How should the “management of things” be? We carried out a questionnaire survey to find out the facts about the stock control of medical supplies and inventory management system in hospitals affiliated with the National Federation of Agricultural Cooperatives for Health and Welfare. Questionnaires were sent out to 98 hospitals with not less than 100 beds. Fifty-one hospitals responded. The number of effective replies was 49. We made analyses of the data as best we could, especially the data on the operation of the inventory management system and stock control.(1) After the adoption of an inventory management system, 41% of the hospitals took more than half a year before the system was put on the right track. (2) The system has turned out to be conductive to the streamlining of such work as placing orders, delivery, storing and stocktaking. (3) Concerning the management of the master file in the system, many respondents gave the accuracy of data, prompt processing and working efficiency as the problems yet to be addressed. (4) In the hospitals using an inventory management system, the in-hospital type SPD took 17.7 days in terms of the holding period in the case where users are supposed to control the consumption of medical materials as against 8.3 days in the case where clerks in charge of warehousing deliver medical materials and take on consumption control. (5) About 80% of the hospitals have introduced their own inventory management system in an effort to promote the standardization of materials, purchase materials in proper quantities, carry out inventory and consumption control, and create an efficient supply system.
control ; Consumption of goods ; Management ; Control brand of phenylpropanolamine ; System

The supply center of the Atsumi Hospital handles medicines, medical supplies, slips, stationery, daily necessities, resterilized things, laundries, linen and washing beds among many others. The center is striving to raise the efficiency of the flow of materials within the hospital and undertakes logistics management single-handed. In January 2003, one copier and one lithographic unit out of the total four duplicating and printing machines in the hospital were removed to the suppy center. Since then, the center has been responsible for handling these machines for individual users. How effective this office meanagement system was in saving time, cutting down on costs and increasing the degree of satisfaction felt by employees was examined as part of TQM activities.Between June 2003, when the advance booking system was adopted for the use of the two machines, and January 2004, it was found that the monthly reservation ratio averaged out 38.3%. A questionnaire survey also found that many menbers of the staff were satisfied as they could make good use of time. As regards cost reduction, the monthly rental for the copying machine was curtailed to ¥57,000. This was made possible as members of the supply center made proper use of the copier and lithography.
Copying Processes ; Economic supply ; Agent ; Central ; Hospitals

Today, the circumstances surrounding the medical economy are severer than ever. Therefore, it is vitally important for a hospital to rationalize management and implement a labor-saving system drastically.In October 2000, Atsumi Hospital moved to a newly built complex. At that time, those sections and departments which do not have any direct relation to medical treatment and care were restructured and established a supply center in order to use human resources effectivily.Before the establishment of the supply center, we had reviewd simple, routine tasks such as ward nursing assistant services, office work and management itself. While introducing our hospital supply center in this paper, we compare efficiencies before and after the move to the new building and dwell on advantages of centralization of ward nursing services.The rearrangement of the personnel, materials and information has made it possible to increase the efficiency of simple work and reduce the number of nursing assistants by 20%. Henceforth, it would be necessary to educate the staff, work on proper personnel changes, carefully make a plan for outsourcing, and choose trustworthy dealers.
Human Resources ; Work ; Economic supply ; Effective ; Central

At medical fields, how should procurement processes of medical material be? We tried to research that onto Hospitals affiliated with the National Federation of Agricultural Cooperatives for health and welfare using questionnaire researchmethod to grasp the actual conditions of medical material procurement processes. The research was proceeded taking the hospitals which have more than a hundred beds as the object. The research requested 97 hospitals and fifty-three hospitals responded. From the research, we could get the following results. The enough results to judge as results; implementation of plan of buying budgets 79%, affirmance of clearance asset 89%, clarification of necessity 96%, trial calculation of profitability and productivity 98%, research for the use utility after adoption 76%, supplement of a job lot 91%, consideration of safety 96%, prime cost dropby joint purchase 61%. On the other hand, it is considered that following things are not enough results;document audit with suppliers' business outline and supplier record 34%, purchasing administrator's lack of acknowledgements of medical material 55%, dealing with immovable stock in subsequent occasion after changes of doctors 41%, efficient ability as in analysis of time by purchase products 59%, transaction expenditure of wastes 46%, reduction of labour by joint purchasing 59%. On the whole, it may be said that hospitals, which have purchase board , are trying to select products from various sides. However, it cannot be said that Secretariat's knowledge a bout medical product are not good enough to selectit. Therefore, deliberating with participants to the committee is important andclue. In this case, substance should be described visually and objectively as in a chart graph. It may bring us excellent purchasing on medical products by consideration of selecting standard.
Research ; Materials ; seconds ; Medical ; Joints

