Introduction to Hospital Pharmacy

Institutional pharmacy practice is a broad term that generally refers to pharmacy

practice in any type of organized healthcare setting. This can include hospitals, clinics,
long-term care facilities, and even correctional facilities.

Difference between institutional pharmacy practice and retail pharmacy:

1. Setting:
• Institutional Pharmacy: operates within organized healthcare settings.
• Retail Pharmacy : standalone stores or located within supermarkets and
malls.
- community : Ex. Independent or chain drug stores MERCURY, SOUTH STAR (manson)

- RONPDs (RETAIL OUTLET FOR NON- PRESCRIPTION DRUGS) : for OTC medications
 2. Patient Interaction:
• Institutional Pharmacy: more direct involvement in patient care, working
closely with physicians and nurses to optimize medication therapy.
- Pharmacist that do rounds and check patient charts is called as CLINIICAL PHARMACIST
• Retail Pharmacy: Pharmacists primarily dispense medications based on
prescriptions from various doctors. While they offer counseling and advice,
their patient interaction might be less frequent and less focused on ongoing
care.
Electronic prescription – 7 days
Prescription for dangerous drug (ESSENTIAL PRESCRIPTION FOR DANGEROUS DRUG or YELLOW PRECRIPTION) – 2months/60days
MULTIPLE PRESCRIPTION or so called as MULTI-MONTH PRESCRIPTION : The doctor can issue 3 prescriptions

- Maximum quantity of DD in prescription : AMPULE (1), TABLET (30- for ordinary cases)

3. Scope of Practice:
• Institutional Pharmacy: wider range of activities, including:
• Preparing sterile medications (injections, IVs)
Ampule – glass ; single use
Vials – it has dropper ; multiple use
Pre-filled syringe – already has the substance to be injected ; contain single dose of medication (Ex. Saccharin)
 • Managing controlled substances within the institution
S3 LICENSE – it is needed by the hospital to retail induced drugs ; validity of the license is 1 YEAR
• Participating in medication-use research
• Educating other healthcare professionals
• Retail Pharmacy: Dispensing prescriptions
• Counseling patients on medication use
• Providing over-the-counter medications and advice
• Offering additional services like immunizations
There are four available vaccines in pharmacy : 1. Flu vaccine 2. Pneumoccocal vaccine 3. Covid vaccine 4. Cervical Cancer vaccine

4. Business Model:
• Institutional Pharmacy: Integrated into the larger healthcare organization's financial
structure.
• Retail Pharmacy: Operates as a more traditional retail business, generating revenue
from medication sales and additional services.
Types of Institutional Pharmacy Practice
1. Long-Term Care Pharmacy ( chronic disease – 3 months above)
•Focuses on patients in nursing homes, assisted living facilities, and other long-term care
settings.
•Pharmacists manage medication therapy management (MTM) for chronic conditions, often
dealing with complex medication regimens and polypharmacy (multiple medication – 5)

2. Correctional Facility Pharmacy

•Provides pharmacy services to incarcerated individuals.
•Pharmacists in this setting need to be aware of the unique challenges of medication
management within a correctional environment.

3. Ambulatory Care Pharmacy ( patient who can manage to walk)

•Serves patients in outpatient clinics associated with hospitals or healthcare systems.
•Pharmacists provide medication management for chronic conditions, such as diabetes,
hypertension, and high cholesterol.
4. Home Infusion Pharmacy
•Prepares and delivers intravenous medications and other therapies to patients' homes.
•Pharmacists monitor patients' responses to therapy and provide education and support.

5. Nuclear Pharmacy
•Specializes in the preparation and dispensing of radioactive medications used in diagnostic
imaging and treatment.
•Nuclear pharmacists require specialized training and work under strict safety regulations.

RADIO PHARMACEUTICAL – used for diagnostic imaging

6. Managed Care Pharmacy (HMO- health maintenance organization)

•Focuses on managing medication use for a large group of patients, often within a health
insurance plan.
•Pharmacists in this setting develop and implement drug formularies, review medication prior
authorization requests, and work to control drug costs.
7. Hospital Pharmacy
• The most common type of institutional
pharmacy. Pharmacists work in inpatient and
outpatient settings, dispensing medications,
monitoring patient drug therapy(dose, efficacy,ADR,ADE), and
advising healthcare providers.
• Specializations within hospital pharmacy:
Oncology pharmacy (CANCER), critical care pharmacy,
infectious disease pharmacy, pediatric pharmacy, and
more.
• CONTAGIUS – high communicable
Geriatric Pharmacy?
Geriatricpharmacyis a specializedfield that focuses
on optimizing medication therapy and improving
medication-relatedoutcomesfor olderadults.
SCOPE:
a. Understanding Age
-Related Changes:
pharmacokinetics, pharmacodynamic, polypharmacy
b. Managing Chronic Condition:
diabetes, heart failure, arthritis, and Alzheimer's
Hypertension,
disease
-non-pharmacological intervention
c. Addressing Cognitive and Functional Decline:
- assess cognitive function and medication adherence
-work with caregivers and families
Scope of Geriatric Pharmacy (cont’d)

d. Promoting Medication Safety

- identify and prevent medication errors, adverse
drug events, and drug interactions
- advocate for appropriate prescribing practices
and deprescribing

e. Providing Patient-Centered Care

- patient education and counseling
- consider patients' goals of care, preferences, and
quality of life
Introduction to Hospital Pharmacy
✓ Department of hospital which deals with procurement, storage,
compounding, dispensing, manufacturing, testing, packaging and
distribution drugs.
✓ It is also concerned with education and research in pharmaceutical
services.
✓ Hospital Pharmacy is controlled by a professional and competent and a
qualified pharmacist.
✓ The practice of pharmacy in a hospital setting including its organizationally
related facilities or services
✓Maybe defined according to its form; physical make-up, quantitative nature
of service Maybe also define according to its purpose/ mission
✓It serves as a focal point for the coordination and delivery of patient care to
its community”
 ✓Department or service in a hospital in which under the direction of a
professional competent, legally qualified pharmacist (Hassan, 1974).
Overview of the General Function of Hospital Pharmacy

Pharmaceuticals
are manufactured Narcotics and
other prescribed
drugs are
dispensed

Special Medications are

Hospital supplied to the
prescriptions are Hospital
filled for patients Pharmacy nursing units and
other services Pharmacy
in the hospital
Injectable Professional
preparations are supplies are often
prepared and stocked and
sterilized dispensed

Prescriptions are
filled for
ambulatory
patients and out
patients
Such practice traditionally involves:
✓Supplying medicines for In-patient and outpatient
✓Preparing of sterile medications
✓Bulk compounding
✓Pre-packing
✓Drug formulation
✓Research
✓Drug therapy information

