Principles of clinical pharmacology and drug therapy

In its widest sense, a drug is any chemical entity that can perturb a biological system. For the purposes of drug therapy, the biological system is the human body and the perturbation is exploited to aid the diagnosis, treatment, or even cure of a disease process. When prescribing for the individual patient, guidelines, formularies, and other prescribing aids are not a substitute for an intelligent clinical approach. The prescriber needs to establish what the patient’s experience and expectations of drug therapy are, and the patient needs to know the likely consequences—both good and bad—of taking any drug that is prescribed. This dialogue is important, since it will often decide whether the patient actually takes the drug as prescribed. Patient compliance is a key variable in the prescribing process, and one over which the doctor often has least control.

What are the Costs of Trauma Center Readiness? Defining and Standardizing Readiness Costs for Trauma Centers Statewide

Trauma center readiness costs are incurred to maintain essential infrastructure and capacity to provide emergent services on a 24/7 basis. These costs are not captured by traditional hospital cost accounting, and no national consensus exists on appropriate definitions for each cost. Therefore, in 2010, stakeholders from all Level I and II trauma centers developed a survey tool standardizing and defining trauma center readiness costs. The survey tool underwent minor revisions to provide further clarity, and the survey was repeated in 2013. The purpose of this study was to provide a follow-up analysis of readiness costs for Georgia's Level I and Level II trauma centers. Using the American College of Surgeons Resources for Optimal Care of the Injured Patient guidelines, four readiness cost categories were identified: Administrative, Clinical Medical Staff, Operating Room, and Education/Outreach. Through conference calls, webinars and face-to-face meetings with financial officers, trauma medical directors, and program managers from all trauma centers, standardized definitions for reporting readiness costs within each category were developed. This resulted in a survey tool for centers to report their individual readiness costs for one year. The total readiness cost for all Level I trauma centers was $34,105,318 (avg $6,821,064) and all Level II trauma centers was $20,998,019 (avg $2,333,113). Methodology to standardize and define readiness costs for all trauma centers within the state was developed. Average costs for Level I and Level II trauma centers were identified. This model may be used to help other states define and standardize their trauma readiness costs.