Objective: The hospital is changing its formulary reference from paper-based to intranet.  There was concern that both paper-based and intranet versions of the formulary would be necessary.  Revising the paper-based hospital formulary each time package inserts are revised is difficult.  For your review we report on the creation of the iPhone® electronic formulary which enables rapid off-line formulary retrieval and easy updates while at the same time providing low cost service in a light device.
Methods: The CSV (Comma Separated Value) of the hospital formulary dictionary was made using a standard personal computer.  The CSV data file was converted using JAMES2DIC into a HTML file format.  Next, the converted HTML file is transformed into the EPWING (Electronic Publishing WING) format using EBStudio.  Finally, we forward the EPWING dictionary file from the personal computer to the iPhone®.  The retrieval becomes possible by using EBPocket for iOS of EPWING/electronic book viewer software for the iPhone®.  The number of items was assumed to be 29 items thought for a lot of inquiries to exist.
Results: We compared the paper-based formulary with the iPhone® electronic formulary.  As a result, the iPhone4® electronic formulary shortened the retrieval time, was smaller, lighter, and excellent at a lower price.
Conclusion: The iPhone4® electronic formulary enables the user to perform complex full-text searches and retrieve information at a much higher speed than is possible with paper based formularies.  It has the additional advantage of seamless integration and deployment of formulary additions or reference material revisions.  We believe we have successfully created a practical electronic formulary.

　　Many patients carried into the emergency room or intensive care unit are suspected to have risk factors for deep-seated mycosis. Using the Actions Bundle, which itemizes diagnosis and treatment of invasive candidiasis, we carried out investigations into facts about the use of antifungal drugs in the intensive care unit of our hospital. The subjects of this retrospective study were 11 ICU patients who were given antifungal drugs intravenously between April 2013 and March 2014. Their medication records revealed that micafungin was administered to five patients, fosfluconazole to another five patients and fulconazole to the remaining one patient. The ratio of the cases where the dugs were used in compliance with what the Actions Bundle suggested worked out at 71.4±15.9%. When it came to the collection rate of two sets of blood culture and the proper dosage, the compliance rates were the lowest with 36% each. As regards dosage, 18% was excessive, 36% proper and 45% insufficient. As pharmacists in charge of the ICU, we have to use the checklist more effectively and intervene in the care of patients with invasive candidiasis at an early stage.

Objective: For effective use of over-the-counter (OTC) drugs that are provided as relief supplies during a disaster, we aimed to develop a list of OTC drugs that can be used during a disaster.
Methods: We obtained information about OTC drugs useful during a disaster by examining results of previous studies and lists of drugs used during a disaster.  We analyzed this information with the expert pharmacist of disaster support and established a rationale for our list and developed “the List of Useful OTC Drugs During a Disaster” and “the Information Card on Useful OTC Drugs During a Disaster.”
Results: We developed our list of OTC drugs based on the following parameters: (1) while people with severe disorders (e.g. renal failure) are treated by medical teams, those with minor physical conditions are treated using OTC drugs and (2) those OTC drugs that can be used as substitutes for prescription drugs were preferably selected.  The List of Useful OTC Drugs ()—During a Disaster (containing 56 items) was developed for use mainly by medical professionals.  Further, pharmacists from disaster-relief medical teams may not always be available in disaster-stricken areas; therefore, the Information Card on Useful OTC Drugs During a Disaster was developed to enable disaster victims to independently make a certain level of decision.  The information card contained pictograms to call the attention of the disaster victims.
Conclusion: Our results can provide a common tool for drug suppliers, medical professionals engaging in relief works in disaster-stricken areas, and disaster victims.