Department wherein the procurement, storage, compounding, manufacturing,

packaging, controlling, assaying, dispensing, distribution and monitoring of medications take
place.
FUNCTIONS OF HOSPITAL PHARMACY
 ✓ Provide specifications for the purchase of drugs, chemicals,
biological etc.
✓ Proper storing of drugs.
✓ Manufacturing and distribution of medicaments such as transfusion
fluids, parenteral products, tablets, capsules, ointments, and stock
mixtures.
✓ Dispensing and sterilizing parenteral preparations which are
manufactured in hospital.
✓ Dispensing of drugs as per the prescriptions of the medical staff of
the hospital.
FUNCTIONS OF HOSPITAL PHARMACY
✓ Filling and labelling of all drug containers from which medicines
are to be administered.
 ✓ Management of stores which includes purchase of drugs, proper
storage conditions, and maintenance of records.
✓ Establishment and maintenance of “Drug Information
Centre”.
✓ Providing co-operation in teaching and research programmes.
✓ Discarding the expired drugs and containers worn and
missing labels.
Evolution and Developmental History of Hospital Pharmacy
6th century
✓Hospitals originated in India and Egypt to protect the
society from contagious diseases, insanity and incurables
✓Some hospitals were developed thru religious and divine
motives
 ✓Greek Temples of God – serves as hospitals. Healing were
associated with divine powers because they believed that
illness is due to lack of purity.
✓TEMPLES OF AESCULAPIUS(Greek God of Medicine)
Ex: Temple of Kos in Greece – it is where Hippocrates
practiced.
Ancient Period ➝ American Era

Urdang (hospital pharmacist)

✓first recognized representative of the pharmaceutical profession
✓were employed in the hospitals which were a part of many early
monasteries
Description” “apothecary shop” and its garden for the cultivation of
medicinal herbs Apothecary’s shop was built.
• Apothecary became the resident in the hospital.
• Elaboratarian – helps in the preparation of medicines; who did the
unskilled work. – it’s like a pharmacy technician
16th century
✓Monasteries had infirmarian – place where successful treatment to diseases were
being offered

17th century
✓Pennsylvania Hospital ( the first hospital in Colonial America) was
opened
✓1752 - Jonathan Roberts was the first hospital
pharmacist/apothecary
✓Medicine and Pharmacy are being practiced together. At that time drug preparation are
often the responsibility of a medical apprentice
18th century
• Hospital pharmacist were rare because there were few hospitals
• Hospitals were “places of dreaded impurity and exiled human wreckage”
• In early 1800s clean air and good food rather than medicines were treatments
emphasized in hospitals
• In 1870s and 1880s responding to the influx of immigrants Catholic hospitals were built.
Early 1900s

✓Advent of hospital
formulary

Hospital Formulary – a list of drugs approved for use within the hospital
or health system by the Pharmacy & Therapeutics Committee. (PTC)
- Only a pharmacist can be a secretary of PTC
• 1920 – Prohibition (alcohol)
• 1930s – AHA (AMERICAN HOSPITAL ASSOCIATION) created a
Committee of Pharmacy to analyze problems and make
recommendations.
• The aim of the committee was to develop minimum standards for
hospital pharmacy department and prepare manual operations.
1957 - 1960
✓Major study conducted by the Audit of Pharmaceutical Services in
Hospitals.
- MORE OF REVIEW AND AUDIT JUST TO APPRAISE WHAT SERVICES ARE BEING GIVEN DURING THIS TIME

✓The group published a book Mirror to Hospital Pharmacy (a publication

documenting the state of pharmacy service in the hospitals in the late
1950s)
Four major themes emerge from an examination changes over the
period:
1. Pharmacist must be in charge of drug product acquisition, distribution
and control
2. Pharmacist has a major role in patient safety
3. Pharmacist has a major role in promoting rational drug therapy
4. Pharmacist has a mission to foster optimal patient outcomes from
medication use.

One Dominant Factor (RELIGIOUS INFLUENCE)

✓Doctrines of Jesus Christ intensified the emotions and virtues of love, pity and
charity
 Another Factor: Military Influence

✓Urgent need for care of the wounded on the

battlefield.

Other Factors:
1. FLEXNER REPORT on medical education- caused revolutionary developments
in medical education and medical internship training.
2. ACTIVITIES OF FLORENCE OF NIGHTINGALE- Quality of NURSING CARE/
nursing school
3. THE PUBLIC INTEREST in HOSPITALS- led to production of finances for further
development, expansion and improvement.
4. SIGNIFICANT GOVERNMENT PROGRAMS- adoption of the HOSPITAL
SURVEY AND CONSTRUCTION ACT (1946)
✓Commonly known as HILL BURTON PROGRAM- Provide federal funds for
hospital construction
5. NATIONAL PLANNING and RESOURCES DEVELOPMENT ACT (1975)-
created the development of HEALTH SYSTEMS AGENCIES (HAS)
Responsibilities of HAS

✓ Improving the health of residents of its health service area

✓ Increasing the accessibility, acceptability, continuity and quality of
services provided.

✓ Restraining increase in the cost of these services.

✓ Preventing unnecessary duplication of health resources.

1949s
✓ Pharmacy was perceived as complementary service department, not as essential
service.
✓ Nurses and Community pharmacists (not hospital pharmacist) were responsible for
hospital drug Until..
1950s
✓ 2 types of services – bulk compounding and sterile solution manufacturing were a major element of the
hospital pharmacist’s identity

✓ Patient Safety
1957
2 ways of drug distribution:
1. ward stock
2. individual prescription
Result: errors in prescribing and transcribing
Solution: Unit dose Drug Distribution
William M. Heller & William W. Tester- conducted important studies on unit dose drug distribution
Promoting Rational Drug Use

1936 – U. S. Edward Spease ( Father of Hospital Pharmacy Standards) and Robert Porter
developed the concept of Pharmacy & Therapeutics Committee
-Committee of medical staff (Dr, RN, RPh etc..) which oversights medication management.
- Establishes Formulary
Makes Recommendation on policies and procedure associated with
medication management.

- Pharmacists serves as the secretary of the committee

Formulary System- A structure for evaluating, appraising and selecting drug products to be
available for use in patient care.
-Framework in which medication-use policies are established and implemented.
Hospital Formulary- A list of drugs approved for use within the hospital.
Fostering Optimal Patient Outcome- To help people make the best use of medicines
During 1950s- Pharmacists were less frequently asked for advice on medications (ADR, dosage
forms..)

