ASHP NATIONAL SURVEY OF HOSPITAL-BASED PHARMACEUTICAL SERVICES - 1994

The results of a national survey of pharmaceutical services in federal and nonfederal community hospitals conducted by ASHP during summer 19 94 are reported and compared with the findings of earlier ASHP surveys . A simple random sample of community hospitals (federal and nonfedera l) was selected from hospitals registered by the American Hospital Ass ociation. A questionnaire was mailed to each director of pharmacy. The adjusted gross sample size was 896. The net response rate was 44% (39 3 usable replies). The mean number of hours that respondents' pharmaci es were open per week for inpatient services was 107.5. An increasing number of pharmacy directors were managing other departments within th e institution. Of respondents, 18% indicated that a patient-focused-ca re model was in place. Complete unit dose drug distribution was offere d by 92% of respondents, and 67% provided complete, comprehensive i.v. admixture services. A total of 29% provided decentralized inpatient p harmaceutical services. Automation of some type to support drug distri bution was used by 55%. Provision of ambulatory care pharmaceutical se rvices was indicated by 82% of nonfederal hospitals and by 98% of fede ral hospitals. Home infusion therapy services were offered by 27% of r espondents. Some 89% had a computerized pharmacy system. The most comm only offered clinical pharmacy services for inpatients were drug-use e valuations and programs to monitor drug therapy, adverse drug reaction s, and drug-food interactions. About half of respondents indicated tha t they did not provide pharmaceutical care. One third indicated that p harmacists had the authority to write drug orders or prescriptions. Ph armacokinetic consultations were provided by 65% and nutritional-suppo rt consultations by 35%. Of nonfederal respondents, 86% participated i n quality assurance for inpatient dispensing and 28% did so for ambula tory care dispensing. A well-controlled formulary system was in place at 60% of the hospitals. About 74% of inpatient pharmacy expenditures went for drugs and fluids, 20% for staff activities, and 6% for other noncapital expenditures. Almost half of respondents indicated that sta ff reductions had occurred. About 9% of nonfederal hospitals had an AS HP-accredited residency program. The 1994 ASHP survey revealed a conti nuation of growth in some areas of hospital pharmacy (clinical service s, computerization, formulary management techniques, and residency pro grams) and identified static areas (ambulatory care services, scope of drug distribution services, and quality assurance programs) that shou ld be addressed by pharmacy leaders.