Medication Management: Perceptions and Opinions of Canadian Hospital Executives
Bibliographic record
Abstract
ABSTRACT Background: Issues relating to access to new medications, medication safety, and the quality of medication use are important to many Canadian hospital executives and managers. Objective: To obtain the opinions of hospital executives and managers about medication management issues. Methods: A survey instrument was developed and pilot-tested with input from key informant interviews and the Canadian College of Health Service Executives (CCHSE). The survey was sent by e-mail and regular mail to a randomized stratified sample from the CCHSE membership of 250 middle managers and 250 executives at the CEO or vice-president level. The responses to the survey questions and underlying themes from respondents’ comments were analyzed using multivariate statistical techniques and content analysis. The results of these analyses are reported in relation to respondents’ demographic characteristics. Results: In total, 272 (56.1%) of the 485 surveys delivered were completed and returned. The respondents reported that changes in physician prescribing habits constituted the most important factor influencing demand for pharmaceuticals. The pharmacy department of the respondent’s organization was listed as the top source of information about medications, and clinical practice guidelines and disease management programs were chosen as the top 2 methods to optimize the use of pharmaceuticals. Respondents considered appropriateness of drug use, medication errors, and proper drug utilization as the drugrelated issues with the highest perceived importance. About 58% of respondents felt that their organizations were getting value for the money spent on drugs. Conclusions: This study provided insight into the perceptions of Canadian hospital executives and managers related to one of the most important issues that they face today—management of pharmaceuticals. There was remarkable consistency in responses across the demographic variables included in the survey. Further work is needed to determine the type of education related to medication management that executives and managers need, suitable methods for providing that education, and the career stages at which it is appropriate to do so. RESUME Historique : Les problemes lies a l’acces aux nouveaux medicaments, a l’innocuite des medicaments et a la qualite de l’emploi des medicaments sont importants aux yeux des dirigeants et des cadres d’hopitaux canadiens. Objectif : Obtenir l’opinion de dirigeants et de cadres d’hopitaux sur les problemes de gestion des medicaments. Methodes : Un outil de sondage a ete mis au point et mis a l’essai par l’entrevue d’informateurs cles et aupres du College canadien des directeurs de services de sante (CCDSS). Le sondage a ete envoye par courriel et par la poste a un echantillon stratifie aleatoire des membres du CCDSS compose de 250 cadres intermediaires et de 250 cadres superieurs occupant un poste de directeur general ou de vice-president. Les reponses aux questions du sondage et les themes sous-jacents aux commentaires des repondants ont ete analyses par des techniques statistiques multivariees et l’analyse de contenu. Les resultats de ces analyses sont presentes par rapport aux caracteristiques demographiques des repondants. Resultats : En tout, 272 (56,1 %) des 485 sondages envoyes ont ete remplis et retournes. Les repondants ont declare que les changements des habitudes de prescription des medecins constituaient le facteur le plus important qui influence la demande de medicaments. Les repondants ont mis « Le service de pharmacie de votre etablissement » en tete de liste des sources d’information sur les medicaments, alors que les guides de pratique clinique et les programmes de gestion therapeutique ont ete choisis comme les deux principales methodes pour optimiser l’utilisation des medicaments. Les repondants ont identifie la pertinence de l’utilisation des medicaments, les erreurs de medication et l’emploi rationnel des medicaments comme les problemes lies a la pharmacotherapie ayant la plus haute importance percue. Environ 58 % des repondants ont estime que leur etablissement obtenait un bon rapport cout des medicaments-efficience. Conclusions : Cette etude a permis mettre en relief les perceptions des dirigeants et des cadres des etablissements de sante canadiens relativement a l’un des enjeux les plus importants de leur milieu aujourd’hui, la gestion des medicaments. Les reponses etaient remarquablement homogenes pour toutes les variables demographiques utilisees.D’autres travaux du genre sont necessaires afin de determiner le type de formation en gestion des medicaments necessaire aux dirigeants et aux cadres, ainsi que les methodes et le moment de la carriere le plus propice a la prestation de cette formation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.004 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".