First Draft 8-14-96
Revised June 97
Pharmacy:
Pharmacy Service in clinics will reflect the changes in VA Health Care to primary care. One
aspect of this is the developing of a benchmarking program to share best practices system wide
so as to improve overall performance and comparison to non-VA benchmarks. Emphasis will be
placed on the provision of medical care as part of an interdisciplinary team. Pharmacists on the
team will stress provision pharmaceutical care including drug therapy monitoring and patient
education. Provision of prescriptions will be supported through electronic communications with a
primary medical facility and establishment of contract relationships (PPO, Fee for Service) with
community pharmacies.
Prescriptions generated by the various clinics will be provided in a number of ways. Each clinic
will be supported by a main medical facility or a Consolidated Mail Outpatient Pharmacy
(CMOP). The small (basic) to medium size clinic will provide a consultation room for pharmacy
and a minimum storage area for initial supplies of pharmaceuticals. After providing patient
consultation on new prescriptions, the pharmacist will enter prescription data into a terminal for
transmission to the main medical facility or CMOP. The pharmacist may provide an initial supply
of medication to the patient or direct the patient to a contracted pharmacy for medication
required immediately. Refills will be handled by mail from the main medical facility.
Larger clinics will have a free-standing pharmacy. This pharmacy can provide a greater number
of services but is designed to be smaller than the pharmacies at Medical Centers. In addition to
the required patient consultation on new prescriptions, the large pharmacy will provide the initial
supply of medication. Refill requests will be handled by the clinic but may be filled by remote
CMOPs. The size of the pharmacies is dependent on the establishment of electronic
communication with all VA medical facilities. VA pharmacies will have the ability to share
prescription data of patients treated at medical facilities throughout the VA health care system.
At present many pharmacies are conducting regular surveys of patients and customers about
their treatment in order to determine where improvement is needed. VA `s goal is to deliver
more with less stress, in a shorter time frame and at more competitive costs.
Security:
There are currently two approaches to dispensing area security in the pharmacy. One direction
is to include the dispensing area within the security zone of the pharmacy. This would include
providing full height concrete masonry walls, bullet proof glass at the dispensing windows, etc.
The other approach is to create the secure area behind the dispensing area in order to have a
more open, commercial pharmacy feel.
The specific approach is at the discretion of the
Medical Center.
Further information on Pharmacy design can be obtained from the Pharmacy Design Guide as
prepared by the VA Central Office Standards Service (187C).
VA DESIGN PRIMER
OUTPATIENT PHARMACY
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