Comparison of pharmacy services at critical access hospitals and other rural and small hospitals in Illinois

• Published in: American journal of health-system pharmacy 2013-08, Vol.70 (15), p.1313-1321
• Main Authors: CRAWFORD, Stephanie Y, SCHUMOCK, Glen T, URSAN, Julia D, WALTON, Surrey M, DONNELLY, Andrew J
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Comparative analysis; Demographic aspects; Drug Compounding - methods; General aspects; General pharmacology; Health Care Surveys; Hospitals, Rural - organization & administration; Hospitals, Rural - statistics & numerical data; Humans; Illinois; Medical sciences; Miscellaneous; Pharmaceutical Preparations - standards; Pharmaceutical services; Pharmacists - organization & administration; Pharmacists - statistics & numerical data; Pharmacology. Drug treatments; Pharmacy Service, Hospital - organization & administration; Pharmacy Service, Hospital - statistics & numerical data; Planification. Prevention (methods). Intervention. Evaluation; Professional Role; Public health. Hygiene; Public health. Hygiene-occupational medicine; Sterilization; Technology, Pharmaceutical - methods; Technology, Pharmaceutical - statistics & numerical data
• ISSN: 1079-2082; 1535-2900
• DOI: 10.2146/ajhp120442

The results of a survey evaluating pharmacy services and technology use at critical access hospitals (CAHs) and other small and rural hospitals in Illinois are reported. A mail survey was sent to pharmacy directors at 86 CAHs and other rural and small hospitals in Illinois not designated as CAHs. Independent sample t tests and chi-square statistics were used to compare CAHs and non-CAHs in areas such as pharmacy services, staffing, use of technology, and sterile compounding practices. The survey response rate was 46.5%, with usable data received from 40 hospitals. Analysis of the survey data indicated that hospitals designated as CAHs were significantly less likely than non-CAHs to have automatic therapeutic interchange policies (p = 0.012) and more likely to conduct pharmacist-provided educational programs on medication costs for physicians and other health care personnel (p = 0.037). Relative to non-CAHs, CAHs were significantly less likely to have automated dispensing cabinets (p = 0.016) and to out-source the preparation of sterile products to offsite vendors (p = 0.012); pharmacy directors at CAHs were less likely to report the use of technology for remote medication order entry or review (p = 0.038). At both types of facilities, pharmacists typically have both distributive and clinical responsibilities, and patient-specific clinical pharmacy services (e.g., patient education or counseling, other drug therapy monitoring, medication reconciliation, pharmacokinetic consultations) are offered at similar frequencies. A survey of pharmacy departments at small and rural hospitals in Illinois determined that there were more similarities than differences between CAHs and non-CAHs. The survey indicated significant differences in dispensing processes, the use of technology and drug policy tools, and outsourcing of sterile product preparation.