Planning and Budgeting in Pharmacy Services - Paper Example

Introduction

Most hospitals have demonstrated growth and current most of the big hospital and even organization have developed several branches to promote new opportunity and to bring solution to the existing challenges.Chicago home healthcare service is recognized as a state-licensed home health agency that is broadly trusted to offer quality, reliable and professional home health care to residents of Dupage, Cook, Lake countries and Will.Chicago Home health care service will be identified for its unwavering commitment and an outstanding leadership in providing excellence in healthcare and fostering and promoting comprehensive community wellness in the central region of Chicago. The mission is "To care for the sick and promote the health of the residents in the community while witnessing the Christian values of dignity, respect, compassion and caring for all person". With the mission statement focusing on the greater motivation and the value of the organization, "Chicago Home Healthcare work diligently and swiftly with our clients as well as their physicians and their family to build a plan of care that is designed in enhancing security and independence while having our major focus on continuity of care".

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The vision of the Chicago Home Health Care Service ensures access to medical care that is responsive to ever-changing conditions in the healthcare needs of the community. It major vision is to promote wellness and prevention of illness in the community and be recognized as a resource for health education. The values of the organization involve respect, caring, stewardship, compassion, and love. With the core values of the organization being to offer kind treatment to every individual in the organization and to facilitate the general improvement of people's lives.

In meeting the health demand of individuals around the region, the hospital has one of the best pharmacy service department in the region and one facility is holding up to three cost centers which entail the hospital pharmacy that caters for teaching and the research unit of the pharmacy department, college pharmacy that offers sophisticated, distributive, clinical and technological services. On the other hand, the ambulatory care pharmacy offers one of the comprehensive pharmaceutical care of the greatest quality and ensure cost-effective and rational use of medications so as to achieve an optimal result. Lastly the Chicago health Antithrombosis which forms the center team of clinical pharmacist and its nationally identified for its experts in monitoring of patients who are receiving the anticoagulants for example the low molecular weight Heparins and other antithrombotic agents. The Chicago home service pharmacy department has in the recorded a productivity index of up to 97% to 124% for a period of five months due to demand for pharmaceutical products and lowered service units the general financial officer as a result of the demand in budget.

On the other hand, the inadequate pharmacist has also been a challenge in this sector and the end result to bring a solution to such a problem is to offer the administration a chance to introduce a new pharmacist. Notably, some of the serious initiative being to facilitate the improvement of patient experience by providing easier access to services, introduce new payment methods and to measure and report quality performance consistently. Focusing on some of the administrative meetings that have taken place in the past, a tremendous emphasis on financial reporting by the head of finance in issue related to the new health insurance exchange, the fee for service to pay value model and bundled payments. This is a greater concern for all of the hospital's managers as they are in the process and they are working hard with challenges in the previous budget in their units and have the obligation of depending on the significance of cost control.

Unit Culture

Technically, there exist four areas which include the hospital pharmacy, ambulatory care Pharmacy, Chicago Home Service Health Antithrombosis center, and the Chicago Home Healthcare personalized medicine program which are being managed under on pharmacy manager. Considering the general performance of all the units, they demonstrated a great culture of serious focus, goal-oriented drive, teamwork with a serious emphasis which has been placed on safe patient-centered care. Corporate strategic initiatives translate into these areas regarding cost control are monitoring patient census and staff accordingly. Some of the challenges recorded involved, clinical pharmacists, in collaboration with referring physicians, focus on maximizing the benefits and reducing adverse effects, however one of the greater challenges is that most of the pharmacist was not scanning patient supplies, which resulted in loss of revenue, supplies were still being stocked to their expected however, what transpired was that the operating budget did not reflect on the overall supply.

From what was recorded in the following month, it is important to consider the fact that the operating statement showed revenue in supplies this was motivating and workers were given a bonus. Basically, the population of those who came for medication was very high. This hence made the Hospital pharmacy to be very crowded building a serious line that was very depressing to work with. According to Suleiman, (2015), what normally transpires is that pharmacist who is stressed and is carrying out their duties in challenging environments in most cases will be less satisfied with their work and as result, the end result will be serious turnover rates. This hence results in the silo many managers in most cases go through the serious challenge where there exists a lack of proper communication between the hospital administrators and the pharmacist. In this case, it is then very clear that pharmacist feels that no manager in the administrative positions care that they are the existing shortage of pharmacist and that due to the shortage, they are being forced to work overtime. Technically this is a great challenge for managers as a result of restrictions due to new constraints. However, as a result of the crisis, the departmental budget had to put an increase on the general patient load but not an additional pharmacist; this, in the long run, makes it very challenging for one to follow the values and the mission of the company on patient-centered care.

