for practicing pharmacists, pharmacy educators, preceptors, and new pharmacy managers.
The book consists of 19 chapters making up 8 separate parts. The chapters in each part focus on related aspects of institutional pharmacy practice. The format provides useful tools. Each chapter begins with learning objectives and key terms with their definitions. The key terms are again defined within the text and additional explanation is
provided. Throughout the book, key points and their significance are offset from the narrative to highlight their importance. All chapters conclude with a summary as well as suggested additional reading and references. Very good review and discussion questions are available at the end of each chapter to emphasize important themes and promote discourse.
Chapters 1 through 3 define institutional pharmacy practice and its history. This section examines the role of accreditation, laws, regulations, practice guidelines, and practice standards in hospital pharmacy. Varying types of hospitals and institutional practice models are presented, including influences on the way services are delivered.
Managing Medication Use is the title of the next section, which includes chapters 4 through 6. Here the reader will find information on the pharmacy and therapeutics committee, formulary management, and medication policies. This section also includes a thorough description of clinical pharmacy and the training and credentials of clinical pharmacists.
Chapters 7 and 8 focus on distribution systems, including how distribution is different for controlled substances due to federal requirements. The unit dose process is reviewed in detail with its goals and advantages.
Technology is the emphasis of chapters 9 through 11. Electronic health records (EHR) are described, including benefits of EHR such as providing data for quality assurance and continuous improvement. Information on computerized provider order entry (CPOE) and the clinical decision support system to facilitate CPOE is also given. Several applications of informatics are presented, as well as the need for the integration of assorted information systems into pharmacy processes. The position of clinical informatics pharmacist is described with the education and training appropriate for this individual. The chapter on
‘‘Automation in Practice’’ (Chapter 11) does an excellent job of reviewing how automation may be used,while stressing the point that technology should not provide a false
sense of security and must be appropriately managed.
Chapters 12 and 13 emphasize financial issues including inventory management and budgeting. Financial terms and financial practices are described with helpful tables depicting balance sheets, budgets and productivity ratios.
The section on sterile products includes chapters 14 and 15. Here the reader will find information on intravenous admixture and the importance of processes to ensure stability and compatibility. Information is given from USP Chapter 797 with figures showing examples of floor plans for clean rooms. A good discussion is provided on the categories of infusion therapies, various delivery systems for parenteral drug therapy, and methods of parenteral administration. Risks of parenteral therapy are also
a focus of this section.
Managing People is the seventh section in the text. Several definitions for leadership are considered, pointing out the difference between leaders and managers. Theories on leadership and styles of leadership are presented. Some personnel issues targeted in this section include recruitment, retention, motivation, and termination. American Journal of Pharmaceutical Education 2011; 75 (2) Article 31. 2
The final section deals with careers in health-system pharmacy. The importance of planning a career path while still in pharmacy school is stressed with details given on advanced training opportunities for pharmacists. Residencies are discussed with information on the application process and also benefits of residency training. Potential barriers to residency training also are identified.
Overall, this is an easy to read, well-organized text with many helpful figures and tables. The material provided is of sufficient detail for a thorough introduction to hospital and health-system pharmacy, and the reader is given many additional sources of information on the topics covered. This book is highly recommended and will be an excellent resource for students as well as practicing pharmacists.
Corresponding Author: Melody C. Sheffield, BSPharm, PharmD,
University of Georgia College of Pharmacy.
— Melody C. Sheffield, BSPharm, PharmD