Administrative directives for clinical practice.

Factors that will influence the future of comprehensive pharmaceutical services are discussed, and administrative strategies for developing clinical pharmacy services in hospitals are presented. The future of clinical pharmacy practice will be affected by: (1) health-manpower levels; (2) the trend toward centralized, prospective payment for health services; (3) emphasis on cost containment; and (4) the quality of existing pharmaceutical services. Of primary importance to the development of clinical services is to have in place a centralized, unified pharmaceutical service. A staff of qualified practitioners, as well as executive direction to determine goals and priorities, is needed. Valid clinical roles should be identified that meet health-care needs, meet legal and accreditation standards, avoid conflict with physician-roles help deal with the nursing shortage, and contain health-care costs. Cost of the clinical service must be determined so that financial support can be arranged.