The hospital consulting, directed to the chain of use of medicines, general medical materials and for orthosis, prosthesis and special high-cost materials (OPMEs) and stewardship of antimicrobials, aims to identify technical-administrative weaknesses in the processes involved through a detailed diagnosis through indicators, and to present customized solutions in addition to planning, training and executing corrective measures of short, medium and long term with the intent of maximizing results.

THE FOLLOWING WORKS ARE PREDOMINANT

• Identifying and solving inconsistencies in the chain of medicine use, general medical materials and OPMEs
• Implementing organizational 5S and PDCA programs
• Stock logistics
• Technical/financial integration on the sectors involved with pharmacy technologies
• Working with indicators and goals
• Structuring technical/administrative processes of the pharmaceutical sector, including clinical pharmacy and therapeutic protocols
• Implementing an antimicrobial stewardship program (fully or partially), prevailing:
• Antimicrobial consumption indicators
• Empirical therapy against most prevalent infections
• Individualized dosage by “PK/PD” and serum dosage
• Sensitivity profile of the main pathogens
• Sequential antimicrobial therapy
• Guidance of surgical antibiotic prophylaxis
• Auditing antimicrobial prescriptions providing feedback
  
  

Some results of consultations carried out in hospitals in Brazil

Management processes

• Implementation of computer-based systems integrating clinical and administrative departments
• Implementation of an achievable stock logistics
• Control of costs and profitability of pharmaceutical supplies
• Establishment of technical and financial quality indicators
• Institution of individualized dispensation of medicines
• Elaboration and implementation of treatment protocols for the main infections treated in the ICU
• Implementation of vancomycin and aminoglycosides therapy guided by serum and PK/PD measurements
• Standardization of injectable drug kits
• Dispensing and control of drugs, medical materials and special high-cost materials in surgeries
• Creation of the Comission of Pharmacy and Therapeutics
• Implementation and maintenance of the 5-S organizational project
  
  

Measurable results

Reduction in use (%)

• 49% of prophylactic cefazolin in surgeries
• 29% of meropenem, reducing daily doses, treatment time and de-escalation
• 24% of IV medications (switch to oral)
• 36% of the pump sets used in the infusion of ꞵ -Lactams antimicrobial
• 32% of linezolid, transferring to vancomycin guided by TDM
• 42% of stress ulcer prophylaxis

 
Increase in use:

• 47% of therapeutic protocols.
• >90% of surgical antibiotic prophylaxis protocols.