ASHP Hilton Head Conference in 1985- emerged the idea that hospital pharmacies should
function as clinical departments with the mission to foster the appropriate use of medicine

Evolution of Hospital Pharmacy in the Philippines

1577 – Hospital de San Juan de Dios and Hospital de San Lazaro
were built by the Franciscans
1962 – The Philippine Society of Hospital Pharmacist was
organized. It promotes the interests of hospital pharmacists.
- Dr. Rosario Capistrano Tan-first president
of PSHP
✓1565- Hospital Militar, cebu
 ✓1571- Hospital Militar, Manila
✓1577- Hospital de San Juan de Dios
✓1577- Hospital de San Lazaro
✓1588- Hospital de San Gabriel
✓1891- Chinese general Hospital
✓1911- Philippine general Hospital
✓1957- Government Hospital Association
✓1960- Private Hospital Pharmacist Association
Uniqueness of Hospital Pharmacy Practice

Similarities of Community and Hospital Pharmacy

Community pharmacists and hospital pharmacists perform some or all of the
following duties:
1. Check prescriptions for proper dosage
2. Compound prescribed pharmaceutical products by calculating, measuring and
mixing the quantities of drugs and other ingredients required and filling appropriate
containers with correct quantity
3. Dispense prescribed pharmaceuticals to customers or to other health care
professionals and advise them on indications, contra-indications, adverse effects,
drug interactions and dosage
4. Maintain medication profiles of customers including registry of poisons and narcotic
and controlled drugs
5. Ensure proper preparation, packaging, distribution and storage of vaccines,
serums, biologicals and other drugs and pharmaceuticals
6. Order and maintain stock of pharmaceutical supplies
7. Advise customers on selection and use of non-prescription medication.
8. May supervise and co-ordinate the activities of other pharmacists, pharmacy
assistants, pharmacy technicians and other staff.
Hospital Pharmacy differ from Community pharmacy in ways such as…

1. has more opportunity to interact closely with the prescriber and, therefore,
to promote the rational prescribing and use of drugs;
2. has a greater opportunity to interact with others, to specialize and to gain
greater expertise;
3. having access to medical records, is in a position to influence the selection
of drugs and dosage regimens, to monitor patient compliance and
therapeutic response to drugs, and to recognize and report adverse drug
reactions;
4. can more easily than the community pharmacist assess and monitor
patterns of drug usage and thus recommend changes where necessary;
5. can control hospital manufacture and procurement of drugs to ensure the
supply of highquality products;
6. takes part in the planning and implementation of clinical trials.
Minimum Standards for Pharmacies in Hospital
1936
• ASHP adopted the Minimum Standards of Pharmacies in Hospital – it serves
as a practice standards for hospital pharmacy practice
• Practice Standard
• Authoritative advisory document
• It offers minimum requirements
 • Provides optimal method for addressing an important issue or problem

✓Must be under the direction of a professionally competent , legally

qualified pharmacist

✓Pharmacist has the authority to develop administrative policies for the

department (SOP)
✓Professional policies must be approved by the P&TC.
✓There must be an ample number of qualified number of personnel in the
department.
✓Adequate facilities
✓Expanded scope of pharmacist’s
responsibilities
✓P&TC must establish a formulary
Task II: Group Presentation
Advances in Healthcare Delivery Service In Hospital
Submission date: September 12, 1:00pm
1. Provide the timeline on the history of telepharmacy implementation in the
Philippines.
2. What are the significant barriers to the implementation of telepharmacy? Briefly
explain each.
3. Suggest a possible intervention or strategy to address the identified barriers in
telepharmacy.
4. What are the essential components of an effective pharmaceutical care plan?
5. What are the different types hospital based on the;
-Type of Service
- Ownership
- Length of Stay
- Bed Capacity
- Based on Service Capabilities (DOH)
A hospital is a residential establishment which provides short-term and longterm
medical care consisting of observational, diagnostic,therapeutic and
rehabilitative services for persons suffering or suspected to be suffering from a disease or
 injury and for parturients. It may or may not also provide services for ambulatory patients
on an out-patient basis’- WHO Expert Committee, 1963
Parturients" is a term used to refer to women who are in labor or giving birth.

The hospital is an integral part of a social and medical organization, the function
of which is to provide for the population complete healthcare, both curative and
preventive, and whose out- patient services reach out to the family in its home
environment; the hospital is also a centre for the training of health workers and for
biosocial research’.- WHO expert committee, 1956
HOSPITAL
An organized structure which pools together all the health professionals, the
diagnostic and therapeutic facilities, equipment and supplies and the physical facilities into
a coordinated system for delivering health care to the public.
GOALS OF HOSPITAL PHARMACY
1. To provide the benefits of a qualified hospital pharmacist to patients and health
care institutions, to the allied health professions, and to the profession of
pharmacy.
2. To assist in providing an adequate supply of such qualified hospital pharmacists.
3. To assure a high quality of professional practice through the establishment and
maintenance of standards of professional ethics, education, and attainments and
through the promotion of economic welfare.
4. To promote research in hospital pharmacy practices and in the pharmaceutical
sciences in general.
5. To disseminate pharmaceutical knowledge by providing for interchange of
information among hospital pharmacists and with members of allied specialties
and professions.
6. the advancement of rational, patient-oriented drug therapy in hospitals and other
organized health care settings.
 PRINCIPLE ELEMENT OF HOSPITAL

1. PERSONNEL- Every health facility shall have an adequate number of qualified,

trained and competent staff to ensure efficient and effective delivery of quality
services. SUCH AS PHARMACIST , PHARMACY TECHNICIAN/ PHARMACY ASSISTANT ETC.
2. Physical facilities- adequate areas to safely, effectively and efficiently
provide health services to patients as well as members of the public as
necessary.
3. EQUIPMENT AND INSTRUMENTS- shall be adequately equipped based on the
level and complexity of healthcare it provides EX. CT SCAN, MRI, XRAY, ULTRASOUND
4. SERVICE DELIVERY- Every health facility shall have documented
administrative Standard Operating Procedures (SOP) for the provision of its
services. EX. QUEUE MANAGEMENT SYSTEM
5. QUALITY IMPROVEMENT (QI) ACTIVITIES- shall establish and maintain a
system for continuous quality improvement activities. EXAMPLE : REPORTING OD ADRs
6. INFORMATION MANAGEMENT- shall maintain a system of communication,
recording and reporting of results of examinations.
✓Contents of Medical Records IREPORTING OF ADRs CAN ALSO BE AN EXAMPLE HERE

✓Collection and Aggregation of Data

✓Records Management
7. ENVIRONMENTAL MANAGEMENT-shall ensure that the environment is
safe for its patients and staff including members of the public as necessary
and that the following measures
THIS INCLUDES EMERGENCY PREPAREDNESS
and/or safeguards shall be observed
Minimum standard for hospital pharmacy

A. Administration
The director of pharmaceutical services is responsible for:
 (1) Setting the long- and short-range goals of the pharmacy based on
developments and trends in health care and institutional pharmacy
practice and the specific needs of the institution.
(2) Developing a plan and schedule for achieving these goals.
(3) Supervising the implementation of the plan and the day- to-day activities
associated with it.
(4) Determining if the goals and schedule are being met and instituting
corrective actions where necessary
Minimum standard for hospital pharmacy

