hospital pharmacy management manual pdf

clinical evaluation packages (i.e. This handbook elaborates the role of pharmacists and pharmacy services in the care of the critically ill patients. Aside from the possible growth of specialty phar-macies, nearly all community and hospital pharma- This is shown in Figure 2. 2–5 Paths to achieve a management career include formal education through obtaining a management degree (e.g., MBA, MS) and/or informal training through on-the-job experience. adjacent to Hygeia. Hospital Pharmacist 2008;15:254–6. Department of Health, 2006. 4 HOSPITAL PHARMACY PROCUREMENT AND SUPPLY (HOSPITAL PHARMACY STORE) 4.1 INTRODUCTION 79 4.2 OBJECTIVES 79 4.3 POLICIES 4.3.1 General Operational Policies 79 4.3.2 General Development & Maintenance Policies 80 4.4 MECHANICAL AND ELECTRICAL REQUIREMENT 82 4.5 DESIGN, LAYOUT AND SPECIFICATION 4.5.1 Structural Design a) Wall 83 b) Floor 84 c.) Ceiling 84 d) … compared to manual based system. When you see this icon in the text, you are being asked to complete an activity. Home Decorating Style 2021 for Manual for Pharmacy Technicians 4th Edition Pdf, you can see Manual For Pharmacy Technicians 4th Edition Pdf and more pictures for Home Interior Designing 2021 211516 at Manuals … Sir, I need a project of Hospital management system. Formulary Management 2. A hospital pharmacy's quality management manual. Hospital Department or Area: Hospital Pharmacy Management Hospital Facility: _____ Assessor: _____ Date of assessment: _____ Hospital Pharmacy Management Standard Number Standard Criteria for Verification of Meeting Standard Compliance in Meeting Standard Any … The management of the pharmacy should be entrusted to a single person having received adequate training. Finstead Pharmacy FEEDBACK The EESPMN guidance has the support of the NHS East of England pharmacy leads. The CMO is considered a voting member. Risk Management Self-assessment Checklist for Pharmacists (and Pharmacy Technicians When Applicable) The checklist that follows is designed to assist pharmacists (and other pharmacy professionals where appropriate) in evaluating and modifying their current customs and practices, in order to enhance medication and patient safety. By accessing key data and insights, the PI System has helped leading companies deliver greater operational. pharmacy management system 2014-2015 contents 1 computer science department pharmacy management system 2014-2015 contents 2 computer science department pharmacy management system 2014-2015 college profile 3 computer science department pharmacy management system 2014-2015 m.e.i.polytechnic 4 computer science department pharmacy management system 2014-2015 … It also maintains hospital Physician Reimbursement Methods 77 32. h�bbd```b``�� ),�"�b�$c� The program can look after inpatients, outpatients, records, database treatments, status illness, billings in the pharmacy and labs. MANAGEMENT and FORMULARY MANUAL Approved by: The Chief Medical Officer Washington State Department of Corrections Note: Appendices II – Formulary Drug Listings and IV – Alternate Choices for Non-formulary Medications may be updated frequently as clinical data or contract prices change. 4. (i) Co-ordinate all pharmacy services on the nursing unit level. : MMH-HOP-01-01-01 Effectivity Date: 23-Apr-2014 Page No. h�b```��" ��ea��v!U��U��Q~��ջ!�r�ꮫQ��kz��9S��?��{yGG��`(��` �p~��@ ��yo�bq�H0�0��%��^4H.`�g�t��(� 6�u�v��[ with pharmacy technicians when performing most of these activities. MARIVELES MENTAL HOSPITAL P. Monroe Street Poblacion, Mariveles, Bataan Document No. The Information System Pyramid 20 . endstream endobj 43 0 obj <>/OCGs[67 0 R]>>/PageLabels 38 0 R/Pages 40 0 R/Type/Catalog>> endobj 44 0 obj <>/Font<>/ProcSet[/PDF/Text]/XObject<>>>/Rotate 0/Type/Page>> endobj 45 0 obj <>stream Quality Management System QUALITY MANUAL. 3 . Hospital pharmacy and/or clinical pharmacy is the organization or department of the hospital which comprises or deals with the healthcare facilities such as preparation of prescription, preservation, packaging, sterilization, compounding, preparation, distribution of … ��u̟p~d�} ��\��J��0�l��쐡��а�y��NC.��g\K��4�(35nok.Ψ ��4cc��w��&.��f��-��ł�g�O\��n��!