this presentation is based on the organisation and structure of hospital and hospital pharmacy including various layout design anf pharmacist requirement according to number of beds and patients and the role and responsibilities of hospital pharmacist .

1. Definition ,classification and
organisational structure of
hospital pharmacy
Presented by - Arbeena shakir
Presented to -Dr. Abdul k najmi sir

2. Introduction :
Hospital pharmacy is one of the most important department among several departments of a hospital.
● Hospital pharmacy may be defined as that department of the hospital which deals with procurement,
storage, compounding, dispensing, manufacturing, testing, packaging and distribution of drugs
● It is also concerned with education and research in pharmaceutical services. A hospital pharmacy is
controlled by a professionally competent and a qualified pharmacist.
● It is also concerned with education and research in pharmaceutical services. A hospital pharmacy is
controlled by a professionally competent and a qualified pharmacist.

3. Classification of hospital
Hospital is an institution of community health organization comprised of dedicated staff consisting of
physicians, surgeons, and a team of technical staff. Hospitals can provide the facilities for the prevention,
diagnosis, and treatment, rehabilitation as well as providing health education and research facilities.
As per the WHO expert committee of 1963, Hospital is a residential establishment, which strives to provide
short-term and long-term medical care facilities comprised of diagnostic, therapeutic, and rehabilitation
services for the suspected patient who is suffering from disease or injury.
As per the WHO expert committee of 1956, Hospital is an essential part of a social and medical organization
that can provide the services for the complete healthcare facilities which include; both curative and
preventive measures. Hospital is also able to provide services to the outpatient.
Hospital is a center for health education and training to health care workers and a center for biomedical and
social research

4. 1. Objectives:
1. General Hospitals
2. Special Hospitals
3. Teaching cum Research Hospitals
2. Administration, Ownership, Control, or Financial Income:
1. Governmental or public Hospitals
2. Non-governmental or private Hospitals
3. Semi government Hospitals
4. Voluntary Agency Hospitals
3. Bed Capacity:
1. Small Hospitals, which can accommodate and provide the facility up to 100 beds.
2. Medium Hospitals, which can accommodate and provide the facility for more than 100 while
less than 300 beds.
3. Large Hospitals, which can accommodate and provide the facility for more than 300 beds.

5. 4. Type of care:
1. Primary Care Hospitals
2. Secondary Care Hospitals
3. Tertiary Care Hospitals
5. System of Medicine:
1. Allopathic Hospitals
2. Ayurvedic Hospitals
3. Homeopathic Hospitals
4. Unani Hospitals
5. Hospitals of other systems of medicine
6. Region dependant:
1. Regional Hospitals
2. Upazilha Health Complex
3. District Hospitals
4. Union Health and Family Welfare Centres
5. Community Clinics

6. 11. As per WHO Classification:
1. Regional Hospitals
2. Intermediate/ District Hospitals
3. Rural Hospitals
Classification based on clinical and non clinical
basis :
General Hospitals: The purpose of general hospitals meant to provide a wide range of various categories of
healthcare facilities in limited numbers. The general hospital provides health care services to various kinds
of diseases for both sexes to cover all ages. Such hospitals provide facilities for general medical, ENT,
surgical, pediatrics, obstetrics and gynecology, etc. while general hospitals are devoid of super-specialty
medical care facilities.
Special Hospitals: Special hospitals have limited services to a particular condition such as; maternity,
pediatrics, geriatric, orthopedics, cardiac, diabetic, oncology, etc

7. Teaching cum Research Hospitals: Such type of hospital is attached with research institute such as;
medical college/nursing college/dental college or Pharmacy College. The rationale behind the attachment
of such type of educational institution is to provide medical care education and research facilities for
budding research students. For example; Christian Medical College Vellore, PGIMER Chandigarh, AIIMS,
Seth G.S. Medical College Mumbai, etc.
Governmental or Public Hospitals: Such types of hospitals are owned and controlled by the government.
These hospitals provide free-of-cost medical care services to particular patients/ at a very low cost
compared to others. The government hospitals are owned by the Ministry of Health, The University, the
Municipal Corporation, or other government corporations and sectors.
Such a type of hospital receives government funding for the organization and maintenance of the hospital.
Examples: AIIMS, Tata memorial hospital Mumbai, Ram Manohar Lohiya hospital New Delhi, Lokmanya Tilak
Municipal general hospital Mumbai, K.E.M Hospital Mumbai, etc.
Private Hospitals: Private hospitals are owned and controlled by an individual or group of physicians or
citizens or by a private organization. The medical care facilities which are provided by such hospitals are
comparatively costly.

