13. Hosp Pharmacy -Th' Committee - My Experience - 1
My experience with Pharmacy Therapeutic Committee
It was the latter part of 1976 while I was serving as Graduate Pharmacist in Government Wenlock hospital, Mangalore, Karnataka I first proposed for the constitution of a hospital therapeutic committee. Till such time, there were no hospital level therapeutic committee and there was only one State Therapeutic committee.
Dr H Sadananda Ballal was the District Surgeon cum Supdt of the hospital. It was not easy to get through as the need was not felt to be very much imminent by the administration and clinicians who were used to functioning with out any such committee. But I used to come across many issues in the minds of doctors that could be discussed and resolved in such a meeting.
Dr Ballal called me for a discussion on my proposal and I told him that there are several issues like: non-availability of drugs desired by them, inefficacy of certain drugs supplied in the stores and from my manufacturing pharmacy. Since these were quite popular complaints it didn’t warrant any verification.
My proposal was approved and a Therapeutic committee took its birth and met for the first time in the Government Wenlock Hospital Mangalore.
During my tenure only one meeting could be held. But, sorry to say the committee has reported to have ceased to function after I left the hospital on transfer.
I had sent the agenda and agenda notes also with the meeting notice which made the very first meeting bit more purposeful and meaning full. The agenda were;
1. Quality of drugs’ supplied in the hospital
2. Requirement of any other drugs
3. Any other issues with the permission of the chair
The doctors found the meeting bit amusing and the subject bit interesting. (This was off the record remark of the H o D medicine Dr K P Ganeshan at the beginning of the meeting)
The first meeting was attended by Dr H S Ballal – who himself was a surgeon, *Resident Medical Officer, Dr K P Ganeshan, H o D Medicine, Dr Thimmaiah, ENT Surgeon, Dr Surendranath Shetty, *Anaesthesiologist (*Sorry, I don’t remember the name), etc.
The meeting started with all sweet talks and appreciation by one and all.
The main comment was on the efficacy of Lignocaine injection supplied from my pharmacy and inadequacy of dressing materials from the stores.
I was delighted when a controversy started over the Lignocaine injection of my pharmacy.
The ENT surgeon expressed unhappiness over the efficacy of pharmacy Lignocaine injection compared to market product. But the Dental surgeon said he was very much satisfied and desired to have some vials with adrenaline.
Now it was my turn to intervene.
I appreciated with due regards the opinion of both and said I would study the issue and revert with the solution in the next meeting and requested their permission to visit their department to understand the problem.
The Dr Thimmaiah, ENT surgeon said he would permit if I agree to have a cup of tea in the department. [Such was the cordial relationship of pharmacy with the doctors.]
The meeting ended in a very happy cordial note to meet again.
Action taken;
The next few days I spent some time ENT department and observed that his problem was true. Since I couldn’t do much to improve the Lignocaine injection, I arranged to supply the same to ENT department from the supply contractor. All were happy there.
As regards, the addition of adrenaline to Lignocaine injection, since my pharmacy was having very limited facility to handle such an admixture, I pleaded my inability to make and supply Lignocaine with Adrenaline.
Bottom line;
I had the satisfaction of having succeeded in constituting a hospital Therapeutic committee.
The discussion prevented negative propaganda on the products of pharmacy
Resolved the bandage issue.
- Bhagavan P S's blog
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Comments
kranthikumar
Wed, 01/13/2010 - 07:18
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Good to know about it sir.
Sir,
Its great !!! I am glad to know about it. SO far i read about therapeutic commitee but now through ur experience i can feel it.
Thank you.
Regards Kranthi http://www.pharmainfo.net/kranthikumar/biography
Bhagavan P S
Sat, 01/16/2010 - 07:25
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Thank you. My blog topics
Thank you.
My blog topics have interlinked issues.
I advise you to go through all to have a comprehensive view.
I invite you to read the reply to Ms Vijaya ratna.
good wishes
Bhagavan.P.S The pic; Explaining pharmacists role to the public in a public fair 'ADHAMYA CHETANA' http://www.pharmainfo.net/bhagavan-p-s/biography
vijayaratna
Wed, 01/13/2010 - 11:03
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P&T Committee can be very effective
Sir
Very happy to know about your experience. My personal feeling is also that if such committees can be formed in hospitals with the pharmacist playing an active role, the type of pharmaceutical care will surely improve. I visited a few hospitals but did not find P&T committees anywhere, not even in the hospitals with good pharmacy practices. Some hospitals have formularies and thats all. Most hospitals do not give any involvement to the pharmacist in purchase of medicines also.
We must congratulate you for taking such an initiative.
Vijaya Ratna
http://www.pharmainfo.net/vijayaratna/biography
Bhagavan P S
Sat, 01/16/2010 - 07:11
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Thank yo madam Vijaya
Thank you Ms Vijaya ratna,
Your input is good.
You are right.
The present pharmacists with due exceptions cannot take on the clinical issues.
