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chapter 13 and 14
| Term | Definition |
|---|---|
| accounting | a standard method for reporting the expenses, revenues and accumulation of assets, and other financial results |
| acuity | variations in the healthcare needs of a patient based on their severity of illness |
| assets | real, intangible and financial items that are owned by the health system |
| balance sheet | a financial statement which lists the wealth of the institution at a specific point of time |
| budget | a plan for future expenses and revenue, typically over a 12-month period |
| capital budget | part of the budget typically comprised of items that cost more than a fixed threshold and have a useful life greater than 5 years |
| capital expense | costs of a physical improvement or a piece of equipment that will provide benefit over a number of years. they are typically significant in size and scope |
| case mix index (CMI) | an indicator of the average diagnosis related group (DRG) weight for all patients at an institution |
| case rate | a negotiated payment that is based on a diagnosis-related group, a per diem (daily) amount, or other benchmark method to determine the hospital's payment |
| chief executive officer (CEO) | highest ranking executive in a health system, in charge of the total management and making the major corporate decisions |
| chief financial officer (CFO) | a corporate officer primarily responsible for managing the financial risks of a corporation |
| diagnosis related group (DRG) | a system to classify hospital cases into one of approximately 500 groups, expected to have similar hospital resource use |
| direct expense | expenses that are incurred by the pharmacy to deliver services and products |
| double entry bookkeeping | bookkeeping technique of entering a transaction on both sides of the balance sheet to keep income and expenses balanced |
| equity (net worth) | net of assets and liabilities |
| expense | a payment made by the health system to others for value received |
| external benchmarking | a process of measuring costs, services and practices and comparing them to the organization's peers or to industry leaders |
| fixed expense | a category of direct expense that does not vary significantly in the short-term with the volume of activity |
| general ledger | a detailed record of each financial transaction of the hospital |
| income statement | a statement that lists the revenue, profit, and expense of the institution over a period of time |
| indirect expense | payments for services that support the pharmacy but are not directly paid by the pharmacy |
| internal benchmarking | the process of measuring costs, services and practices against the organization's prior performanct |
| liabilities | the debts the hospital owes to creditors, loans, and bonds issued |
| operating budget | part of the budget that represents a forecast of the daily expenses required to operate the pharmacy |
| return on investment (ROI) or return on equity (ROE) | a mathematical model that measures how effectively funds invested in the firm by its owners or stockholders have been used |
| revenue | money received for products or services provided to customers |
| time and motion study | a review of the activities and resources required to produce a good or service. it is used to determine the resources necessary to complete a task or set of tasks and can be the basis to set goals for improvement or change |
| variable expense | a category of direct expense that varies in the short- term with the level of activity |
| variance | the difference between the budgeted amount and the actual amount spent for a period, typically a month or for the fiscal year to date |
| volume budget | the number of admissions, patient days, CMI, outpatient visits, emergency department visits, and other activities. it is prepared by the CFO and is the basis for budget calculations |
| work volumes | work units and paid hours describe this. it may include rx filled, orders processed, doses dispensed or a combination of these |
| ante area (anteroom) | ISO class 8 or better air quality area where personnel perform hand hygiene, and garbing procedures, staging of components, order entry, compounded sterile preparation (CSP) labeling and other high particulate-generating activities |
| aseptic technique | methods used to manipulate manufacturer-supplied sterile products so that they remain sterile as compounded sterile preparations |
| biological safety cabinet (BSC) | a primary engineering control device that is a ventilated cabinet for CSPs, personnel, product and environmental protection |
| buffer area (or room) | area where the PEC is physically located |
| clean room (or buffer room) | room in which the concentration of air borne particles is controlled to meed a specified airborne particulate cleanliness class |
| cold storage conditions (refrigerator) | 2-8C (36-46F) |
| components | individual ingredients, containers and closures that are used to compound sterile preparations |
| compounded sterile preparation (CSP) | a dose or doses of medication prescribed for a patient that must be prepared for administration and is sterile |
| compounding aseptic containment isolator (CACI) | PEC that provides worker protection from exposure to undesirable levels of airborne drug throughout compounding and material transfer processes and to provide an aseptic environment for compounding sterile preparations |
| compounding aseptic isolator (CAI) | PEC that is a form of isolator for compounding pharmaceutical ingredients or preparations. designed to maintain an aseptic compounding environment throughout compounding and manufacturing transfer process |
| critical site | a location that includes any component or fluid pathway surfaces, openings exposed and at risk of direct contact with air, moisture or touch contamination |
| direct compounding are (DCA) | critical area within ISO class 5 PEC where critical sites are exposed to unidirectional HEPA-filtered air |
| first air | air exiting HEPA filter in a unidirectional air stream that is essentially particle free |
| garb | clothing worn by personnel during compounding of sterile preparations to minimize particulates being shed from body and clothing into the buffer room and PEC |
| hazardous drugs | studies in animals or humans indicate that exposure to them has potential for causing cancer, developmental or reproductive toxicity, or harm to organs |
| laminar air flow workbench (LAFW) | PEC that is a controlled environment created by HEPA to retain airborne particles and microorganisms |
| media-fill test | test which qualifies aseptic technique of compounding personnel or processes and to ensure that the processes used are able to produce sterile product without microbial contamination |
| primary engineering control (PEC) | device or room that provides ISO class 5 environment for exposure of critical sites when compounding CSPs |
| pyrogens (bacterial endotoxins) | metabolic products of living microorganisms, or the dead microorganisms causing a pyretic response upon injection |
| low risk | transfer, measuring and mixing manipulations using nmt 3 commercially manufactured packages of sterile products an nmt 2 entries into any one sterile container or package of sterile product or administration container/device to prepare CSP |
| medium risk | multiple individual or small doses of sterile products are combined to prepare a CSP that will be administered to multiple patients or one patient on multiple occasions |
| high risk | contains nonsterile ingredients... |
| secondary engineering controls | ante are and buffer area |
| standard operating procedures (SOPs) | set of instructions or steps someone follows to complete a job safely with no adverse impact on the environment and optimizes operational and production requirements |
| USP Chapter 797 pharmaceutical compounding- sterile preparations | pharmacy-related general chapter in USP-NF |
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