B. Facilities- there shall be adequate space, equipment, and supplies for the
professional and administrative functions of the pharmacy. The pharmacy shall
be located in an area (or areas) that facilitate (s) the provision of services to
patients. It must be integrated with the facility's communication and
 transportation systems. Space and equipment, in an amount and type to provide
secure, environmentally controlled storage of drugs, shall be available.
There shall be designated space and equipment suitable for the preparation of
sterile products and other drug compounding and packaging operations. The
pharmacy should have a private area for pharmacist- patient consultations.
C. Drug Distribution and Control- the pharmacy shall be responsible for the
procurement, distribution, and control of all drugs used within the institution
Minimum standard for hospital pharmacy

D. Drug Information- the pharmacy is responsible for providing the

institution's staff and patients with accurate, comprehensive information
about drugs and their use and shall serve as its center for drug
information.
 E. Assuring Rational Drug Therapy - the pharmacist, in concert with the
medical staff, must develop policies and procedures for assuring the quality
of drug therapy leading to maximizing rational drug therapy.
F. Research- the pharmacist should conduct, participate in, and support
medical and pharmaceutical research appropriate to the goals, objectives,
and resources of the pharmacy and the institution

A.O No. 2012-0012: “Streamlining of Licensure and Accreditation of Hospitals”

- THIS ONE IS THE NEW CLASSIFICATION OF HOSPITALS AND OTHER HEALTH FACILITIES IN THE HOSPITAL

Subject: Rules and Regulations- Governing the New Classification of Hospitals and -Other Health
Facilities in the Philippines

• Pursuant to Section 16 of Republic Act No. 4226 otherwise known as

Hospital Licensure Act, "The licensing agency shall study and adopt a system
 of classifying hospitals in the Philippines as to: (1) general ( IT HAS A WIDE VARIETY OF
DISEASES) or special ( IT SPECIFY THE FOCUS OF THE HOSPITAL FOR EXAMPLE CARDIOVASCULAR DISEASES, THEN A HOSPITAL IS SPECIAL

OR SPECIALTY HOSPITAL); (2) service capabilities; (3) size or bed capacity and (4)

classification of hospital whether training or not

- LEVEL 1 MORE OR LESS IT BASE ON THE BED CAPACITY
- A LABORATORY IN A LEVEL 1 HOSPITAL CAN BE CLASSIFIED AS TERTIARY IF IT HAS HIGHLY ADVANCED EQUIPMENTS WHICH IS USUALLY USEED BY TERTIARY HOSPITAL
- THERE’S NO CLASSIFICATION OF PHARMACY IF IT’S LEVEL ONE, LEVEL 2, LEVEL 3. BUT IT CAN BE FULL SERVICE PHARMACY

• A research project was therefore undertaken by the Department of Health

(DOH) through the Bureau of Health Facilities and Services (BHFS) to map
out the services and equipment available in all hospitals and to get an
overview of the typology of the existing hospital classification and other
hospital-based facilities
- HOSPITAL PHARMACY LICENSE IS 3 YEARS , AND THERE IS AUTOMATIC RENEWAL
- HOSPITAL LTO (LICENSE TO OPERATE) IS 1 YEAR

Scope and Coverage

Regulatory offices – BHFS, FDA (THERE ARE FOUR CLUSTERS MAINLY THE CENTER FOR DEVICE REGULATION, RADIATIO, CENTERS FOR
DRUG REGULATION, THEN CENTER FOR COSMETICS (HERE IN COSMETICS IT INCLUDE THE HOUSEHOLD AND HAZARDOUS SUBSTANCES), PRODUCTS
REGULATION AND RESEARCH) , CHD (CENTER FOR HEALTH DEVELOPMENT), PhilHealth
 All government and private hospitals

DOH LICENSE
All DOH licensed hospitals shall be deemed automatically accredited by PhilHealth as Centers
of Safety. (Basic Participation per Philhealth Circular No. 54)
Stakeholders shall comply with the standards and requirements prescribed in the enhanced
assessment tool for licensure of hospitals posted at DOH website.

Objective

• To improve access to quality health facilities with the efficient use of limited
government resources and without compromising the quality of care
EVOLUTION OF HOSPITAL NOMENCLATURE
AO No. 70–A s. AO No. 147 s.
2002 2004
AO No. 68–A s. AO No. 2005 –
1989 YOU DO REFERRAL IF YOU CAN’T PROVIDE A 0029
PARTICULAR SERVICE
COMMUNICATION SHOULD BE HOSPITAL TO IN HERE THE FOCUS IS ON THE SEVERITY OF
HOSPITAL BUT USUALLY NURSES COORDINATED
THE PATIENTS CONDITION

Primary Infirmary Infirmary Level 1

These are primary care facilities that
provide basic health services.

First Level Primary Care Level 2

These secondary care facilities offer a
Referral Hospital Hospital broader range of services than Level 1
Secondary IT CAN CATER ORDINARY CASES hospitals. They can handle more complex
medical cases and usually have the
capacity for inpatient care, basic surgical
procedures, and specialized outpatient
services.

Tertiary Second Level Secondary Care Level 3

These tertiary care facilities provide
(NonTeaching) Referral Hospital Hospital advanced medical services and have
specialized departments for various
 medical fields. They are equipped with
more sophisticated diagnostic and
therapeutic facilities, allowing them to
handle serious and complex health
conditio

Tertiary Third Level Tertiary Care Level 4

(Teaching & Training Hospital)
(Teaching) Referral Hospital Hospital DOH Administrative Order No. 2005-0029
amending Administrative Order No. 147, s.
-RESIDENCIES, 2004
Also known as teaching and training
FELLOWSHIP, INTERNS, MEDICAL STUDENTS
hospitals, Level 4 facilities offer the
highest level of care. They are equipped
with expensive and sophisticated
diagnostic and therapeutic facilities, often
associated with medical schools for
training healthcare professionals. These
hospitals are capable of conducting
complex surgeries and providing
specialized medical treatment
Legal Basis for Defining a Hospital Per R.A. 4226 (HOSPITAL LICENSURE ACT
OF 1960) WE DEFINE HOSPITAL AS A PLACE DEVOTED TO DIAGNOSE ,TREAT PATIENTS. AND THEN CARE.

✓Section 2 - Beds or cribs or bassinets for 24 hour use or longer

- ✓Section 8- Bed space Laboratory OR, X-ray, Pharmacy, OPD, DR

Isolation Morgue
- Section 16- Classify hospitals as to- General or Special Service

Capacity
- Size or bed capacity Training or not

All 3 Sections of the Law have to be complied with to be classified as a hospital.