In order to combat this silo, the administrative leadership team can meet with the management to raise the arising challenge and even to discuss on how being supportive to pharmacist staffs is important by letting them share their issues. Through this, it would be one of the best strategies that will work as an excellent rebuilder and confidence reassurance so that the pharmacist will stay and not threaten to resign. According to Walker, (2018), hospital administrators should conduct an open that is consistent with the hospital staff, which will facilitate better understanding for the pharmacist. In matters that are dealing with policies and general wellbeing, it is imperative that all leaders consult with nurses when unit issues arise or asking for their input regarding revision of goal setting and policy making, this hence provides a keen sense of ownership within the company and not just their unit.

Considering the current situation, the hospital financial state is on the decline as a result of a greater number of uninsured patient admissions. This is a greater challenge that can lead to poor prescription and even wastage in the long run. However, the key is through creating an assurance for the managers and pharmacist being consistently available. As reported by Wachsmuth, Jowett & Harwood,(2018), it is important for managers to be approachable and visible so that they play an important role in fostering and bridging various ideas on how solutions for problems can be achieved.

Patient Population, Delivery and Reimbursement Method

According to Feinglass, Norman, Golden, Muramatsu,& Cornwell, (2018), it is important to note that the population in the zip code, where the Chicago healthcare service hospitals' location has over 30,000 residents with children as well as elderly under the age of five listed as the two highest inhabitants. Considering the greater population, what has transpired is that there exist the greater level of Hispanic patients since the hospital is existing in the region where the Hispanic race population percentage is significantly above the state's average and this area has over forty percent income below poverty level.The Hospital Pharmacy Services is the pharmacy service department of Chicago Home Healthcare service has been recording a continuous population of 1000-2,200 attendance on a weekly basis with the delivery of care being case method or total patient care. In all four areas, one pharmacist takes care of one patient during the patients stay in that specific area. If multiple pharmacists were to interchange patients, serious mistakes could take place or some orders will be missed as a result of a break in the continuity of care and communication breakdown. According to Dennison, (2018), the basis of total patient care is patient-centered, comprehensive and continuous so when there is a change in the patients' status, it's recognized more easily by the pharmacist.

In the current health treatment, it is important to consider that the reimbursement for health care services has a great dependency on patients having health insurance, which is in place to reduce the overall exposure to the risk of loss, by having the insurer assume the risk. Basically, as reported by Centers for Medicare & Medicaid Services, (2014), the Centers for Medicaid and Medicare Services uses various strategies for reimbursement to home health services, inpatient rehabilitation facilities, inpatient psychiatric facilities, hospital outpatient, long-term care hospitals, skilled nursing facilities, and hospice. Notably, Fee for Service reimbursement is a healthcare payment approach in which those who are offer reimbursement, gain payment for each service rendered and the fee is the set amount for the service in which a specific payment is made for every service rendered. The second party, the provider of the healthcare service and charges a fee for each type of service, where the health insurance provides a better means of paying for it. Examples of fee-for-service reimbursement are self-pay and managed care.

Current Staffing and Skill Mix

Considering the current staffing, it is important to note that the unit and the hospital in general pay the staffs offer payment to staff in all units. However, with the new healthcare reform focusing on cost reduction, this company has put in place serious pressure on the pharmacist leader to increase efficiency while considering improvement and patient outcomes in various departments. Value-based trends regarding hospital reimbursements will benefit from pharmacist support, but they must understand the significance of reducing expenditures in their unit.

According to Dubois, & Singh (2009), flexible approach and dynamic leadership approach to role delegation are some of the major keys to maximize the skills mix in community mix and helping to reduce the workload pressure. In this case, it is important to make use of individuals in the right role in the handling of the task at hand, with consideration provided to all the members of the team.

Stakeholders

Since everything is everything is revolving around the patient's care, the current stakeholders are considered to be patients and the providers. Much emphasis is being inserted by the executive team for pharmacist to leaders to increase their competitiveness, effectiveness and efficiency...