Accounting & Financial Mgmt in the Hospital

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Mar 21, 2019

Pharmacy managers are held accountable for the financial performance of a pharmacy, or perhaps even share in the accountability of even larger units, such as the case with a hospital. While pharmacy managers in the chain pharmacy setting will likely be comparing profit-and-loss (P&L) statements with desired outcomes established by upper management, and independent community pharmacists are performing ratio analyses compared with industry averages, hospital pharmacy directors are expected to manage unit of the institution that is as very costly by upper management. There are so many potential cost drivers, starting with the inventory, but also costs of medication procurement, preparation, drug delivery throughout various nurses stations/wards, and administration of the drug to the patient. Hospital pharmacy directors are expected to be cognizant of these myriad cost drivers and be constantly on the lookout for effective strategies to reduce costs, be it through inventory or human capital.

Berlana et al conducted an assessment of various costs, time, and errors in preparation of parenteral nutrition (PN) using two different types of nutrition bags.1 They found that the use of multi-chamber bags resulted in a cost savings of $8.50 per PN order. The time to prepare the multi-chamber bag was an average 38 minutes shorter, and there was also a statistically significant reduction in errors using those same multi-chamber bags.

The results of this study demonstrated a clear advantage in changing materials used routinely in practice. The results of such comparisons will not always be that clear cut, so pharmacy directors must be able to weigh the advantages and disadvantages of various materials, technologies, delivery systems, drug lists, and other resources to present to upper administration in the hospital system. Even prior to that, directors and pharmacists aspiring to be managers in the health system setting must be keen enough to firstly identify opportunities such as the one referenced here to promote cost-savings strategies that do not compromise patient care.

Additional information about Financial Reports can be found in Pharmacy Management: Essentials for All Practice Settings, 4e. If you or your institution subscribes to AccessPharmacy, use or create your MyAccess Profile to sign-in to Pharmacy Management: Essentials for All Practice Settings, 4e. If your institution does not provide access, ask your medical librarian about subscribing.

1Berlana D, Almendral MA, Abad MR, Fernandez A, et al. Cost, time, and error assessment during preparation of parenteral nutrition: Multichamber bags versus hospital-compounded bags.  J Parenter Enteral Nutr. 2018; doi: 10.1002/jpen.1436.

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Shane Desselle

Professor of Social and Behavioral Pharmacy, Touro University California


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Shane Desselle 3 months ago

What skills do you require further to be a successful hospital pharmacy manager?