8. Classification of Hospital-based on Level of Care :
Primary Care Hospitals: Primary care hospitals provide the services of the day-to-day healthcare facilities
by health care practitioners. In such hospitals, the health care provider act as the principal and main point
of contactors for continuing care of the patient and may co-ordinate other specialists for the care of the
patient if need. This type of hospital provides mostly basic health care facilities and consider as a gateway
to receive more specialty care facilities for example: Upazilha Health Complex.
Secondary Health Care: This type of hospital provides the first level of recommendation services which are
more complicated and beyond the scope and capacity of the primary level. This level is allocated to
provide some specialist care services mostly in Internal Medicine, General Surgery, Obstetrics and
Gynaecology, and Paediatrics. Such level of a hospital usually provides 50-200 bedded capacity.
Tertiary Level: Such a level of hospitals deals to provide highly specialized care services at regional or
central-level hospitals. Like teaching hospitals, super-specialized hospitals like; Cancer hospitals, Chest
hospitals, Infectious Disease hospitals, and Mental Disease hospitals are also included in this level of care.

9. Classification of Hospital as per WHO (Expert Committee 1957) :
1. Regional Hospitals: Provide a complex range of treatment and highly specialized services. Serve a larger
area than local hospitals. For example: Government Medical College Hospitals.
2. Intermediate/District Hospitals: District hospital typically is the major health care facility in their locality.
3. Rural Hospitals: These are remote hospitals with a small number of beds and limited service capacity. It
should have 20-100 beds. For example: Upazilha Health Centre.

10. Organizational Structure of Hospital :

11. Board of Trustees/Governing Board:
● The “board of trustees,” controls the hospital in the belief of the community health care and has
obligatory duty to protect the resources of the hospital through efficient operation.
● The guardians or trustees are accountable for founding the hospital’s mission and launching its
regulations and strategic policies.
● Trustees appoint the administrative leader called Chief Executive Officer (CEO) for the hospital and
delegate the hospital’s daily procedures and budgeting.
Executive Administration:
● The chief executive officer (CEO) reports to the board of trustees and delivers leadership services
for the implementation of the strategic plan, goals, and decisions established by the board of
trustees.
● The CEO also symbolizes the hospital to the community and the external environment for its growth.
● The CEO should also coordinate effectively with the hospital’s staff.
● The CEO is also responsible to participate in the establishment of hospital policies and procedures
as well as involves in the performing of public relations duties.

12. Informational Services:
There are various departments under informational services to perform the following duties,
responsibilities and provide the information:
● Admissions-related information of patients which includes full information and history of patients.
● Billing and Collection: There is a separate department that provides the responsibilities for billing the
service provided.
● Medical Records: These are responsible for maintaining the medical record of all patients.
● Computer Information Systems: In this, the personnel is responsible for maintenance of computer
and hospital network.
● Health Education: The personnel involved in these services are responsible for health education to
staff and patients.
● Human Resources: The personnel involved in this service is responsible for recruiting employees and
looking towards to benefits of employees.

13. Therapeutic Services:
Provides treatment to patients which include following departments:
● Physical Therapy: Associated with various treatments to improve large muscle mobility.
● Occupational Therapy: In this, the treatment goal is to help the patient to regain fine motor skills.
● Speech/ Language Pathology/therapy- It is associated with identifying, evaluating, and providing
treatment for speech/language disorders.
Diagnostic Services
Determines the cause(s) of illness or injury includes:
● Medical Laboratory – dealing with studies on body tissues.
● Medical Imaging – dealing with providing the services related to radiology, MRI, CT, Ultra Sound.
● Emergency Medicine – dealing with providing the services related to emergency diagnoses and
treatment.

14. Hospital Pharmacy Organization Structure :
The proper structure involves a two-step process:
● The pharmacy manager identifies a relatively standard organizational design that most closely fits the
pharmacy’s needs. The design is molded to match with unique requirements of the pharmacy and
hospital administrator.
● The size and nature of a pharmacy department’s management staff will depend on the number of
personnel in the department and the scope of services delivered.
● Small pharmacies tend to have much simpler organizational structures, this is usually generally
understood and no problems arise (for example: the pharmacy in primary health center).
● Large pharmacies with assistant chief pharmacists, supervisors, and unprofessional personnel have
complex organizational structures. Therefore, the authority must be delegated by the chief
pharmacist.

