Hospital Topics
ISSN: 0018-5868 (Print) 1939-9278 (Online) Journal homepage: http://www.tandfonline.com/loi/vhos20
Outpatient: The Need for a Patient Drug Profile: Related to Hospitals Participating in the Ghetto Medicine Program in New York City Al Schwarz CSW, ACSW & Carl H. Marazzi To cite this article: Al Schwarz CSW, ACSW & Carl H. Marazzi (1976) Outpatient: The Need for a Patient Drug Profile: Related to Hospitals Participating in the Ghetto Medicine Program in New York City, Hospital Topics, 54:5, 6-52, DOI: 10.1080/00185868.1976.9948060 To link to this article: http://dx.doi.org/10.1080/00185868.1976.9948060
Published online: 13 Jul 2010.
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Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=vhos20 Download by: [La Trobe University]
Date: 19 June 2016, At: 20:13
The Need for a Patient Drug Profile Related to Hospitals Participating in the Ghetto Medicine Program in New York City. ALSCHWARZ, CSW, ACSW Assistant Commissioner Evaluation and Institutional Review City of New York Department of Health
Downloaded by [La Trobe University] at 20:13 19 June 2016
CARL H. MARAZZI Senior Pharmacist Bureau of Ambulatory Care New York City Department of Health
Q
uality care is predicated upon comprehensive treatment by medical practitioners accompanied by the proper utilization of medications and related products when indicated. Consider the population universe, demographic and geographical considerations and educational levels of people served by the ghetto medicine program. Fewer pharmacies are available to meet patients’ medication needs. The hospital’s allinclusive Medicaid fee encourages patients to obtain their medications at the outpatient pharmacy because of convenience and, perhaps, for economic reasons. The accessibility and availability of pharmaceutical services in the hospital in emergency situations also stimulate patients to utilize the hospital pharmacy. The hospital outpatient department’s posture as the one place in the community to render total health care to the population, combined with its social aspects, serves as the main conduit for the patient’s primary and frequently only contact with medical care. The efficacy of the patient medication profile record system depends on the acquisition of drugs from a single provider so that the patient’s complete medication history can be monitored. The patient’s perception of the hospital as described above virtually assures that the patient receives all medications from the outpatient pharmacy. Patient medication records must be reviewed and monitored by the pharmacist to determine if the patient is receiving safe and effective drug therapy. Incompatibilities are screened and drug regimen modifications are discussed with the physician. Prescriber-pharmacist communications preclude occurrences of “therapeutic misadventures.” 6
Hospitals participating in the ghetto medicine program meet contractual requirements by maintaining up-to-date patient drug profile records in the pharmacy. These records contain the following information: patient identification, known allergies and sensitivities, chronic conditions, diagnosis, medication quantity, strength and directions for use and refill information. The Outpatient Medication Profile Record is completed in the following manner: 1. Nameandaddress of the patient
2. Date of birth 3. Telephone number
4. Clinic ident$cation number 5. Patient history including known allergies
When a prescription is presented, the pharmacist fills in the following information: 1. Date
2. Prescription Number 3. Medicaiion(s)
4. Dosage directions
5. Amount(s) dispensed 6. Manufacturer’s name, drug control number and expiration date, qany.
7. Prescribing physician ’s name 8. Dispensingpharmacist’s name 9. Paiient diagnosis
The profile is examined by the pharmacist at the time of the presentation of the prescription. The pharmacist will note any drug interactions and other relevant information. Discrepencies are discussed with the prescriber before the medication is dispensed to the patient. The Outpatient Medication Profile card is then filed alphabetically according to the patient’s name. Continued on page; 52 HOSPITAL TOPICS
Downloaded by [La Trobe University] at 20:13 19 June 2016
CARL H. MARAZZI
AL SCHWARZ, CSW, ACSW
Mr. Marazzi received his A.B. from Columbia University and his B.S. (Pharmacy), from Fordham University and a M.S. (Pharmaceutical Administration) from Lung Island University Brooklyn Cullege of Pharmacy. He formerly was successively, Asst. Professor and Chairman of the Department of Pharmaceutical Administration, Medical University of South Carolina College of Pharmacy, Asst. Professor of Administrative Pharmacy, Columbia University College of Pharmaceutical Sciences, and Asst. Professor of Pharmucy Administration, Xavier Univemity of Louisiana ColIegeofPharmacy. He serwd as Director of Pharmacy, New York City Medicaid and iF presently, Senior Pharmacist and Program Research Analyst, Bureau of am hula tor^ Care Services.
Mr. A1 Schwarz is Assistant Commissioner of the New York City Health Department respansible for Evaluation and Institutional Review. Staff under his direction are presently evaluating am bulatoty health care delivery in voluntary and municipal hospitals, HIP centers, private methadone maintenance treatment centers, free standing clinics, ambulatotycare units and other providers of health services. Mr. Schwarz received an A B (Psychologv) degree from Brooklyn College (CUNY) in 1959 and an MSWdegree from Columbia University in 1961. Mr. Schwarz also has an Honorary Diplomate of Philosophy degreefrom Colorado Christian College. and He is an active member of numerous profewiinul or~.unizutii~ns urcthor i~numerousarticles on the delivery of heulth cart: social servicec und other related matten.