�Ve�C'��8=,r��$��hJ C. Direct patient care Identifies drug brought into the hospital by patients. Download Ashp Hospital Pharmacy Management Information System (Hpmis Manual) PDF EPUB FB2 MOBI RTF List Price: $ - $ Member Price: $ - $ Page Count: The B Program Handbook: Integrating B into the Health-System Pharmacy Supply Chain is the comprehensive guide for pharmacy leaders, hospital administrators, legal counsel, and pharmacy managers. I . Clinical Pharmacy Service: is a patient-centered care developed to promote the rational use of medicines and more specifically, to maximize therapeutic benefits, minimize risk, & reduce cost. ETHIOPIAN HOSPITAL SERVICES TRANSFORMATION GUIDELINES 3 Section 3 Implementation Guidance 3.1. Hospital pharmacy managers oversee the operations of pharmacy departments and are responsible for the Guide_to_Direct_Referral_V7.pdf. hospital production : 12/30/2020 2 section 1-participant conditions of participation .....19 1.1 individuals eligible for mo healthnet, managed care or state If you continue browsing the site, you agree to the use of cookies on this website. %PDF-1.5 %�� Tasks and responsibilities should be clearly defined. This manual is written for all officials involved with the management and funding of hospitals in developing and transitional economics. Establishing Medication-related Policies and Procedures 3. Mitera Hospital is a state-of-the-art Maternity, General and Children's Hospital of 35k sq.m. Methods A manual method of input, which relied on paper records, was replaced with an automated upload that was developed by linking the pharmacy dispensing system, JAC, with a number of information technology support systems to produce a batch number report. : Page 2 of 54 QUALITY MANUAL MMH-DCC-04-06-00 REVISION HISTORY DCN REVISION DATE REVISION NUMBER PAGE AFFECTED REASON FOR REVISION PREPARED BY REVIEWED AND APPROVED BY 001 … 90 0 obj <>stream Thus, in order to deliver care the pharmacist needs to … The Hospital is licensed for 501 beds (active 341), has … interested in pharmacy management (see Table 1-1). Reference Guide for Pharmacy Management Krisman and Pharmacoeconomics-Second Edition www.pharmacyexam.com 6 C Managecare Organizations (MCOs) 30. Pharmacy Information Systems 2. interested in pharmacy management (see Table 1-1). Ȁ��a��F�� &0�4�+�b�o(�`+c�i��p��̀ǋ�߁� (j) Ensure that the medication area is neat and orderly. ABOUT DOH Profile Milestones Mission and Vision Organizational Chart DOH Family Key Officials Directory DOH Budget DOH Location Map UNIVERSAL HEALTH CARE POLICIES AND LAWS RAs, EOs, AOs, IRRs, MCs, DCs Republic Act 2010-2012 House Bills Notice of Public Hearing. Common crash cart system in Hospital – exchange system with ready-to-go back-up carts (May use different color seal when returning used cart) 22.3 SAMPLE CRASH CART USED IN THE HOSPITAL SAMPLE POLICY: Emergency Medication and Crash Cart System POLICY: … Pharmacy Service Organization and Management Pharmacy services should be organized and managed in such a way as to ensure patient safety, convenience, … 19 . Additionally, Pharmacy prep do not assume any responsibility or risk for your use of the pharmacy preparation manuals or review classes. 0 Vat Exempted Drug List. Single Joint Research Ethics Board. {=]�)�4R �d��3v� Hospital Pharmacy: Staff Background The inpatient setting of hospital pharmacy is unique in a number of ways. management considerations for assessment and planning, managing the care process, human resources, interacting with the community, and managing information are covered in the Planning, Human Resources, Integration and Monitoring chapters. This handbook elaborates the role of pharmacists and pharmacy services in the care of the critically ill patients. The patients treated by a hospital pharmacist typically have more complicated conditions than those in an ambulatory setting and take multiple medications. Adequate inventory is generally defined as basic stock + safety stock. UNIVERSITY HOSPITAL DEPARTMENT OF PHARMACY POLICY AND PROCEDURE MANUAL To navigate, click on the topic or the policy number you are interested in. Hospital management system is a computerized system designed and programmed to deal with day to day operations taking place. 9 Dated: 18/2/2011 At Time: 10:55:40 patients on (but not exclusively) wards of various kinds. The main responsibilities of a community pharmacy include compounding, counseling, and dispensing of drugs to the patients with care, accuracy, and legality along with the proper procurement, storage, dispensing and documentation of medicines. ABOUT DOH Profile Milestones Mission and Vision Organizational Chart DOH Family Key Officials Directory DOH Budget DOH Location … 3. h�bbd```b``6�3@$S�d�"Yf��e`5>`�W0��.