-normal deliveries
- pregnant women
Obgyne – more on consultations
Classification of Hospitals: According to Ownership

A. Government- created by law. May be under DOH, DND (DEPARTMENT OF NATIONAL DEFENSE) ,
DOJ , PNP, LGU ), SUCs
( DEPARTMENT OF JUSTICE) , GOCC
(LOCAL GOVERNMENT UNIT (STATE UNIVERSITIES AND COLLEGES) (GOVERNMENT OWNED

and others
AND CONTROLLED CORPORATION)

B. Private- owned, established and operated with funds through donation,

principal, investment or other means by any individual, corporation,
association or organization.
• May be a single proprietorship, partnership, corporation, cooperative,
foundation, religious, non-government organization and others
 Classification of Hospitals
According to SCOPE OF SERVICES
A. General Hospital (THERE’S NO SPECIALIST)

• Provides medical and surgical care to the sick and injured and maternity
care and shall have as minimum, the following clinical services:
medicine, pediatrics, obstetrics and gynecology, surgery and
anesthesia, emergency services, out-patient and ancillary services.
Ancillary and Support Services such as, clinical laboratory, imaging facility
and pharmacy.
B. Specialty Hospital
• Specializes in a particular disease or condition or in one type of
patient. (THEY ARE NOT ACCEPTING OUT-PATIENT)
A specialized hospital may be devoted to treatment of any of the following:
Examples of SPECIALTY HOSPITALS

Particular Disease Particular Organ(s) Particular Group of Patients

National Orthopedic
Philippine Children’s
Hospital Lung Center
- THEY SPECIALIZED IN SKELETAL OR
Medical Center
BONE DISEASES

National Center for Mental

Philippine Heart Center National Children’s Hospital
Health
Dr. Jose Fabella Memorial
San Lazaro Hospital National Kidney and
- Hospital
FOCUS ON INFECTIOUS/
CONTAGIOUS DISEASES
Transplant Institute - ITS FOCUS IS MATERNAL,
OBSTETRICS, GYNECOLOGY, PEDIATRICS
 CLASSIFICATION OF HOSPITAL ACCORDING TO FUNCTIONAL
CAPACITY
GENERAL HOSPITAL
A Level 1 hospital shall have as minimum the services stipulated under Rule V. B. 1. b. 1. of this Order, including,
but not limited to, the following:
✓ A staff of qualified medical, allied medical and administrative personnel headed by a physician duly licensed by PRC;
✓ Bed space for its authorized bed capacity in accordance with DOH Guidelines in the Planning and Design of Hospitals;
✓ An operating room with standard equipment and provision for sterilization of equipment and supplies in accordance
with:
✓ DOH Reference Plan in the Planning and Design of an Operating Room/Theater (Annex A);
✓ DOH Guidelines on Cleaning, Disinfection and Sterilization of Reusable Medical Devices in Hospital Facilities in the
Philippines (Annex B);
✓ A post-operative recovery room;
✓ Maternity facilities, consisting of ward(s), room(s), a delivery room, exclusively for maternity patients and newborns;
✓ Isolation facilities with proper procedures for the care and control of infectious and communicable diseases as well as
for the prevention of cross infections;
✓ A separate dental section/clinic;
✓ A DOH licensed secondary clinical laboratory with the
services of a consulting pathologist;
✓ A DOH licensed level 1 imaging facility with the services
of a consulting radiologist;
✓ A DOH licensed pharmacy.

CLASSIFICATION OF HOSPITAL
ACCORDING TO FUNCTIONAL CAPACITY
GENERAL HOSPITAL
A Level 2 hospital shall have as minimum, all of Level 1 capacity, including, but
not limited to, the following:
• An organized staff of qualified and competent personnel with Chief of Hospital/Medical Director
and appropriate board certified Clinical Department Heads;
• Departmentalized and equipped with the service capabilities needed to support board
certified/eligible medical specialists and other licensed physicians rendering services in the
specialties of Medicine, Pediatrics, Obstetrics and Gynecology, Surgery, their subspecialties and
ancillary services;
• Provision for general ICU for critically ill patients;
• Provision for NICU;
• Provision for HRPU;
• Provision for respiratory therapy services;
 • A DOH licensed tertiary clinical laboratory;
• A DOH licensed level 2 imaging facility with mobile x-ray inside the institution and with capability
for contrast examinations.

CLASSIFICATION OF HOSPITAL
ACCORDING TO FUNCTIONAL CAPACITY
GENERAL HOSPITAL
A Level 3 hospital shall have as minimum, all of Level 2 capacity, including, but
not limited to, the following:
• Teaching and/or training hospital with accredited residency training program for
physicians in the four (4) major specialties namely: Medicine, Pediatrics, Obstetrics and
Gynecology, and Surgery.
• Provision for physical medicine and rehabilitation unit;
• Provision for ambulatory surgical clinic;
• Provision for dialysis facility;
• Provision for blood bank;
• A DOH licensed tertiary clinical laboratory with standard equipment/reagents/supplies
necessary for the performance of histopathology examinations;
• A DOH licensed level 3 imaging facility with interventional radiology.
CLASSIFICATION OF HOSPITAL
ACCORDING TO FUNCTIONAL CAPACITY
According to Trauma Capability: Guidelines formulated by PCS (PHILIPPINE COLLEGE
OF SURGEONS) – THEY ARE FORMULATE GUIDELINES DOR TRAUMA, INJURY, BIRTH CARE infirmary

A. Trauma-Capable Facility – a DOH licensed hospital designated as a

trauma center.

B. Trauma-Receiving Facility- a DOH licensed hospital within the trauma

service area which receives trauma patients for transport to the point of
care or a trauma center.
CLASSIFICATION OF OTHER HEALTH FACILITIES
Category A: Primary Care Facility — a first-contact healthcare facility
that
offers basic services including emergency service and provision for normal
deliveries . It is subdivided into:
(LYING IN CLINICS, BIRTHING HOME)

1. With In-patient beds — a short stay facility where a short (average ofone
to three days) length of time is spent by patients before discharge.
a. Infirmary ( they are usually associated with institutions for example ; schools)
basic medical services
b. Birthing home- a homelike facility that provides maternity service
on pre-natal and post-natal care, normal spontaneous delivery, and care of
newborn babies.
2. Without beds — a facility where medicine, medical and/or dental
examination/treatment is dispensed. (clinics)
CLASSIFICATION OF OTHER HEALTH FACILITIES

Category B: Custodial Care Facility — a health facility that provides long term care,
including basic human services like food and shelter to patients with chronic or mental
illness, patients in need of rehabilitation owing substance abuse, people requiring
ongoing health and nursing care due to chronic impairments and a reduced degree of
independence in activities of daily living.
- Examples are : nursing homes, psychiatric facilities, rehabilitation centers