Some hospital administrators are resistant to the patient medication profile record for financial reasons. It was felt that budgetary limitations precluded the implementation of this system. However, New York City Department of Health’s staff has proved conclusively that a feasible program can be financed through present Budget Commitments. Administration fears of the need for additional personnel have also been dispelled. Both administrators and pharmacy directors frequently viewed the system in too highly a sophisticated manner, equating its effectiveness to the installation and use of computer technology, requiring expenditures for equipment beyond the institution’s financial capabilities. It has- been demonstrated that manual or duplicate label recording of this data, utilizing present personnel is not only possible but has proven very effective without increasing costs. Although maintenance of up-to-date patient profiles for all outpatients is a contractual requirement, the Bureau of Ambulatory Care Services of the New York City Department of Health allows hospitals to phase in the profile on a clinic by clinic basis. This results in minimum disruption of present employee productivity levels. I t also af-
fords pharmacy personnel the opportunity to develop a degree of expertise so that the system can be gradually expanded. The rationale for the medication profile system is directly related to the proper delivery of quality health care services. Discovery of drug multiuse, contraindications, synergisms and allergies is instrumental in preventing untoward side effects and patient injury. Detection of medication over utilization also results in cost savings. By maintaining, updating and monitoring patient drug utilization records, the pharmacist as the medication specialist, assumes a n integral role on the clinic team. The pharmacist’s sharing the responsibility for proper prescribing practices and patient drug information instruction reinforces and supplements physician and nurse educational programs. This enables health care practitioners to better function within their professional purview. Additional physician, nurse time may become available to provide more comprehensive and continuous patient care. Thus, the aforementioned meaningful communications among members of the health care team will lead to better intraprofessional and interprofessional relations.
Note: For comrnunicatirig with the authvrs write: Medical AsLrsistance Program (Medical) Division ojlnstitutivnal Bin bulatvty Services 330 West 34th Street, J r J j l w r New York, New York 10001 Telephone: 790-3900
52
REFERENCES Schwarz. Al: “Evaluating Ambulatory Care’’, The Record, (GNYMRA) Winter 1974-75, pp. 30-32. ‘The Ghetto Medicine Contract’, A contract between the City of New York and 29 Voluntary Hospitals.
HOSPITAL TOPICS
ISSN: 0018-5868 (Print) 1939-9278 (Online) Journal homepage: http://www.tandfonline.com/loi/vhos20
Outpatient: The Need for a Patient Drug Profile: Related to Hospitals Participating in the Ghetto Medicine Program in New York City Al Schwarz CSW, ACSW & Carl H. Marazzi To cite this article: Al Schwarz CSW, ACSW & Carl H. Marazzi (1976) Outpatient: The Need for a Patient Drug Profile: Related to Hospitals Participating in the Ghetto Medicine Program in New York City, Hospital Topics, 54:5, 6-52, DOI: 10.1080/00185868.1976.9948060 To link to this article: http://dx.doi.org/10.1080/00185868.1976.9948060
Published online: 13 Jul 2010.
Submit your article to this journal
Article views: 1
View related articles
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=vhos20 Download by: [La Trobe University]
Date: 19 June 2016, At: 20:13
The Need for a Patient Drug Profile Related to Hospitals Participating in the Ghetto Medicine Program in New York City. ALSCHWARZ, CSW, ACSW Assistant Commissioner Evaluation and Institutional Review City of New York Department of Health
Downloaded by [La Trobe University] at 20:13 19 June 2016
CARL H. MARAZZI Senior Pharmacist Bureau of Ambulatory Care New York City Department of Health
Q
uality care is predicated upon comprehensive treatment by medical practitioners accompanied by the proper utilization of medications and related products when indicated. Consider the population universe, demographic and geographical considerations and educational levels of people served by the ghetto medicine program. Fewer pharmacies are available to meet patients’ medication needs. The hospital’s allinclusive Medicaid fee encourages patients to obtain their medications at the outpatient pharmacy because of convenience and, perhaps, for economic reasons. The accessibility and availability of pharmaceutical services in the hospital in emergency situations also stimulate patients to utilize the hospital pharmacy. The hospital outpatient department’s posture as the one place in the community to render total health care to the population, combined with its social aspects, serves as the main conduit for the patient’s primary and frequently only contact with medical care. The efficacy of the patient medication profile record system depends on the acquisition of drugs from a single provider so that the patient’s complete medication history can be monitored. The patient’s perception of the hospital as described above virtually assures that the patient receives all medications from the outpatient pharmacy. Patient medication records must be reviewed and monitored by the pharmacist to determine if the patient is receiving safe and effective drug therapy. Incompatibilities are screened and drug regimen modifications are discussed with the physician. Prescriber-pharmacist communications preclude occurrences of “therapeutic misadventures.” 6
Hospitals participating in the ghetto medicine program meet contractual requirements by maintaining up-to-date patient drug profile records in the pharmacy. These records contain the following information: patient identification, known allergies and sensitivities, chronic conditions, diagnosis, medication quantity, strength and directions for use and refill information. The Outpatient Medication Profile Record is completed in the following manner: 1. Nameandaddress of the patient
2. Date of birth 3. Telephone number
4. Clinic ident$cation number 5. Patient history including known allergies
When a prescription is presented, the pharmacist fills in the following information: 1. Date
