Strategic approach for improving the medication-use process in health systems: the high-performance pharmacy practice framework.

Purpose: A strategic approach to improving the medication-use process in health systems by using a framework for setting priorities on the basis of feasibility, the potential for financial return, and the effect on quality and safety is described.

Summary: A panel consisting of leaders in health-system pharmacy identified seven dimensions of high-performance pharmacy (HPP) framework: medication preparation and delivery, patient care services, medication safety, medication-use policy, financial performance, human resources, and education. Performance elements, which are specific policies, procedures, activities, and practices that indicate high performance and result in a financial or clinical return on investment of resources, within each dimension were identified.

Noncompliance with drug therapy for chronic obstructive pulmonary disease: a risk factor for hospitalization?

Objective: To determine if patients who were noncompliant with prescribed medications for chronic obstructive pulmonary disease (COPD) had higher rates of hospitalization.

Methods: A retrospective case-control study was performed in a tertiary-care university-affiliated Veterans Administration Health Care System setting. Subjects included 93 patients hospitalized for exacerbation of COPD and 93 controls with a diagnosis of COPD who did not require hospitalization.

An iconoclastic perspective on progress in pharmacy practice.

Progress in pharmacy practice is examined and areas for improvement are identified. Data from surveys of hospital and health system pharmacy practice from 1957 to 1994 show that the steady progress from 1974 to 1985 was not sustained over the past decade. Changing to a profession in which all practitioners provide pharmaceutical care will be difficult when practice in hospitals, where the most acutely ill patients are treated, does not meet the profession's recommended standards.