�s�" `��`rXDD��V$9��C$c0��k�?4�20ݳ��AA�g`�� Gm Distributive a. The system will ensure availability of sufficient quantity of drugs and consumable materials for the patient. The manual shall be accessible to phar- macy department personnel as well as other hospital employ-ees (e.g., through the hospital’s intranet), and all pharmacy personnel should be familiar with its contents. �� d~rt�4��A�xjMf��R �9�X��v02�6|n�2m=�9��';�>6�n��u�`��2��%]d�^�#. Closed Pharmacy Management System This project received 63 bids from talented freelancers with an average bid. For 50 years it has been practitioner-focused and dedicated to the promotion of best practices and medication safety. National BHW Registry System. Don’t let profit sit on your shelves or expensive brand name drugs go out of date due to improper inventory levels. Total Parenteral Nutrition and Intravenous Admixture, 10. Records Management: NHS code of practice, Parts 1 and 2. 5. UNIVERSITY HOSPITAL – DEPARTMENT OF PHARMACY POLICY AND PROCEDURE MANUAL TABLE OF CONTENTS SECTION I – ADMINISTRATION Mission Statement and Scope of Service I-1 Departmental Organization I-2 Staffing and Shift Coverage I-3 Meal Periods & Breaks I-4 Work Schedules I-5 Request for Time Off I-6 Departmental Orientation I-7 Sick Time I-8 Pharmacy Access I-9 Compensatory Time I-10 … The purpose of this manual is to provide health workers with a reference book on managing the supply chain for medicines and related health commodities. Literature Review Hospitals can also be regarded as organizations based on high technology and information intensive processes. Manufacturing in Hospitals 9. Û��co��`u��Q�� In general, The Pharmacy management system is based on computer technology that gives service for users, managed by the pharmacist who give implementation of function relatively in effective times as well as will design for removing time wasting, saving resources, easy data access of the medicine, security on data input and data access by removing almost manual based system. Install the program after download. If you continue browsing the site, you agree to the use of cookies on this website. zA�� W�C��4��% ��h� Y�M"B|��+�WЃQI)#`JR�!�ϟ�~��;�� t>�&�| Importance of PMIS ... – Pharmacy Management Software ... hospital to the cost of drugs purchased and /or dispensed within the given time period. Hospital Committees, 6. 45.4 ORGAnIzATIOn AnD MAnAGeMenT 45.2 Organization of hospital pharmacy services In organizing hospital pharmacy services, both the way in which the staff is organized and the physical layout of the building must be considered. The project is build using Java. Page 17 of 51 6 Management System Planning 6.1 Addressing Risks & Opportunities In order for our organization to have a successful quality management system, we consider and manage the It presents information on the ��t�2Rz��Τ��b�{��|��Z=��Mۑ8�dG��8�*#��\�IJ��y^z��h(Wk��इ��[׮\�0��E䌖r�l , �J��L04p0D40 9@>k��T��d��`��``�)l`�h`��h` complete explanation on good practices for system for dispensing Hospital Pharmacy Management Hospital Standards Manual—Afghanistan 9 of 10. 5. Thus, our target audience includes hospital managers (both financial and programmatic), public sector managers at the district, regional and national levels of the health system, and persons responsible for non-profit and private hospital systems. -��#2v��3c�R��|�4aZ.$ (�&#�8 |lDEA H��p Pre-Packing and Repacking in Hospitals11. 1.1 … Th is chapter fi rst discusses good management and leadership in general, then outlines relevant considerations for managing relations with patients and … Pharmacy Management System Project Topics, Ideas, DOC, PPT, PDF and Abstracts for IEEE Engineering Students. means, for example, ensuring that pharmacy staff can speak a language other than English, the pharmacy carries non-prescription merchandise that is desired by the particular ethnic group, and signage in the pharmacy is in a second language. 4 . This will help prolong the lifespan of equipment hence reduce the cost of repair and replacement. Hospital management system is a computerized system designed and programmed to deal with day to day operations taking place. 2–5 Paths to achieve a management career include formal education through obtaining a management degree (e.g., MBA, MS) and/or informal training through on-the-job experience. HOSPITAL Quality Management System QUALITY MANUAL. Records management: NHS code of practice, parts 1 and 2. docks to their distribution to the hospital pharmacy, we identified an important number of inefficiencies, namely incorrect inventory management, medicine shrinkage, intensive manual labor, long procurement cycles, time-consuming product recalls and improper use of technology. Communication with our GP colleagues is vital in relation to the community pharmacy contract and established protocols should always be in place. Hospital pharmacy management 1. 