Christine Clark PhD FRPharmS FCPP(Hon)
Innovation and experimentation are the hallmarks of progressive hospital pharmacy practice – prescribing pharmacists and high-tech equipment are examples of critical innovations
There has rarely been a better time for innovation and experimentation – we are getting to grips with a wide range of monoclonal antibodies, new forms of drug delivery are being developed and marketed and high-tech solutions are coming into hospital pharmacies. These developments both demand and support developments in hospital pharmacy services. Fittingly, the European Association of Hospital Pharmacists has chosen to open its 2014 congress with a keynote address on scientific and societal drivers for innovation in hospital pharmacy.
One of the key innovations in drugs is the explosion in the numbers of monoclonal antibodies. These are usually relatively expensive products and hospitals may impose restrictions regarding their use. In addition, monoclonal antibodies may require special handling so as not to damage the drug or pose risks to operators. These factors mean that they can be challenging products to manage effectively.
Another key innovation is the use of high-tech equipment in hospital pharmacies. This means that new types of hospital pharmacy service can be developed – often services that could not be contemplated in the paper era. For example, one hospital in Spain has a completely paperless system for prescribing and dispensing of medicines. Electronic, barcode-driven systems allow pharmacy assistants to replenish a drug cart with unit doses in a fraction of the time that it used to take staff to fill carts using clunky, paper-based systems.
High-tech solutions now include compounding robots that marry industrial standards of precision and accuracy with healthcare requirements for flexibility, speed and economy. This is a radical change indeed.
All of this means that new approaches are needed in the design and operation of hospital pharmacy services. Prescribing pharmacists in the UK are no longer a novelty – in many institutions they are fast becoming part of the basic fabric of hospital services. This is because the benefits that they deliver have been clearly quantified and recognised. One example is pharmacists working in cardiology who have reduced the time taken to discharge patients by ensuring that discharge prescriptions are free from errors and can be dispensed on time. Delays in discharges because of prescribing errors and time-consuming, clumsy discharge procedures are a common cause of complaint.
Another area where the benefits of prescribing pharmacists is being felt is in preoperative assessment clinics. Surgical procedures today are carefully timetabled and monitored. It is essential that patients present themselves in a surgery-ready state at the appointed time. Part of this involves discontinuing certain medicines that could increase the risks of surgery or anaesthesia. Although preoperative assessment clinics have been in place in the UK for some time, experience suggests that the advice given about medicines has often been confused, inaccurate and unhelpful. If ever a situation cried out for the application of pharmaceutical expertise, it was this. It is encouraging to see that this is an area that is now undergoing rapid development in the UK. Patients will be relieved.
These are only a few of the innovations that are marking the progress of hospital pharmacy. Many more will be explained, demonstrated and debated at the forthcoming EAHP congress. We feel confident the congress will provide inspiration and encouragement, together with the opportunity to meet like-minded colleagues.
We hope to see you there!