Category C: Diagnostic/Therapeutic Facility — a facility that examines the human

body or specimens from the human body (except laboratory for drinking water
analysis) for the diagnosis, sometimes treatment of diseases. The test covers the
preanalytical, analytical and post-analytical phases of examination.
- Examples are : imaging centers offering CT scans, MRI
 Category D: Specialized Out-Patient Facility — a facility with highly competent and
trained staff that performs highly specialized procedures on an out-patient basis.
- EXAMPLES ARE : DIALYSIS CENTERS, REHABILITATION CENTER FOR PHYSICAL THERAPY AND OCCUPATIONAL THERAPY, ONCOLOGY CENTERS

Other basis of classification hospitals in average bed size (76

beds to 252 beds per hospital).
Size Basing on Length of Stay
a. Short-term or short-stay hospitals (Stay
1. Small hospitals: Fewer than 100
less than 30 days)
beds b. Long-term or long-stay hospitals: (Stay
2. Medium hospitals: 100 to 499 beds more than 30 days)
3. Large hospitals: 500 or more beds
By teaching affiliation: a. Teaching
Location hospital
b. Non-teaching hospital
Rural hospitals are much smaller—less
than one-third the size of urban
In summary, the services and facilities provided by each level of
General Hospital is shown below:
CATEGO
RY

Level 1

Level 2

Level 3

Level 4
Therefore, Level 1 does not qualify as a hospital and must be given a different category for licensure
purposes.
 Classification of General Hospitals
OLD NEW
RE-CLASSIFY TO OTHER HEALTH
LEVEL I
FACILITIES

LEVEL 2 LEVEL 1

LEVEL 3 LEVEL 2

LEVEL 4 LEVEL 3

GENERAL LEVEL 1 LEVEL 2 LEVEL 3

Consulting Specialists in: Level 1 plus all: Level 2 plus all:

Clinical Services and Facilities Medicine Pediatrics OB-GYNE Teaching/ training with
for In-Patients Surgery Departmentalized Clinical accredited residency training
Services program in the 4 major clinical
services

Emergency and Out- patient

Respiratory Unit
Services Physical Medicine and
Rehabilitation Unit
Isolation Facilities General ICU

Surgical/ Maternity Facilities High Risk Pregnancy Unit Ambulatory Surgical Clinic

Dental Clinic NICU Dialysis Clinic

Tertiary lab with

Ancillary Services Secondary Clinical Laboratory Tertiary Clinical Laboratory
histopathology

Blood Station Blood Station Blood Bank

2nd Level X-ray with mobile

1st Level X-ray 3rd Level X-ray
unit

Pharmacy

NEW CLASSIFICATION OF OTHER HEALTH FACILITIES

A B C D

Diagnostic/ Therapeutic Specialized Out- Patient

Primary Care Facility Custodial Care Facility
Facility Facility

Dialysis Clinic (DC)

Laboratories:
•▪ Clinical Lab/ HIV
With In-patient Beds:
•▪ Blood Service
▪ Infirmary/
Psychiatric Care Facility •Facilities Ambulatory Surgical Clinic
Dispensary
•▪ Drug Test Lab (ASC)
▪ Birthing Home
•▪ NB Screening Lab
•▪ Water Lab

Without Beds: ▪ Medical

Drug Abuse Treatment and Ionizing Machines as Xray,
Outpatient Clinics In-Vitro Fertilization (IVF)
Rehabilitation Center CT scan,
▪ OFW Clinics ▪ Dental Centers
(DATRC) mammography and others
Clinics

Non-Ionizing Machines as Radiation Oncology

Sanitarium/ Leprosarium
ultrasound, MRI and others Facility

Nursing Home Nuclear Medicine Oncology Center/ Clinic

New Classification
HOSPITALS OTHER HEALTH FACILITIES

GENERAL A. Primary Care Facility

•Level 1 B. Custodial Care Facility
•Level 2
•Level 3 C. Diagnostic/ Therapeutic Facility
•(Teaching/ Training)

SPECIALTY D. Specialized Out- Patient Facility

Implementing Mechanisms

• The name of the institution shall be compatible with the functional capacity of
the health facility. All health facilities regulated by DOH applying for SEC and/or
DTI registration shall undergo clearance from BHFS.

• Every health facility shall have a duly licensed physician to oversee the clinical/
medical operations of the health facility.
PRIVATE HOSPITAL - HOSPITAL ADMINSTRATOR AND MEDICAL DIRECTOR

GOVERNMENT HOSPITALS – CHIEF OF HOSPITALS ( ADMINISTRATION AND OPERATION)

 MODEL ORGANIZATIONAL STRUCTURE
A. ORGANIZATIONAL CONFIGURATION
1. The new standards on organizational structure and staffing pattern of government hospitals took
into consideration the following factors:
• Minimum DOH Licensing Requirements and Philhealth Accreditation Requirements (
• New hospital licensing category (Level 1, Level 2, Level 3 hospitals) based on Department of
Health Administrative Order No. 2012-0012.
• Specialty Society Training Accreditation Requirements (particularly for Medical Staff)
• Distribution of Medical Staff to cover the Outpatient Department , Emergency Room and
Inpatient hospital areas; and
• Health Human Resource Master Plan