15. Layout of hospital pharmacy :

18. Staff Required in Hospital Pharmacy :
A staff requirement in the hospital pharmacy depends upon the strength of patients available in the hospital
wards or hospital premises. Based on the strength, the following table shows the requirement of staff i.e.
pharmacists in the hospital pharmacy department

19. FLOOR SPACE REQUIREMENTS :
• 250 sq. feet is the minimum required area for any sized hospital. 10 sq. feet per bed in 100 bedded
hospital. Floors of pharmacy should be smooth, easily washable and acid resistant.
• In manufacturing sections, drains should be provided, walls should be smooth, painted in light color.
Wooden cabinets are laminated. Fluorescent lamps are placed above prescription counter. Counter for
Bunsen burner are also required.

21. Role and Responsibilities of a Hospital Pharmacist :
Hospital and Therapeutic Committee: The pharmacist is an important member of the hospital and
therapeutic committee. A pharmacist usually comes second in command, after a physician in the
committee. Pharmacists work toward maximizing and maintaining rational drug use.
Dispensing to IPD/OPD: Before dispensing a drug, the pharmacist must make sure about the correct
prescription of the drug and its validity with regards to diagnosis and treatment. Pharmacists should also
check for any modification concerning the dose regimen. A pharmacist is responsible for the distribution of
drugs within the ward and he is coordinating with nurses. A pharmacist also supervises a steady supply of
drugs as per their needs. IPD/OPD pharmacist works together with inventory, drug distribution in-charge,
and physicians.
Drug Distribution: Pharmacist has a major role in supervising regarding proper distribution of drugs across
inventory, pharmacy, floor pharmacy, ward pharmacy, IPD, OPD, etc. to avoid ambiguities or any other
failures. A pharmacist also supervises the purchase orders, manages logs of material transfer across
departments, and maintains smooth functioning of drug distribution across the hospital.

22. Purchasing, Inventory Control, and Budget: Hospital pharmacist plays an important role in purchasing drug
account. There are varieties of products with similar characteristics in such cases pharmacist has to choose
the best few from a variety of products. The pharmacist has to take balancing and rational decisions
considering the economy, health, and end-user service. A pharmacist has to play a role in budgeting
pharmacy. The role also includes paperwork and clerical jobs.
Controlled Substances, Procurement, and Distribution: Hospitals procure controlled substances in large
volumes thus supervising this unit by the pharmacist has crucial. For the procurement of controlled
substances, there is required complete legal paperwork and the pharmacist is authorized by law for
procurement. Without the consent of a pharmacist, the hospital cannot procure the same. A pharmacist has
also a responsibility to regulate the use of such substances on hospital premises because such substances
are very likely to misuse.
Manufacturing Bulk and Sterile Product: Large hospitals manufacture their bulk drugs to save cost and
allow a steady supply of commonly used drugs, for example: Paracetamol, Ranitidine, Saline solution,
Dextrose solution, etc. In such a hospital, the manufacturing plant or unit is segregated into several
departments like manufacturing, packaging, labeling, QA, etc. A pharmacist has to supervise the activities
of manufacturing as well as have a responsibility to control them.

23. Functions of hospital pharmacist :
• To provide & evaluate pharmaceutical services and thereby supporting the medical staff, with due
consideration of the objectives and policies of the hospital.
• To draw a plan for hospital administration and to evolve responsibilities of each category of personnal
involving pharmaceutical services like assistant pharmacist, storekeeper, nursing staff etc.
• To establish liaison between administrative authorities and medical doctors who will order medicines and
ancillary products in the hospital.
• To estimate the requirements of the department and enforce the policies and procedures of the
recruitment of adequate and competent staff.
• To develop and maintain an effective system of clinical and administrative records and reports.
• To participate in and adhere to the financial plan of the operation for the hospital.
• To estimate the needs for facilities, supplies and equipment and to see that there is proper control of
inventory, stocks, dispensing and manufacturing of the medicaments (if carried out in hospital).
• To initiate, utilize and participate in research projects designed for the improvement of a patient care and
of other administrative and hospital services.
• To participate and adhere to the safety programs of the hospital.
• To participate and/or facilities all educational programmes which include student experiences in the
department.

24. Thank you………