Forget about Hospital Pharmacy, they are not comfortable even in the trading pharmacy. The Course is not giving them the appropriate in put in an appropriate way.
The very purpose of writing my blog with my little knowledge and experience is that one day our policy makers and educationists would open their eyes to understand ground reality and come out with a pragmatic curriculum and our teachers would refine their teaching which can make our pharmacists a true pharmacist worth the name and status.
Sorry to say with due regards, the present books, teaching and the teaching curriculum have distanced the pharmacist from the reality and practice and system in vogue.
Day - before - Yesterday, One of my student Mr Raghukiran, a lecturer in Governemnt College of Pharmacy, Bangalore came to my house to greet me on the occasion of Shankranti.
While talking, he narated a new method he adopted in one of his class to teach hospital pharmnacy.
He had given a brief introduction to the topic "Internal drug distribution" in the hospital.
He called one of his friend a Hospital Pharmacist on his mobile, asked him whether he was free to talk, explained that he was in a class, has students before him and would put him on the speaker phone and requested him to explain step-by-step how the system is working in his hospital.
He turned on the speaker of his mobile phone and as the Hospital pharmacist was explaining, he went on writing the flow map on the board and the students listened to the hospital system LIVE on line. Students could interact and seek clarification.
He said all students appreciated, were very happy and this interaction made his teaching very easy and effective.
I congratulated him
This incident clearly shows that students are eager to learn and know. What is needed is innovative ideas in the teachers to teach and a curriculum that matches with the reality.
But unfortunately, we are taking students on an imaginary ride to the hospital that doesn't exist as given in the books.
"IT IS HIGH TIME THAT WE BRING THE PHARMACIST ON TO THE MAIN STREAM AND AVOID TEACHING MYTHS THAN REALITIES"
Good wishes
Bhagavan.P.S The pic; Explaining pharmacists role to the public in a public fair 'ADHAMYA CHETANA' http://www.pharmainfo.net/bhagavan-p-s/biography
Harish
Tue, 01/19/2010 - 16:44
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AVOID TEACHING MYTHS THAN
being a student i've got to agree to that sir, most of what is in the current syllabus no more holds good in practicality (rather than saying the syllabus is outdated i'd prefer to put it as we are yet to update ourselves)
for example we still study nikethamide! for its former actions with no mentions about its current banned status!
Mr. Raghukiran's ideas are really innovative (it is with immense pleasure i call myself his student).
Bhagavan P S
Thu, 01/21/2010 - 09:31
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AVOID TEACHING MYTHS THAN
Thank you Mr harish,
You are right, it is high timwe that we stopped teaching myths.
The curriculum of Primary school, Engineering, Nursing, Medical, Law etc are all changing fast with the world. They study what is existing around them.
Likewise, the Pharmacy curriculum also needs dynamism and should be sensitive to the world around us.
Even in pharmaceutics students are taught manual pharmacy where as the industry is on the mechanized and e-program format.
Hope, your feelings are heard.
I appreciate your gesture towards Mr Raghukiran
Good wishes
Bhagavan.P.S The pic; Explaining pharmacists role to the public in a public fair 'ADHAMYA CHETANA' http://www.pharmainfo.net/bhagavan-p-s/biography
bhupendra
Wed, 01/13/2010 - 13:02
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Pharmacy Therapeutic Committee
It can not function well in the absence of a pharmacist actively a member of it. A pharmacist may be a person who is a PhD or like that.
I agree with Ratna Madam that pharmacists also given involvement in purchase of medicines in hospitals. The reason is that many times most of the medicines are wasted just because they have no user. In dispensary medicines are supplied which are either used in OT or in large hospitals on prescription of an expert. Since most of dispensaries not have specialist their is wastage of medicines. This can be overcome by inviting requirement from various hospitals and dispensaries then only medicines be purchased according to demand.
Bhagavan P S
Sat, 01/16/2010 - 07:09
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Thank you for the input. In
Thank you for the input.
In pharmacy we too have certain well demarcated departments.
Drugs selection: Therapeutic committee recommendation through the administrator
Indent from end user - from the clinics
Demand analysis statement from the pharmacist.
Contract fixation: clinical - Pharma - administration
warehousing: Design, facility, stocks. SOP
Procurement: Indent - Purchase Order - Receipt - payment
The subject in this blog is therapeutic committee.
I love to have your comments on the Therapeutic Committee.
Good wishes
Bhagavan.P.S The pic; Explaining pharmacists role to the public in a public fair 'ADHAMYA CHETANA' http://www.pharmainfo.net/bhagavan-p-s/biography
vijayaratna
Sat, 01/16/2010 - 07:57
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Pharmacist has a big role in a hospital
Dear sir
Thank You for your reply. I appreciate the innovative idea of Mr.Raghukiran. Yes, students are always very eager to learn. I want to tell everyone some things which we have been doing since more than 8 years. We take our III B.Pharm students on a visit to a very well run hospital, The Visakha Steel General Hospital. I give them a lot of information before I take them there. There the different people in the hospital; doctors, pharmacists, dentists, physiotherapists, nurses, other staff show them around and explain everything in detail. This hospital has 13 big rooms for storage of drugs. Drugs are stored as per WHO categorisation of drugs and as per their guidelines. Nearly 40 pharmacists are working here and till recently one madam with M.Pharm used to be the chief of this unit. Now the chief is a very friendly and efficient doctor.
