1. ASPECTS AFFECTING THE HOSPITAL OPERATION Financial Financial Operational Operational Administrative Administrative Clinical Clinical Safety Safety

2. FINANCIAL Pharmacy budget is 14 % of hospital budget. Pharmacy budget is 14 % of hospital budget. Negotiations to get best price on medications. Negotiations to get best price on medications. Expensive medication (chemotherapy, biological agent, etc) Expensive medication (chemotherapy, biological agent, etc) Control cost. Control cost. Inventory control. Inventory control.

3. Alternative to expensive drugs. Alternative to expensive drugs. Control physician preferences. Control physician preferences. Limit off-hospital formulary Limit off-hospital formulary Collect data to review usage and cost to predict future utilization. Collect data to review usage and cost to predict future utilization. Review financial history and compare prior budgets with actual spending and identify outlier area and past cost containment measures and analyze it. Review financial history and compare prior budgets with actual spending and identify outlier area and past cost containment measures and analyze it.

4. Build high priority drug budget A relatively small number (50-60) of products typically represent 80 percent to 90 percent of the total budget. Efforts should focus on this list. Plot historical spending patterns and carefully project future cost and volume. Build high priority drug budget A relatively small number (50-60) of products typically represent 80 percent to 90 percent of the total budget. Efforts should focus on this list. Plot historical spending patterns and carefully project future cost and volume.

5. Establish drug cost containment plan by using benchmarking programs, areas of potential inefficiencies, inappropriate prescribing patterns, and formulary noncompliance to find areas of savings based on preliminary budgets. Establish drug cost containment plan by using benchmarking programs, areas of potential inefficiencies, inappropriate prescribing patterns, and formulary noncompliance to find areas of savings based on preliminary budgets.

6. Monitor actual use and expenditures against budget to figure out the reasons for variances and factor those into future budgets. Document and collect data. Monitor actual use and expenditures against budget to figure out the reasons for variances and factor those into future budgets. Document and collect data. Be up to date with third-party payers new rules and regulations. Be up to date with third-party payers new rules and regulations.

7. OPERATIONAL Collaboration with other professionals (Doctors, Nurses, Nutritionists) Collaboration with other professionals (Doctors, Nurses, Nutritionists) Educating other professionals( new therapies and introducing of new medications). Educating other professionals( new therapies and introducing of new medications). Management of the staff properly managing staff, utilizing resources, and provide best service for patients) Management of the staff properly managing staff, utilizing resources, and provide best service for patients) Problem solving. Problem solving.

8. ADMINISTRATIVE Policies and procedures. Policies and procedures. Operations manuals Operations manuals Quality improvement. Quality improvement. Laws and regulations Laws and regulations Recruitment Recruitment Orientation. Orientation.

9. Performance evaluation. Performance evaluation. Education and training. Education and training. Insure patient confidentiality. Insure patient confidentiality. Committee involvement Committee involvement Workload and financial performance. Workload and financial performance. Position descriptions Position descriptions

10. CLINICAL Apply scientific knowledge( planning and development in hospital setting) Apply scientific knowledge( planning and development in hospital setting) Apply medical knowledge( keep the pharmacy aligned with all departments) Apply medical knowledge( keep the pharmacy aligned with all departments) Creating new knowledge by conducting research ( in a university hospital). Creating new knowledge by conducting research ( in a university hospital). Patient education. Patient education. Scientific contribution( pharmacy research, multidisciplinary research) Scientific contribution( pharmacy research, multidisciplinary research)

11. Control clinical protocols Control clinical protocols Control the use of antibiotics. Control the use of antibiotics. Ensure that quality of pharmaceutical services are provided according to accreditation and professional standards. Ensure that quality of pharmaceutical services are provided according to accreditation and professional standards.

12. SAFETY Medication dispensed from the pharmacy is labeled with the name of the patient, name of the drug, concentration or strength, dosage and expiration date Medication dispensed from the pharmacy is labeled with the name of the patient, name of the drug, concentration or strength, dosage and expiration date Drug storage locations are locked Drug storage locations are locked High-risk drugs are stored in a location separate from the other drugs High-risk drugs are stored in a location separate from the other drugs