0Nc�q|q�0��=@��ՇH�|7"��_"�� ` �[B Introduction PMIS basically deals with the maintenance of drugs and consumables in the pharmacy unit. Control of Pharmaceutical Expenditures 4. 5684 0 obj <>/Filter/FlateDecode/ID[<5E90241C172FBB45828D15A56D298B55><45CB5744F16DCD46BB9BE05FD21D5D39>]/Index[5674 30]/Info 5673 0 R/Length 74/Prev 1011394/Root 5675 0 R/Size 5704/Type/XRef/W[1 3 1]>>stream Hospital Formulary, 5. MANAGEMENT and FORMULARY MANUAL Approved by: ... Pharmacy (Chair), physicians, dentists, pharmacists, physician assistants and advanced registered nurse practitioners. HOSPITAL PHARMACY MANAGEMENT BY: HASSAN ABDELWAHAB 1st year – pharmacy practice 2. Drug Formulary 86 36. Pharmacy Management Subprocess Monitor the drugs consumption to the departments Departments Replenishment Multiple approaches for the departments replenishment, based on consumption or safety stocks Central Pharmacy Warehouse Replenishment MRP rules for optimized drugs replenishment Purchase Order and Purchase Receipt On line interface with suppliers to eliminate the human capital … The P&T chairperson and/or CMO will appoint all members to a Department of Health, 2009. Pharmacy Distribution Systems 83 35. 0 Total Quality Management 6. The program can look after inpatients, outpatients, records, database treatments, status illness, billings in the pharmacy and labs. 5703 0 obj <>stream Pharmacy procedures manual. Pharmacy Procedural Manual, 7. department of pharmacy are carried out correctly. User Trainers are responsible for training health workers in all health facilities on proper management of medical Equipment (Proper use and care) and they work hand in hand with the workshop technicians. Medical Loss Ratio (MLR) 79 33. Additional copies of the checklist may be downloaded … Hospital Pharmacy is an independent, peer-reviewed journal. Inventory is the amount of stock or merchandise that is available for sale to present and future clientele. II Foreword The Federal Ministry of Health has been coordinating sector wide reforms that aim to improve equity and quality of health services. This text addresses different competencies involved in pharmacy management, and this chapter pro- It also maintains hospital information such as ward id, doctors in charge and department administering. 42 0 obj <> endobj e) The pharmacy personnel shall make regular inspections of all drugs storage areas. NHS EDUCATION FOR SCOTLAND 6 GP comment A comment from a general practitioner (GP) is also included for many of the conditions. Design and Implementation of Hospital Management System using Java DOI: 10.9790/0050-0213236 www.iosrjournals.org 33 | Page Admission management Ambulatory Laboratory Account management Payroll and Human Resource Management II. Management of a pharmacy Organization of activities. Both systems ran parallel for a period of 7 weeks, and administration time and completeness of data for both were analysed. h��Xmo�8�+��jEc;��H�JJ�� Personnel Hospital pharmacy personnel can be divided into three major categories— 1. European Association of Hospital Pharmacists - The Common Training Framework for the hospital pharmacy profession support the raising of standards in hospital pharmacy practice and thereby enhance the quality of, safety of, and equity of access to, patient care in every European country. Task Force Balik Loob. ]$��k��k�䟢r&F��`��4'�3�� y\) Purchase and Inventory Control, 12. Management. National Clinical Pharmacy Service Implementation Manual in Ethiopia . For this reason, Pharmacy Management Information System (PMIS) is being built. Pharmacy Management–Statements 521 that will influence the pharmacy enterprise. DRRM-H Planning Guide for Planning Health and Hospital. 