Total online system is there for dispensing, purchase and inventory control. Everyone is very friendly. The budget of the hospital on drugs alone runs into crores annually. Our College has a very friendly relationship with this hospital and for our NPW celebration we invited the doctor in charge of this drug store as chief guest. He was all praise for the way our students were learning things when we were in their hospital.
When my students answer questions like; what is inpatient dispensing or how is a central sterile supply unit run; I can see that they are writing on the basis of their observation rather than on the basis of a text book.
But even here there are some points which I observed. There is no P&T committee. A P&T committee will surely bring out efficient policies with respect to purchase, inventory control and maintenance of different units in the hospital. At present there are very good practises in these areas and the authorities are taking inputs from working pharmacists before they take decisions; thats all.P& T committee should naturally consist of some doctors, administrators , chief nurse and chief pharmacist. The general feeling is that purchase and inventory control have more management principles than pharmacy principles.
The central sterile supply unit ( a very big unit consisting of horizontal autoclaves, gas sterilisers, glove washers, dryers ) is under the charge of a doctor and trained technicians do the job of actual daily operations. I do believe that a trained B.pharm graduate with good knowledge of principles and methods of sterilisation can do a better job.
In addition to pharmacy issues when students make visits to hospitals and industries they also learn leadership, communication and team playing skills.
vijaya Ratna
http://www.pharmainfo.net/vijayaratna/biography
Bhagavan P S
Sat, 01/16/2010 - 10:48
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Thank you for the input. I
Thank you for the input.
My apologies to you. Now I saw your profile and came to know that you are Dr Vijayaratna - Gold medalist.
Congrats to you.
I am glad you are following my blogs.
I very much appreciate your method of teaching.
I liked it when you said 'students write on the basis of their observation'. Its excellent.
Hope you have gone through my previous blog on PTC.
I dbeg to differ from you on the need of administrator in PTC.
Non-technical persons should be among invitees when needed.
As regards teaching, the college should dedicate one or two A/c rooms with a central table and a speaker phone and a good system with internet for online conference.
It should be available to any class to go on on line conference.
Even one can go on International call or e-phone
Again, regarding CSSD, I strongly feel that it is nurses domain and our knowledge and exposure to various dressings is too less if not nil.
I dont know who introduced this which is not under pharmacy anywhere.
Even if it it is there under pharmacy, may be pharmacist is only a figure head.
We should downplay CSSD in our curriculum.
Thank you again
Bhagavan.P.S The pic; Explaining pharmacists role to the public in a public fair 'ADHAMYA CHETANA' http://www.pharmainfo.net/bhagavan-p-s/biography
vijayaratna
Sat, 01/16/2010 - 12:18
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pharmacist in CSSD
Sir
I am honoured by your response and I appreciate your opinions on Pharmacist's role in CSSD. I am indeed following your blogs on PTC, on quality and the one titled as "who will bell the cat?" ( http://www.pharmainfo.net/og/pharmindia/who-should-bell-cat). They are very interesting.
Thank You, Sir
Vijaya Ratna
http://www.pharmainfo.net/vijayaratna/biography
SUPRIYA VAVILAPALLI
Sun, 01/17/2010 - 11:51
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Dear sir, thank u for sharing
Dear sir,
thank u for sharing your experience with us.............
Supriya vavilapalli
THE COGNITIVE MOLECULES
http://www.pharmainfo.net/supriya-vavilapalliBhagavan P S
Mon, 01/18/2010 - 07:57
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Thank you Supriya, Good
Thank you Supriya,
Good wishes
Bhagavan.P.S The pic; Explaining pharmacists role to the public in a public fair 'ADHAMYA CHETANA' http://www.pharmainfo.net/bhagavan-p-s/biography
srigayatri
Thu, 01/28/2010 - 15:14
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Dear sir, thanku for sharing your experience
Dear sir,
Thanku for sharing your experience with us.I have seen your other blogs regarding PTC.
gayatri
Bhagavan P S
Mon, 02/15/2010 - 11:33
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Thank you
Bhagavan.P.S The pic; Explaining pharmacists role to the public in a public fair 'ADHAMYA CHETANA' http://www.pharmainfo.net/bhagavan-p-s/biography
meghnadatta
Mon, 02/15/2010 - 08:43
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Thank you for sharing this
Bhagavan P S
Mon, 02/15/2010 - 11:32
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thank you
Bhagavan.P.S The pic; Explaining pharmacists role to the public in a public fair 'ADHAMYA CHETANA' http://www.pharmainfo.net/bhagavan-p-s/biography