Institutional Pharmacy

Practice
Chapter 1

Institutional Pharmacy Practice

Provision of distributional and clinical pharmacy services at a broad range of
institutional settings including hospitals, long-term care, hospice, correctional
facilities and others

Integrated Health Systems

Integrate all care under the umbrella of a central organization
Often include:
inpatient/acute care
primary care/outpatient care
long term care
home care

Hospitals
Traditionally focused on providing care to acutely ill patients that require
constant care by a team of highly skilled professionals

Biggest component of institutional practice

Differentiated by these factors:
Location
Size
Specialization

Types of Hospitals
COMMUNITY HOSPITAL
Most common type
Deal with an assortment of diseases and injury
Treat a broad group of medical conditions

SPECIALIZED HOSPITAL
Particular disease
Specific organ
Type of patient

Types of Hospitals
TEACHING HOSPITAL
Training future health-care professionals

PROFIT HOSPITAL
Owned by corporation or private investors

NON-PROFIT HOSPITAL
do not seek a return on investment for owners

Types of Hospitals
GOVERNMENT HOSPITAL
Owned or heavily supported by federal , state, country or other governmental entities

Evolution of Hospital Nomenclature

AO no. 68-A s.
1989
Primary

AO no. 70-A s.
2002
Infirmary

AO no. 147 s.
2004
Infirmary

AO no. 20050029
Level 1

A.O. no. 20120012

Other health
facilities

Secondary

1st level Referral

Hospital

Primary Care
Hospital

Level 2

Level 1

Tertiary (NonTeaching)

2nd level
Referral Hospital

Secondary
Care Hospital

Level 3

Level 2

Tertiary
(Teaching)

3rd level Referral

Hospital

Tertiary Care
Hospital

Level 4

Level 3

Legal Basis for Defining Hospital

(R.A. 4226)
Beds/cribs for 24 hours use or longer (sec 2)
Must have Minimum Standards and Construction of a Hospital (sec 8)
Bed space

OPD

Laboratory

DR

OR

Isolation

X-ray

Morgue

Pharmacy

Legal Basis for Defining Hospital

(R.A. 4226)
Classify hospitals as to: (sec. 16)
General or Special

Service capacity
Size or bed capacity
Training or not

NEW Classification of Hospitals and other

Facilities
A.O. no. 2012 0012
DOH Bureau of Health Facilities and Services

CLASSIFICATION OF HOSPITALS
According to Ownership:
A. Government
Created by law
Maybe under DOH, DND, DOJ, PNP, LGU, SUCs, GOCC and others

B. Private
Single proprietorship, Partnership, Corporation, Cooperative, Foundation, Religious,
NGO

CLASSIFICATION OF HOSPITALS
According to Functional capacity:
A. General Hospital

Clinical services
Emergency services
Outpatient services
Ancillary and Support services

CLASSIFICATION OF HOSPITALS
According to Functional capacity:
B. Specialty Hospital
Particular disease e.g. National Orthopedic Hospital, National
Center for Mental Health, San Lazaro Hospital
Particular organ(s) Lung Center, Phil. Heart Center, NKTI
Particular Group of Patients PCMC, NCH, DJFMH

CLASSIFICATION OF HOSPITALS
According to Trauma Capability
A. Trauma Capable Facility
DOH licensed hospital designated as a trauma center

B. Trauma Receiving Facility

Receives trauma patients for transport to trauma center

New Classification of General Hospitals

ANCILLARY
SERVICES

CLINICAL SERVICES AND FACILITIES FOR

IN-PATIENTS

LEVEL 1

LEVEL 2
Level 1 plus all:

LEVEL 3
Level 2 plus all:

Departmentalized Clinical
Services

Teaching/training with
Accredited residency
program in the 4 major
clinical services

Emergency and OPD

Respiratory Unit

Physical Medicine and

Rehabilitation unit

Isolation Facilities

General ICU

Ambulatory Surgical Clinic

Surgical/ Maternity
Facilities
Dental Clinic

High Risk Pregnancy Unit

Dialysis Clinic

NICU

Secondary Clinical
Laboratory
Blood Station
1st level X-ray

Tertiary Clinical Laboratory

Tertiary lab with

histopathology
Blood bank

Medicine
Pediatrics
OB-GYNE
Surgery

Pharmacy

Blood station
2nd level X-ray with mobile
unit

3rd level X-ray

New Classification of other Health Facilities

A
Primary Care Facility
With In-patient Beds:

Infirmary

Birthing Home

Without Beds:

Medical Out-patient
clinics

OFW clinics

Dental clinics

B
Custodial Care Facility
Psychiatry Care Facility

C
Diagnostic/ Therapeutic
Facility

D
Specialized Out-Patient
Facility

Laboratories:

Clinical Lab/HIV

Blood service
facilities

Drug Test lab

NBS

Water lab

Dialysis Clinic

Drug Abuse Treatment

and Rehabilitation Center
(DATRC)

Ionizing machines:
X-ray, CT scan,
Mammography, etc

In-Vitro Fertilization
Centers

Sanitarium/ Leprosarium

Non-Ionizing machines:
Ultrasound, MRI and
others

Radiation Oncology
Facility

Nursing Home

Nuclear medicine

Oncology center/ clinic

Ambulatory Surgical Clinic