• Level 1 and Level 2 hospitals shall have four (4) basic organizational units: the Office of the
Chief of Hospital; Medical Service; Nursing Service (MOST NUMBER OF MANPOWER IN HOSPITAL); and
Hospital Operations and Patient Support Service (HOPSS). Internal management functions are
combined under one organizational unit, the HOPSS, which shall subsume both administrative
and finance services.
 • A Level 3 hospital shall be provided with an additional division-level entity, the Finance Service,
to handle accounting, budgeting, cashiering, billing and claims and cash operations. Given the
need to attain financial sustainability of said hospitals, this unit shall be tasked to improve
revenue generating capacity.
ORGANIZATIONAL CONFIGURATION The general functions of the
major organizational units are as follows:
• Office of the Chief of Hospital/ Medical Center Chief
• Shall be responsible for the overall management and administration of the hospital; formulation of policies, plans, programs
and strategies to ensure implementation of health standards for the attainment of quality health care and high standards of
clinical training for medical and allied medical personnel; and the day-to-day supervision and administration of the functional
units.
• Medical Service
• Shall be responsible for providing quality inpatient and outpatient care and high standards of clinical training for medical and
allied medical personnel and advising and assisting the chief of hospital in the formulation and implementation of policies,
plans and programs of the hospital.
• Nursing Service
• Shall be responsible for implementing nursing programs for total quality health care; providing nursing care to medical cases;
and developing, coordinating and implementing relevant training programs for nursing personnel.
- BLS ( BASIC LIFE SUPPORT)
• Hospital Operations and Patient Support Service (formerly Administrative Service)
• Shall be responsible for the provision of administrative services relating to personnel management, administrative records
management, property and supply management, general services (utility), engineering, and security.
• Finance Service
• Shall be responsible for the provision of financial services relating to budgeting, accounting, cash operations, billing and
claims ( philhealth, HMO).
• 3. Below these offices/services, sub-units are allowed depending on service capability, ancillary services, ( radtech, medtech,
pharmacy) kind and level of care and segregation of patients, and kind and variety of support functions. The hospital
administration is given the flexibility to structure/group its internal management support units in a manner deemed more
efficient and effective for the hospital’s organization and operation.
ORGANIZATION AND PERSONNEL
The hospital pharmacy should be properly organized meeting the
minimum requirements
The organization of a hospital pharmacy must satisfy the needs of the
pharmacists performing their role as the vital link in the chain of health providers
dedicated to patient care.
The hospital Pharmacy Service shall be under the general supervision of
the administrative officer or Chief of Hospital (COH); it will directly be
administered and supervised by a licensed pharmacist.
The organization serves to establish the authority relationships between
positions and to assign special tasks that achieve the pharmacy’s objectives.
The pharmacy head practices the five essentials of good management,
namely, planning, organizing, directing coordinating and controlling.
Organizational Structure
 RELATIONSHIP
The Pharmacy Service shall expect the following services from:
The Office of the Chief of Hospital
• Supports and approves all official requirements relevant to the pharmacy activities/programs.
Administrative Services
• Attends to the following financial matters:
Budget - budget requirements
Supply - actual drug procurement and turn-over of delivered drugs properly documented to the
pharmacy.
Accounting - availability of funds and replenishment of revolving fund.
Billing - report on all drugs paid by the patient based on forwarded charge slips.
Plus other personnel, housekeeping, engineering and maintenance requirements.
Medical Social Work Service
• Responsible for patient classification, and assistance for drug availability to patients.
Nursing Service
• Responsible for the patient’s drug needs and all other drug-related matters.
 RELATIONSHIP
The Pharmacy Service shall expect the following services from:
Medical Service
• Coordinates with the PTC on drug and drug-related matters.
• Provides the drug requirements of patients in coordinating efforts:
• Assistance in the preparation of the hospital formulary based on the Philippine National
Drug Formulary (PNDF) and the Generics Act of 1988.
• Assistance in the preparation of the Annual Drug Procurement Program (ADPP) and the
semi-annual drug requirement for the DOH bidding.
• Active participation and inputs on drug and drug-related matters such as Adverse Drug
Reaction (ADR), Drug Utilization Review (DUR), Infection Control, etc.
Dietary Service
• Provides referrals on request for hyper-alimentation diet and/or total parenteral nutrition.
• Resident Commission on Audit (COA) Auditor
• Responsible for auditing matters
Pharmaceutical Services expected by other hospital service components:

Chief of Hospital (COH)

• Provides an adequate supply of safe, effective and good quality drugs in appropriate dosage
forms consistent with the needs of the patients and rationalizes drug utilization in
collaboration with the medical staff.
Administrative Service
• Submits budgetary requirements
• Submits monthly report to the accountant for the reimbursement of the Maintenance and
Other Operating Expenses (MOOE) Fund of the hospital issued to charity/service patients.
• Forwards charge slip to the billing section for drug payment of patients prior to their discharge.
• Supply Office - prepares Requisition Issue Vouchers (RIVs) with the specifications, quantity arid
cost of drugs based on the Official Price Schedule with attached individual stock position sheet
of each item for the actual procurement of drugs.
Pharmaceutical Services expected by other hospital service components:
Medical Service
• Coordinates closely with the medical staff on drug and drug-related matters:
• Provides the drug requirements through the PTC.
• Prepares the final ADPP and the semestral drug requirements for bidding.
• Establishes the Hospital Drug Formulary.
• Disseminates information on other drug-related matters.
• Participates actively in committee activities as ADR, DUR, Infection Control, etc.
Nursing Service
• Provides drugs needed by patients by doctors’ orders and other related matters
that affect the Nursing Service.
Medical Social Service
• Assures availability of drugs for deserving patients.
Pharmaceutical Services expected by other hospital service components
Dietary Service
• Disseminates drug information on food-drug interaction.
FOR DIET, PARENTERAL NUTRITION (OF – ORAL FEEDING)

Medical Records Service

• Prepares monthly report on the number of prescriptions filled;
• Prepares statement of expenses on drugs/medicines.
Resident COA Auditor
• Establishes a Good Inventory Control System - such as no over and under
stocking of drugs, expired and deteriorated drugs, breakages, etc.
Services the drug requirements of personnel and the general public including
referrals to health facilities and the “Murang Gamot Project” of selected hospitals.
GENERAL QUALIFICATIONS OF A HOSPITAL PHARMACIST
PHARMACY PERSONNEL QUALIFICATION STANDARD
REQUIREMENTS
CHIEF PHARMACIST
 • B.S. Degree in Pharmacy;
• Duly licensed by law to practice pharmacy;
• M.S. in Pharmacy or its equivalent;
• With 6 years experience - 3 years supervisory work and 3 years as dispensing pharmacist, with on-thejob
training/continuing education; and
• Physically, mentally, emotionally, and morally fit to work.

SUPERVISING PHARMACIST
• B.S. Degree in Pharmacy;
• Duly licensed by law to practice pharmacy;
• With 4 years experience - with 2 years of supervisory work in a pharmacy and 2 years as dispensing
pharmacist; with at least 12 units of M.A. and on-the-job training/continuing education; and
• Physically, mentally, emotionally, and morally fit to work.
GENERAL QUALIFICATIONS OF A HOSPITAL PHARMACIST
PHARMACY PERSONNEL QUALIFICATION STANDARD
REQUIREMENTS
SENIOR PHARMACIST
• B.S. Degree in Pharmacy;
• Duly licensed by law to practice pharmacy;
• With at least three (3) years experience, 1 year on supervisory work and 2 years as
dispensing pharmacist with on-the-job training/continuing education; and
• Physically, mentally, emotionally, and morally fit to work.