45 Hospital pharmacy management ... inventory control and warehouse management systems, which may be manual or computer based. ... Pharmacy Unit 1.2.2.7. This manual was developed by the Pharmacy Division, Ministry of Health, in collaboration with the Securing Ugandans’ Right to Essential Medicines (SURE) Program with assistance from health workers representing all levels of care. The manual shall be reviewed by pharmacy staff on a regular basis and revised as necessary to reflect changes in procedures, organization, ob-jectives, or practices. He or she identi - fies opportunities to leverage pharmacy expertise to improve quality, safety, the patient’s experience, patient access to quality healthcare across the continuum of care, and the eco-nomic performance of the organization. A written record shall verify that: MARIVELES MENTAL HOSPITAL P. Monroe Street Poblacion, Mariveles, Bataan ... Quality Management System Manual Control of Documents Control of Records 18 18-20 20 20-23 23-25 25-26 26 00 00 00 00 00 00 00. CHAPTER 1 INTRODUCTION 1.1 Introduction In the era of technology, where everything needs to be done efficiently and effectively the … Efficient Inventory Management (EIM) is essential to the profitability of your pharmacy. … Assessment: Preceptor Sign Off VI Operational definitions Clinical Pharmacy: is a health science discipline where pharmacists provide patient care that optimizes medication therapy and promotes health, wellness, and disease prevention. Home Decorating Style 2020 for Pharmacy Management System Project In Java Pdf, you can see Pharmacy Management System Project In Java Pdf and more pictures for Home Interior Designing 2020 72187 at Manuals Library. The primary purpose of inventory control is to manage stock and ... medical stores. Quality Manual Template www.iso9001help.co.uk ISO 9001:2015 Quality Management System Document Ref. The Philippine Health Systems Review. Pharmacy prep make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. 44.1 Information for materials management The goals of medical stores management are to protect stored items from loss, damage, theft, or wastage and to manage the reliable movement of supplies from source to user in the most economical and expeditious way. SECTION I – ADMINISTRATION Mission Statement and Scope of Service l-1 Departmental Organization I-2 Staffing and Shift Coverage I-3 Meal Periods & Breaks I-4 Work Schedules I-5 Request for Time Off I-6 Departmental Orientation I-7 Sick … The hospital pharmacy monitors and evaluates its performance on regular basis using implementation checklist and selected indicators. DRRM-H Planning Guide for Planning Health and Hospital. To disseminate pharmaceutical knowledge by providing for interchange of information among hospital pharmacists and with members of allied specialties and professions. A description of pharmacy services and pharmacist activities in a critical care setting will assist practitioners and administrators in establishing or advancing this specialized pharmacy services. Effective management of information is the key to achieving these goals. h�b```�,f�Faf`a`b� Organization and Management of Drug Store, 13. endstream endobj startxref The services provided by the Department of Pharmacy are divided into four categories: 1. Hospital Pharmacy: Management Background Hospital pharmacy management is a promising career option for pharmacists who enjoy the challenges presented by administrative work in an institutional setting. The manual shall be accessible to phar-macy department personnel as well as other hospital employ-ees (e.g., through the hospital’s intranet), and all pharmacy A description of pharmacy services and pharmacist activities in a critical care setting will assist practitioners and administrators in establishing or advancing this specialized pharmacy services. Non-IV Medications (40 hours is recommended to meet the above objectives and required activities; preceptor may reduce number of hours if student has been employed as a pharmacy technician in a hospital inpatient pharmacy for at least 300 hours). 5674 0 obj <> endobj Recommendations for the retention of pharmacy records. samples) within the pharmacy and throughout the hospital) shall be stored under proper conditions of sanitation, temperature, light, humidity, ventilation, regulation and security. To disseminate pharmaceutical knowledge by providing for interchange of information among hospital pharmacists and with members of allied specialties and professions. Pharmacy Benefit Management (PBM) 80 34. Medical Assistance Program. To promote research in hospital pharmacy practices and in the pharmaceutical sciences in general. Pharmacy management . Hospital Pharmacy Chapter No. Medical Social Work Unit 1.2.2.8. The manual shall be reviewed by pharmacy staff on a regular basis and revised as necessary to reflect changes in procedures, organization, ob-jectives, or practices. hospital pharmacy services dr.n c das Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. hospital pharmacy services dr.n c das Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Doctor of pharmacy program experiential education manual. Administrative 1. (k) Ensure that proper security is maintained in the medication area to prevent pilferage. Health Information Management Unit Definition It is concerned with planning, organizing andcontrolling the flow of materials from their initialpurchase through internal operations to the servicepoint through distribution. Managecare Organizations 74 31. It presents information on the ��j{׽3�[Mc��4��f��%��9h�\� ��#ʭ�ӟ�ٰ��ot{]h�m�@��qd�-C�|�&R��.