2. Prescription Number 3. Medicaiion(s)
4. Dosage directions
5. Amount(s) dispensed 6. Manufacturer’s name, drug control number and expiration date, qany.
7. Prescribing physician ’s name 8. Dispensingpharmacist’s name 9. Paiient diagnosis
The profile is examined by the pharmacist at the time of the presentation of the prescription. The pharmacist will note any drug interactions and other relevant information. Discrepencies are discussed with the prescriber before the medication is dispensed to the patient. The Outpatient Medication Profile card is then filed alphabetically according to the patient’s name. Continued on page; 52 HOSPITAL TOPICS
Downloaded by [La Trobe University] at 20:13 19 June 2016
CARL H. MARAZZI
AL SCHWARZ, CSW, ACSW
Mr. Marazzi received his A.B. from Columbia University and his B.S. (Pharmacy), from Fordham University and a M.S. (Pharmaceutical Administration) from Lung Island University Brooklyn Cullege of Pharmacy. He formerly was successively, Asst. Professor and Chairman of the Department of Pharmaceutical Administration, Medical University of South Carolina College of Pharmacy, Asst. Professor of Administrative Pharmacy, Columbia University College of Pharmaceutical Sciences, and Asst. Professor of Pharmucy Administration, Xavier Univemity of Louisiana ColIegeofPharmacy. He serwd as Director of Pharmacy, New York City Medicaid and iF presently, Senior Pharmacist and Program Research Analyst, Bureau of am hula tor^ Care Services.
Mr. A1 Schwarz is Assistant Commissioner of the New York City Health Department respansible for Evaluation and Institutional Review. Staff under his direction are presently evaluating am bulatoty health care delivery in voluntary and municipal hospitals, HIP centers, private methadone maintenance treatment centers, free standing clinics, ambulatotycare units and other providers of health services. Mr. Schwarz received an A B (Psychologv) degree from Brooklyn College (CUNY) in 1959 and an MSWdegree from Columbia University in 1961. Mr. Schwarz also has an Honorary Diplomate of Philosophy degreefrom Colorado Christian College. and He is an active member of numerous profewiinul or~.unizutii~ns urcthor i~numerousarticles on the delivery of heulth cart: social servicec und other related matten.
Some hospital administrators are resistant to the patient medication profile record for financial reasons. It was felt that budgetary limitations precluded the implementation of this system. However, New York City Department of Health’s staff has proved conclusively that a feasible program can be financed through present Budget Commitments. Administration fears of the need for additional personnel have also been dispelled. Both administrators and pharmacy directors frequently viewed the system in too highly a sophisticated manner, equating its effectiveness to the installation and use of computer technology, requiring expenditures for equipment beyond the institution’s financial capabilities. It has- been demonstrated that manual or duplicate label recording of this data, utilizing present personnel is not only possible but has proven very effective without increasing costs. Although maintenance of up-to-date patient profiles for all outpatients is a contractual requirement, the Bureau of Ambulatory Care Services of the New York City Department of Health allows hospitals to phase in the profile on a clinic by clinic basis. This results in minimum disruption of present employee productivity levels. I t also af-
fords pharmacy personnel the opportunity to develop a degree of expertise so that the system can be gradually expanded. The rationale for the medication profile system is directly related to the proper delivery of quality health care services. Discovery of drug multiuse, contraindications, synergisms and allergies is instrumental in preventing untoward side effects and patient injury. Detection of medication over utilization also results in cost savings. By maintaining, updating and monitoring patient drug utilization records, the pharmacist as the medication specialist, assumes a n integral role on the clinic team. The pharmacist’s sharing the responsibility for proper prescribing practices and patient drug information instruction reinforces and supplements physician and nurse educational programs. This enables health care practitioners to better function within their professional purview. Additional physician, nurse time may become available to provide more comprehensive and continuous patient care. Thus, the aforementioned meaningful communications among members of the health care team will lead to better intraprofessional and interprofessional relations.
Note: For comrnunicatirig with the authvrs write: Medical AsLrsistance Program (Medical) Division ojlnstitutivnal Bin bulatvty Services 330 West 34th Street, J r J j l w r New York, New York 10001 Telephone: 790-3900
52
REFERENCES Schwarz. Al: “Evaluating Ambulatory Care’’, The Record, (GNYMRA) Winter 1974-75, pp. 30-32. ‘The Ghetto Medicine Contract’, A contract between the City of New York and 29 Voluntary Hospitals.
HOSPITAL TOPICS
