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Faculty of Pharmacy, University of Sydney; Royal North Shore Hospital, Northern Sydney Central Coast Health; and Society of Hospital Pharmacists of Australia (NSW Branch), New South Wales, Australia
Published Online, June 27, 2006. www.theannals.com, DOI 10.1345/aph.1H054
Audience: As expressed by Brown, this text is "designed for both student and practitioner." Certainly for students, it provides a comprehensive introduction to institutional pharmacy practice. Likewise, for those who are new to the US healthcare system, for example, internationally trained pharmacists and/or those reentering the workforce after a period of absence, the text is a useful resource, bringing together a diversity of topics in a reasonably accessible format. For senior managerial practitioners, it provides a comprehensive summary of issues and an opportunity to reflect on the evolution and current status of practice, thereby setting the scene for future directions and serving as a tool to prompt a review of institutional systems and processes.
Purpose: This book is designed as an "all-in-one" handbook that practitioners may consult at any time for clarification of issues pertaining to institutional pharmacy practice. Practitioners choosing to add this "go-to" text to their library should recognize that it will serve primarily as a "what-is?" rather than a "how-to" text; it is not a comprehensive step-by-step instruction manual for institutional practice.
Content: The authors present a very diverse, and relatively complete, spectrum of topics, ranging from clinical review systems to drug distribution systems to information systems, as well as funding and economic issues, accreditation and standards, policy development, practice models, and contemporary practice themes (eg, medication safety), to name just a handful. The information is presented as a compendium of 40 distinct chapters, with each discussing a pertinent theme (ie, 40 specific topics are covered). The chapters are essentially reviews, integrating such sources as relevant literature, position statements, and legislation as appropriate.
Preceding the major topics is an overview of the history and evolution of pharmacy practice in the US, describing major turning points and highlighting significant advances over a relatively short period, as well as practitioners who have forged the development of the profession. Readers will find this historical reflection both compelling and motivating. The introduction leads into, and provides a context for, the current issues and challenges shaping contemporary pharmacy practice, which will be appreciated by even the most senior pharmacists.
In terms of ease of information access, the table of contents instantly offers the practitioner a list of diverse topics, highlighting the breadth of coverage by the authors. Unfortunately, there does not appear to be a deliberate order to the sequence of chapters following from the introductory chapters, disturbing the flow of the information from cover to cover. For example, Chapter 6 (Evolution of the Management of US Health Care) seems out of place between chapters on Long-Term Care and Home Care.
Chapters are well written and easy to comprehend, although they are written in varying styles, with some being textually more complex, reflecting the contributions of a multitude of authors. Readers may find some chapters easier to read than others, depending on their style preferences.
Usability: Each chapter reflects the knowledge and expertise of the numerous authors and is well referenced against pertinent literature, position statements, policies, and/or guidelines. Given that the text is produced by the American Society of Health-System Pharmacists (ASHP), there is much reference to, and perhaps in some instances reliance upon, ASHP-developed documents. Overall, most chapters have managed to integrate history, management, and clinical practice issues quite well; an example of this is Chapter 8 (Hospice and Palliative Care). Due to the number of topics, the text is relatively large for a handbook, but not prohibitively so. At a cost of $90 for ASHP members and $113 for nonmembers, the book seems reasonably priced.
Highlights: A welcome feature is the inclusion of definitions of key terms preceding the main text of individual chapters, to assist novices, and extensive reference lists at the conclusion of each chapter, providing resources for those wishing to probe further. It also offers, in some sections, examples of tools and documentation systems/forms/templates that have been developed by individual institutions or organizations, which practitioners will find helpful. For example, Chapter 3 (Pharmacy Staff) provides an appendix containing examples of staffing structures and position descriptions, while Chapter 16 (Therapeutic Plans) offers a sample set of documents and recording forms.
Limitations: Most practitioners will look to this resource for highly practical guidance and, frustratingly, this book stops short of offering this in some sections. The inclusion of more examples and templates to guide the application and implementation of practice models and systems would be welcome. For example, Chapter 11 could offer some examples of competency-based assessment procedures or tools.
The text would be enhanced by some cross-referencing between chapters, as there is some overlap and repetition, and perhaps reorganization of the topics to provide a more logical flow and connection between them.
Other aspects of institutional practice that could perhaps be addressed more explicitly in this text include research as a core activity, addressing the identification of research priorities, processes in undertaking research, the application of research findings to practice, and the interface of research with academia; training and credentialing of preceptors; and communication issues, covering both workplace relations and patient/client education, as well as the impact of cultural diversity.
Comparison with Previous Edition or Version: In keeping with advances and developments, and reflecting the increasing utilization of new technologies in practice, the current edition includes dedicated chapters on evidence-based medicine, collaborative practice models, and interprofessional teams, as well as prescriber order-entry system pharmacy, automation in practice, electronic medical records, information systems, and the company Informatic.
Comparison with Other Related Books or Products: Unlike other texts that tend to focus on and isolate the legislative, managerial, or clinical aspects of practice, this handbook broadly addresses and integrates all of these issues within the text; in this respect it is a fairly unique resource. Readers will need to consult specific references for more indepth coverage of issues.
Reviewer's Summary: Overall, this is a handy reference providing a broad overview of institutional pharmacy practice in the US, which will be appreciated by pharmacy practitioners at all levels, in any setting. While the context for the information is the US healthcare setting, international readers will also be able to draw parallels with, and translate key issues to, their local practices.
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