STAFF PHARMACIST
• B.S. Degree in Pharmacy;
• Duly licensed by law to practice pharmacy;
• New graduate/or at least 1 year pharmacy practice, orientation with further on-the-job
training/ continuing education; and
• Physically, mentally, emotionally, and morally fit to work.
GENERAL QUALIFICATIONS OF A HOSPITAL PHARMACIST
 PHARMACY PERSONNEL QUALIFICATION STANDARD
REQUIREMENTS
PHARMACY AIDE
• Completion of at least two (2) years of college studies;
• Two (2) years experience in a pharmacy; and
• Physically, mentally, emotionally, and morally fit to work.
CLERK
• Completion of two (2) years of college studies;
• One (1) year experience in the preparation of routine office correspondence, endorsements, reports or other related
clerical work;
• Career Service (Subprofessional) Relevant Eligibility for First Level Position; and
• Physically, mentally, emotionally, and morally fit to work.
STOREKEEPER
• Completion of two (2) years of college studies;
• One (1) year experience in recording and storing of supplies;
• Career Service (Subprofessional) Relevant Eligibility for First Level Position; and
• Physically, mentally, emotionally, and morally fit to work.
STANDARD STAFFING PATTERN
Hospital Professional Personnel in Indirect Patient Care Services

• In general, units or sections needing 24 hours services will require a minimum of 5

personnel to fill the 24 hours-seven days a week schedule following the 40-hour labor law
• With present demands for a commercial pharmacy (service for outpatients as well), an extra
pharmacist for such purpose will be needed. In Dispensing Pharmacy, the ratio of
pharmacist to administrative assistant (pharmacy assistant) is: 1 pharmacist: 2
administrative assistants.
• The requirement for other allied health personnel is determined based on the time and
motion study conducted by DOH's National Center for Health Facility Development (NCHFD).
As the result of the study, the ratios of staff to bed capacity in the following units are
indicated below:
Pharmacy 1:25
Nutritionist-Dietetics 1:60
Medical Social Work 1:25
 Health Information Management 1:20
STANDARD STAFFING PATTERN

Level 1 Hospital
1. Staffing Pattern for a 25 Bed Capacity 2. Staffing Pattern for a 50 Bed Capacity
Hospital Hospital
No. of Pos. Position Title Salary Grade No. of Pos. Position Title Salary Grade
1 Pharmacist II 15 1 Pharmacist II 15

2 Pharmacist I 11
3 Pharmacist I 11

1 Administrative Aide IV 4
1 Administrative Aide IV 4

STANDARD STAFFING PATTERN

Level 2 Hospital
3Hospital . Staffing Pattern for a 75 Bed Capacity 1. Staffing Pattern for a 100 Bed Capacity
Hospital
No. of Pos. Position Title Salary Grade No. of Pos. Position Title Salary Grade

1 Pharmacist II 15 1 Pharmacist III 18

4 Pharmacist I 11 5 Pharmacist I 11
1 Administrative Aide IV 4 1 Administrative Aide IV 8

2. Staffing Pattern for a 150 Bed Capacity Hospital

No. of Pos. Position Title Salary Grade
1 Pharmacist III 18
6 Pharmacist I 11
1 Administrative Aide IV 8

STANDARD STAFFING PATTERN Level 3 Hospital (Teaching and Training)

1. Staffing Pattern for a 200 Bed
3. Staffing Pattern for a 200 Bed Capacity
Hospital
Capacity Hospital

No. of Pos. Position Title Salary Grade No. of Pos. Position Title Salary Grade

1 Pharmacist III 18 1 Pharmacist V 22

8 Pharmacist I 11 1 Pharmacist IV 20

1 Administrative Aide IV 8 6 Pharmacist II 15

12 Administrative Aide IV 8

2. Staffing Pattern for a 300 Bed Capacity Hospital

No. of Pos. Position Title Salary Grade
1 Pharmacist V 22

1 Pharmacist IV 20
10 Pharmacist II 15
20 Administrative Aide IV 8
 34 Administrative Aide IV 8
STANDARD STAFFING PATTERN The hospital is a complex organization utilizing
combination of intricate, specialized scientific
3. Staffing Pattern for a 400 Bed Capacity equipment, and functioning through a corps of trained
Hospital people educated to the problem of modern medical
No. of Pos. Position Title Salary Grade science These are all welded together in the common
1 Pharmacist V 22
purpose of restoration and maintenance of good health

1 Pharmacist IV 20
13 Pharmacist II 15
Hospital Pharmacy
The department or service in a hospital which is under
26 Administrative Aide IV 8
the direction of a professionally competent, legally
qualified pharmacist, from which all medications are
supplied to the nursing units and other services, where
4. Staffing Pattern for a 500 Bed Capacity special prescriptions are filled for patients in the
Hospital hospital, where prescriptions are filled for ambulatory
No. of Pos. Position Title Salary Grade patients and outpatients, where pharmaceuticals are
1 Pharmacist V 22
manufactured in bulk, where narcotic and other
prescribed drugs are dispensed, where injectable
2 Pharmacist IV 20 preparations should be prepared and sterilized, and
17 Pharmacist II 15 where professional supplies are often stocked and
dispensed.
Divisions Of Hospital Pharmacy Service
A. Administrative Services Division
1. Plan and coordinate departmental activities.
2. Develop policies.
3. Schedule personnel and provide supervision.
4. Coordinate administrative needs of the Pharmacy and Therapeutics Committee.
5. Supervise departmental office staff.
B. Education and Training Division
• 1. Coordinate programs of undergraduate and graduate pharmacy students.
• 2. Participate in hospital-wide educational programs involving nurses, doctors etc.
• 3. Train newly employed pharmacy department personnel
C. Pharmaceutical Research Division
• 1. Develop new formulations of drugs, especially dosage forms not commercially
available, and of research drugs.
• 2. Improve formulations of existing products.
• 3. Cooperate with the medical research staff of projects involving drugs.
Divisions Of Hospital Pharmacy Service 4. Provide drug consultation services to
staff and medical students.
D. Out-Patient Services Division E. Drug Information Services Division
1. Compound and dispense out-patient prescriptions. 1. Provide drug information on drugs
2. Inspect and control all clinic and emergency service and drug therapy to doctors,
medication stations. 3. Maintain prescription nurses, medical and nursing
records. students and the house staff.
2. Maintain the drug information center. H. Central Supply Services Division
3. Prepare the hospital's pharmacy newsletter. Develop and coordinate
4. Maintain literature files. distribution of
medical supplies and irrigating fluids.
F. Departmental Services Division
I. Assay and Quality Control Division
1. Control and dispense intravenous fluids.
1. Perform analyses on products
2. Control and dispense controlled substances.
manufactured and purchased.
3. Coordinate and control all drug delivery and 2. Develop and revise assay
distribution systems procedures.
G. Purchasing and Inventory Control 3. Assist research division in special
Division formulations.
1. Maintain drug inventory control. J. Manufacturing and Packaging Division
2. Purchase all drugs. 1. Manufacture wide variety of items in
3. Receive, store and distribute drugs. common use at the hospital.
4. Interview medical service representatives
Divisions Of Hospital Pharmacy Service
 2. Operate an overall drug packaging and prepackaging
program.
3. Undertake program in product development.
1. Centralize the procurement, storage and
4. Maintain a unit dose program.
dispensing of radioisotopes used in
K. Sterile Products Division
clinical practice.
1. Produce small volume parenteral.
2. Intravenous Admixture Division
2. Manufacture sterile ophthalmologic, irrigating solutions
3. 1. Centralize the preparation of
etc.
intravenous solution admixture. 2.
3. Prepare aseptic dilution of lyophylizal and other
Review each I.V. admixture for
"unstable" sterile injections for administration to patients.
physiochemical incompatibilities
L. Radiopharmaceutical Services division