Having provided chemotherapy at its outpatients clinics since 2002, the Saku Central Hospital in February 2006 established a Chemotherapy Center for Patients Discharged from Hospital. At this center, pharmacists check doctors' prescriptions, review all medications patients have been taking and dispense the prescriptions in a sterilized state. In addition, they are assigned on a daily basis to collect information on, and give guidance to, the patients. At the outpatient clinics, the length of time that can be set aside for the tabulation of information from patients' case records and for contact with the patients is inevitably likited. Given this situation, we began case study meetings in order to share information about patients between pharmacists in charge of guidance on the control of drugs at the time of their hospitalization and those who are in charge of chemotherapy at the Center. Later, these case study meetings were joined by physicians and nurses who thought it necessary to share information, thus leading to the establishment of a Conference at the Center. At this conference, pharmacists introduce information about patients at the time of their hospital admission and a discussion begins with the participation of various hospital staff members to solve given problems. By so doing, it has become possible to come to grips with the conditions of inpatients, enabling us to shift to services at the Center smoothly and give proper guidance when a medication produces undesirable effects. We consider the Conference signifies a step forward to the practice of medical care by teams.
Central ; Hospitals ; Chemotherapy-Oncologic Procedure ; Information ; Therapeutic procedure

The Saku Central Hospital classified muscular relaxants, potassium products and the like as “high-risk medicines”, but when it came to insulin, did not take any standardized measure against it to prevent accidents. Having organized a team of personnel from a wide variety of job, our hospital has recently carried out a campaign for improvements in medical care. With pharmacists playing a leading role, we grappled with measures for the prevention of errors in the administration of insulin using quality control (QC) methods. As a consequence, the campaign served to decrease the number of medical mistakes. As there still occur many incidents involving medication, the role played in risk management by pharmacists remains significant. In future, pharmacists will hopefully play a constructive role in risk management to prevent medical incidents involving medical supplies. That said, a campaign for improvements inmedical care through the practical use of QC methods seems likely to bring about favorable results.
Role ; Quality Control ; Analysis ; Avoidance ; ERROR

We report two cases of patients with intractable upper abdominal pain and histories of injury or surgery. The patients' pains were successfully treated with tokishigyakukagoshuyushokyoto (TSG). Case 1 involved a 59-year-old woman with left upper abdominal and thoracodorsal pain lasting 5 years. Kampo drugs such as tokito or prescriptions containing saiko were ineffective. Two years after her first visit, we noticed an injury scar from childhood that passed near the left hikon (pi-gen, ExB4) and induration and tenderness of the left hikon. TSG was administered, and the pain promptly improved. Case 2 involved a 66-year-old woman. She complained of epigastric, right­-upper-­quadrant abdominal and back pain lasting 7 years. Two years before presentation, the pain had worsened, but the cause was unclear. Although keishibukuryogan or Kampo drugs containing saiko were ineffective, her pain improved when TSG plus bushi was administered. A wound from a cholecystectomy was observed on her right abdomen. Induration and tenderness of the right hikon were demonstrated. The combination of past history of injury or surgery of the upper abdomen or back and induration of hikon can be associated with development of indications for TSG.