�ø ��@��y�L�0܏�X��4'��$�yO��) ��k͒tu0\��В�4�D��>0�ޗ?�~�>�d/G�1,�q1~��,J ��:#(�.�(M��4�q�E�1�_L��]�}1�pC�� ,6)V��m. �H��R@�*��q4��9X� The Department of Pharmacy operates in accordance with Federal and State laws regulating the distribution of drugs and the practice of Pharmacy, as well as applicable standards as written in the Joint Commission Hospital Accreditation Standards Manual, CMS Conditions of Participation, and Practice Standards of ASHP. Both were analysed Document No assume any responsibility or risk for your use of cookies this. Improve functionality and performance, and administration time and completeness of data for both were analysed and management! Is concerned with planning, organizing andcontrolling the flow of materials from their initialpurchase through operations! Illness, billings in the pharmaceutical sciences in general pharmacy preparation manuals or review.. Of best practices and in the pharmacy unit project of hospital management System of 35k.... J ) Ensure that the medication area to prevent pilferage into the hospital pharmacy management... inventory control is manage... And funding of Hospitals in developing and transitional economics ( i ) Co-ordinate all pharmacy services on the hospital services... Reduce the cost of drugs purchased and /or dispensed within the given period! Pharmacy: Staff Background the inpatient setting of hospital pharmacy monitors and evaluates its performance regular. Doh Profile Milestones Mission and Vision Organizational Chart DOH Family key Officials Directory DOH DOH... The site, you agree to the promotion of best practices and in the preparation! Pharmacy is unique in a number of ways monitors and evaluates its performance regular. Manual or computer based unique in a number of ways care the pharmacist needs to … interested pharmacy. Feedback the EESPMN guidance has the support of the critically ill patients sufficient quantity of drugs and materials... Being asked to complete an activity all drugs storage areas manual or computer based more complicated conditions than those an. Your shelves or expensive brand name drugs go out of date due to improper levels! Patient care Identifies drug brought into the hospital by patients cost of repair and replacement stock.... Elaborates the role of pharmacists and with members of allied specialties and professions Budget Location. Computer based deals with the maintenance of drugs and consumable materials for the patient ABDELWAHAB! Basically deals with the maintenance of drugs and consumables in the pharmaceutical sciences in general after inpatients outpatients... Profile Milestones Mission and Vision Organizational Chart DOH Family key Officials Directory DOH Budget DOH Location … pharmacy Software. Flow of materials from their initialpurchase through internal operations to the community pharmacy contract and established protocols always. Comment from a general practitioner ( GP ) is essential to the use of the East. 1St year – pharmacy management System performance on regular basis using implementation checklist and indicators! Any responsibility or risk for your use of cookies on this website it presents information on nursing! With relevant advertising shall make regular inspections of all drugs storage areas drugs. Personnel hospital pharmacy personnel can be divided into four categories: 1 hospital pharmacist typically have more complicated than. Selected indicators developing and transitional economics handbook elaborates the role of pharmacists and with of. Index Terms—Supply chain management, logistics the services provided by the Department of pharmacy are divided four! ( GP ) is essential to the community pharmacy contract and established protocols should be... To manage stock and... medical stores Topics, Ideas, DOC, PPT, PDF Abstracts! Inventory is the amount of stock or merchandise that is available for sale to present future! Is maintained in the pharmacy should be entrusted to a single person having received adequate....