Restrictions on the use of antimicrobial agents are reported to lead to a reduction in the use of carbepanem (CP) antiobiotics and in the detection of resistant bacteria. Our hospital began monitoring the use of specific antimicrobial agents in June 2014. In the present study, we examined changes in the use of injectable broad-spectum antibiotics and in the susceptibility of Pseudomonas aeruginosa before and after introducing our antimicrobial use monitoring system (pre-and post-monitoring). We obtained a total of 301 specimens taken before the introduction of the system (January 2012-May 2014,143 specimens) and after after the introduction (June 2014-December 2016, 158 specimens). We then examined antimicrobial use density (AUD) and P. aeruginosa sensitivity per 100 patient-days.Comparisons of pre-monitoring results (2012) and post-monitoring results (2016) show that AUD decreased for imipenem/cilastatin (IPM/CS;0.26 to 0.1), meropenem (0.46 to 0.19), CAZ(0.52 to 0.16), and CZOP (0.17 to 0.09) and increased for tazobactam/piperacillin (0.67 to 1.16). Susceptibility of P. aeruginosa tended toward recovery (IPM/CS:0.8 to 0.87, piperacillin: 0.89 to 0.92, ceftazidime: 0.87 to 0.93,and cefozopran: 0.8 to 0.94). Our antimicrobial use monitoring system reduced the use of CP antibiotics and helped to restore the susceptibility of P. aeruginosa.

The predicted rate of compliance with the Guidelines on the Management and Treatment of Glucocorticoid-induced Osteoporosis is around 20%. The notion that the occupational abilities of pharmacists could be useful in management and treatment of this iatrogenic disease led to a nationwide questionnaire survey of 102 Kosei Hospitals on the treatment of glucocorticoidinduced osteoporosis. In total, 67 hospitals responded (response rate, 65.7%). Analysis revealed that hospital pharmacies did not have a clear view on managing patients with a history of longterm steroid prescription. However, pharmacists had made proposed changes to prescriptions for preventing glucocorticoid-induced osteoporosis in approximately 30% of hospitals, and such proposals were usually acceptable to doctors. Also, 70% of chief pharmacists believed that pharmacists can play important roles in raising the rate of compliance with the guidelines.

Background/Aims: Asymptomatic esophageal eosinophilia (aEE) is considered to be a potential precursor of eosinophilic esophagitis (EoE). However, there are few clinical parameters that can be used to evaluate the disease. Therefore, we aimed to clarify the factors involved in the symptoms of EoE by examining the clinicopathological differences between aEE and EoE. Methods: We reviewed 41 patients with esophageal eosinophilia who underwent endoscopic ultrasonography and high-resolution manometry. They were divided into the aEE group (n=16) and the EoE group (n=25) using the Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease score. The patients’ clinicopathological findings were collected and examined. Results: The median Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease score was 3.0 in the aEE group and 10.0 in the EoE group. There was no significant difference in patient characteristics, endoscopic findings and pathological findings. The cutoff value for wall thickening was 3.13 mm for the total esophageal wall thickness and 2.30 mm for the thickness from the surface to the muscular layer (total esophageal wall thickness: 84.0% sensitivity, 75.0% specificity; thickness from the surface to the muscular layer: 84.0% sensitivity, 68.7% specificity).The high-resolution manometry study was abnormal in seven patients (43.8%) in the aEE group and in 12 (48.0%) in the EoE group. The contractile front velocity was slower in the EoE group (p=0.026). Conclusions The esophageal wall thickening in the lower portion of the esophagus is an important clinical factors related to the symptoms in patients with EoE.