[Critical elements for the extension of working hours in an in-hospital Pharmacy Department]

INTRODUCTION: Individualised drug dispensation facilitates compliance with validated prescriptions, the application of criteria for rational use, the prevention and solution of drug-related problems. However, its complexity entails a risk for errors in procedure design and implementation, which renders quality assessment and continual improvement mandatory. OBJECTIVE: To analyse critical elements justifying the extension of working hours in an in-hospital Pharmacy Department, and other improvements within the pharmaco-therapeutic process through activity and hospital care quality indicators. METHODS: This is an observational, analytic study wherein seven activity and quality indicators were established. Regarding the latter, a qualitative and quantitative cause analysis was performed. The study period was from April to June 2001. RESULTS: Monthly average of hospital admissions was 641+/-50; of these, 40% take place during the evening-night hours, and 559+/-197 scheduled surgical procedures were performed. A total of 1,499+/-158 monthly prescriptions were processed, representing 36,790+/-733 doses. Eighteen percent of daily prescriptions were received at 14-15 h, and 21% were offset 24 h with respect to prescription date. During the evening-night period the on-call supervisor visited the Pharmacy 4 times a day to dispense 10 drugs corresponding to 4 patients; 47.7% of cases took place at 15-21 h, patient admissions and pharmacy dispensation errors being the main reason for visits. CONCLUSIONS: Extending the hours of operation in a Pharmacy Department would improve pharmaco-therapeutic patient care, but this should be associated with an integral improvement of doctor and both ward and pharmacy nursing staff work procedures.