(Also refer to the general goals and objectives for PhPr 803)
The purpose of the administrative rotation is to give the doctor of pharmacy student an opportunity to acquire first-hand experience in the managerial and administrative aspects of pharmacy practice. The rotation is a six-week experience that focuses on the application of management principles in a professional practice setting.
The administrative rotation can be done at a variety of sites including hospitals, independent and chain community pharmacies, health maintenance organizations, managed care programs, third-party programs, and manufacturers.
To accommodate the needs of the student and best use the resources of the site, the content of the rotation is flexible. It is recognized that each site has its own unique strengths to share with students. At the beginning of the clerkship, the preceptor and student should jointly select objectives from the attached "menu" and from the site-specific objectives (Objectives beyond these lists can also be pursued).
It is recommended that approximately six objectives be selected, with about one week devoted to each. Again, this is variable. A schedule that covers the six-week period, with assignments and their due dates, should also be developed at this time. It is recognized that for a variety of reasons outside the student's control, not all aspects of each objective selected can be completely obtained.
In addition to any assignments made by the preceptor, the student is required to write a case study of managerial problem solving. This should include a description of the problem, the options available, the pro's and con's of each option, the alternative selected, the results (if known), and the decision-making process (e.g., participation, analysis).
At the mid-point and conclusion of the clerkship, the student will be formally evaluated. The evaluation encompasses reliability in attendance, self-initiated style, response to critique, reliability in assignments, and meeting objectives. An evaluation form is attached.
The primary source of the objectives in this document was the APhA Community Pharmacy Residency Program: Programmatic Essentials. For purposes here, the objectives have been divided into the categories of:
- Personnel Management
- Purchasing and Inventory Control
- Financial Management
- Marketing and Strategic Planning
- Clinical Oriented Administrative Functions
- Operations- At the completion of this rotation, the student should be able to:
1. Establish and/or implement comprehensive, written policies and procedures for the entire scope of operations, and regularly assess the effectiveness of all policies and procedures.
2. Establish, develop, and/or refine an efficient system of drug distribution.
3. Establish, develop, and/or refine computer applications to pharmacy operations (e.g., patient profiles, drug utilization, compliance monitoring, purchasing, inventory control, billing, financial reporting).
4. Develop an organizational chart for pharmacy operations (intra or interdepartmental).
5. Assure that pharmacy operations comply strictly with all applicable accreditation standards as well as local, state, and federal laws and regulations.
6. Establish and maintain an appropriate pharmacy security system designed to prevent theft and pilferage.
- Personnel Management- At the completion of this rotation, the student should be able to:
1. Establish and administer personnel policies and procedures that assure productivity and accountability.
2. Prepare and/or refine written job descriptions.
3. Recruit, interview, select, hire and terminate personnel.
4. Develop programs to train personnel in carrying out responsibilities effectively and efficiently.
5. Supervise and evaluate job performance of personnel.
6. Schedule work hours of pharmacy personnel.
7. Administer wage, salary, and benefit programs.
- Purchasing and Inventory Control - At the completion of this rotation, the student should be able to:
1. Establish drug quality specifications for drugs to be purchased.
2. Establish and maintain purchasing policies with consideration given to quality of drug supply, reliability of vendor, cost, delivery schedule, ordering process, alternate sources of supply, and mechanisms for regular assessment of purchasing policies.
3. Prepare and effectively review both routine and emergency purchase orders.
4. Establish and maintain a system of inventory control that maximizes turnover while assuring adequate inventory levels.
5. Explain the strengths and weaknesses of purchasing groups and contract buying pharmaceuticals.
6. Establish and maintain a system for properly storing a wide range of pharmaceutical dosage forms.
- Financial Management -At the completion of this rotation, the student should be able to:
1. Establish and maintain a pricing structure for products and services based on sound management principles that allow for a fair and reasonable financial return on investment.
2. Establish and maintain an ongoing cost, pricing, and reimbursement analysis program by using effective accounting systems to allow for development of pricing and reimbursement strategies.
3. Establish, maintain, monitor, and reconcile accounts receivable from third-party payers.
4. Establish, control, review, and evaluate an operations budget.
5. Prepare, review, and analyze periodic reports of fiscal performance related to budget projections (e.g., profit and loss statements, balance sheets, cash flow statements, turnover, payroll, gross margin, and net profit).
- Marketing and Strategic Planning - At the completion of this rotation, the student should be able to:
1. Plan for effective advertising, merchandising, and marketing of goods and services.
2. Plan or assist in the planning of the layout and physical facilities of a pharmacy that will maximize sales, profitability, and employee efficiency and productivity.
3.Implement new and innovative services in nontraditional areas of pharmacy practice such as home health care (e.g., parenteral nutrition, parenteral therapies, durable medical equipment,
4. Develop mechanisms for predicting and measuring the costs and benefits associated with both new and existing services.
5. Participate in contract negotiations and contract development for services provided to other entities (e.g., long-term care facilities, health maintenance organizations, and prisons).
6. Conduct an environmental analysis, describing trends in customers (markets), competition, and relevant macroeconomic factors.
7. Develop and implement a marketing plan (covering the marketing mix of product, price, place, and promotion) for a product-line or service.
- Clinically Oriented Administrative Functions - At the completion of this rotation the student should be able to:
1. Total quality management/continuous quality improvement
- Define quality and quality improvement methods.
- Identify pharmacy internal and external customers.
- Plan or assist in quality measurement surveys.
- Use statistical process techniques to identify common cause variation and recommend corrective alternatives.
- Establish and direct process action teams to improve various pharmacy processes.
- Develop strategies to increase teamwork and empower employees.
2. Drug Usage Evaluation
- Review and revise the policies and procedures and mission statement for the scope of DUE operations.
- Review existing marketing materials and develop a marketing program promoting the DUE program that is acceptable for distribution to potential clients. The program should be applicable to health care professionals (physicians, nurses, and administrators) as well as health benefits managers.
- Actively participate in literature analysis and lead discussions on specific clinical topics.
- Discuss proposal development of prospective drug use evaluation programs and pharmacy cognitive services.
- Incorporate appropriate outcomes assessment criteria in the reporting on a drug utilization review.
- Define cost effective, cost-benefit, cost-minimization, and cost utility and how these concepts relate to drug utilization review.
- Establish specific DUE criteria to be used in the following practice settings: an ambulatory environment, community hospital, and a psychiatric acute care hospital.
- Develop a protocol to evaluate a DUE program. The protocol will include at least the literature background analysis, methodology, budget, and data analysis.
- Participate in the DUE peer review program and provide written comments and recommendations on patients medication profiles as needed.
- Prepare at least one client report summarizing DUE activities and interventions. The report will be acceptable for distribution to the client.
- Summarize DUE data with a data base management program regarding the types of problems detected by an ambulatory DUE program.
3. Publication of Drug Product Formulary
- Define the utility of a drug product formulary.
- Organize information for the purpose of publishing a drug product formulary.
- Explain the process of drug product review for inclusion in a formulary listing.
- Provide useful information to be included in the publication of a drug product formulary.
- Review and edit draft copy of a formulary publication.
4. Pharmacy and Therapeutics Committee Functions
- Define the purpose of a pharmacy and therapeutics committee.
- Define the membership of a pharmacy and therapeutics committee.
- Participate in a therapeutic review process, adverse drug reaction reporting, or drug utilization evaluation reporting.
- Disseminate information to providers and the pharmacy and therapeutics committee.