1
|
de Souza JFF, Fernandes BD, Rotta I, Visacri MB, de Mendonça Lima T. Key performance indicators for pharmaceutical services: A systematic review. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2024; 14:100441. [PMID: 38665264 PMCID: PMC11044031 DOI: 10.1016/j.rcsop.2024.100441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/03/2024] [Accepted: 04/05/2024] [Indexed: 04/28/2024] Open
Abstract
Background Key performance indicators (KPIs) are a set of indicators that improve the quality of services provided by pharmacists. They enable the monitoring and evaluation of result progress and optimize decision-making for stakeholders. Currently, there is no systematic review regarding KPIs for pharmaceutical services. Objectives To identify and assess the quality of KPIs developed for pharmaceutical services. Methods A systematic review was conducted in PubMed, Scopus, EMBASE, and LILACS from the inception of the database until February 5th, 2024. Studies that developed a set of KPIs for pharmaceutical services were included. The indicators were evaluated using the Appraisal of Indicators through Research and Evaluation (AIRE) instrument. Two independent reviewers performed the study selection, data extraction, and quality assessment. Results Fifteen studies were included. The studies were conducted in different regions, most of which were developed for clinical services in hospitals or ambulatory settings, and used similar domains for the development of KPIs such as medication review, patient safety, and patient counseling. Literature review combined with the Delphi technique was the method most used by the studies, with content validity by inter-rater agreement. Regarding methodological quality, most studies described information on the purpose, definition, and stakeholders' involvement in the set of KPIs. However, little information was observed on the strategy for risk adjustment, instructions for presenting and interpreting the indicator results, the detailed description of the numerator and denominator, evidence scientific, and the feasibility of the set of KPIs. Only one study achieved a high methodological quality in all domains of the AIRE tool. Conclusion Our findings showed the potential of KPIs to monitor and assess pharmacy practice quality. Future studies should expand KPIs for other settings, explore validity evidence of the existing KPIs, provide detailed descriptions of evidence, formulation, and usage, and test their feasibility in daily practice.
Collapse
Affiliation(s)
| | | | - Inajara Rotta
- Department of Pharmacy, Federal University of Paraná, Curitiba, Brazil
| | - Marília Berlofa Visacri
- Department of Pharmacy, Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Tácio de Mendonça Lima
- Department of Pharmacy and Pharmaceutical Administration, Faculty of Pharmacy, Fluminense Federal University, Niterói, Brazil
| |
Collapse
|
2
|
McVannel T, Tangedal K, Haines A, Semchuk WM. Anticoagulation Interventions by Pharmacists in Acute Care. Can J Hosp Pharm 2023; 76:126-130. [PMID: 36998749 PMCID: PMC10049768 DOI: 10.4212/cjhp.3276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
Background Clinical pharmacy key performance indicators (cpKPIs) relate to activities performed by pharmacists that have been shown to improve patient outcomes. Within Saskatchewan Health Authority (SHA) Regina, most cpKPIs are incorporated into the organization's clinical practice standards, which provide guidance in prioritizing care, especially for high-risk medications, including anticoagulants. To track pharmacists' interventions associated with clinical practice standards, a locally developed electronic data-capture system (known as AIM High) was implemented. Objectives To quantify and describe pharmacists' anticoagulation interventions on 16 wards with dedicated ward-based clinical pharmacists and to compare intervention rates between the cardiology and internal medicine wards to further evolve the organization's practice model. Methods Data from the electronic data-capture system were retrospectively analyzed for a 5-year period (January 2016 to December 2020). Results A total of 94 201 interventions were recorded in the AIM High system (average 362 interventions per week or 26 interventions per pharmacist per week). Of these, 15 661 (16.6%) cited the anticoagulation standard (average 60 anticoagulation interventions per week or 4 anticoagulant interventions per pharmacist per week). For the cardiology and internal medicine wards, 4183 of 11 888 (35.2%) and 9034 of 54 843 (16.5%) interventions cited the anticoagulation standard, respectively. The top 4 types of anticoagulation interventions were dose changed (n = 4372 or 27.9%), drug started or restarted (n = 3867 or 24.7%), patient education (n = 3094 or 19.8%), and drug discontinued (n = 2944 or 18.8%). Conclusion Dedicated ward-based clinical pharmacists were following clinical practice standards incorporating the majority of cpKPIs to complete anticoagulation interventions. The types of anticoagulation interventions evolved over time and were influenced by the patient population.
Collapse
Affiliation(s)
- Taylor McVannel
- , BScPharm, ACPR, was, at the time of this study, a Pharmacy Resident with the Department of Pharmacy Services, Saskatchewan Health Authority, Regina, Saskatchewan. She is now with the Department of Pharmacy Services, Brandon Regional Health Centre - Prairie Mountain Health, Brandon, Manitoba
| | - Kirsten Tangedal
- , BSP, ACPR, is with the Department of Pharmacy Services, Saskatchewan Health Authority, Regina, Saskatchewan
| | - Aleina Haines
- , BSP, ACPR, is with the Department of Pharmacy Services, Saskatchewan Health Authority, Regina, Saskatchewan
| | - William M Semchuk
- , BSP, MSc, ACPR, PharmD, FCSHP, is with the Department of Pharmacy Services, Saskatchewan Health Authority, Regina, Saskatchewan
| |
Collapse
|
3
|
Defining clinical pharmacy and support activities indicators for hospital practice using a combined nominal and focus group technique. Int J Clin Pharm 2021; 43:1660-1682. [PMID: 34165664 PMCID: PMC8642326 DOI: 10.1007/s11096-021-01298-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 06/10/2021] [Indexed: 11/05/2022]
Abstract
Background Although clinical pharmacy is a crucial part of hospital pharmacist’s day-to-day activity, its performance is not usually subject to a holistic assessment. Objective To define a set of relevant and measurable clinical pharmacy and support activities key performance indicators (cpKPI and saKPI, respectively). Setting Portuguese Hospital Pharmacies. Method After a comprehensive literature review focusing on the metrics already in use in other countries, several meetings with directors of hospital pharmacies were conducted to obtain their perspectives on hospital pharmacy practices and existing metrics. Finally, five rounds with a panel of 8 experts were performed to define the final set of KPIs, where experts were asked to score each indicator’ relevance and measurability, and encouraged to suggest new metrics. Main outcome measure The first Portuguese list of KPIs to assess pharmacists’ clinical and support activities performance and quality in hospital pharmacies. Results A total of 136 KPIs were assessed during this study, of which 57 were included in the original list and 79 were later added by the expert panel. By the end of the study, a total of 85 indicators were included in the final list, of which 40 are considered to be saKPI, 39 cpKPI and 6 neither. Conclusion A set of measurable KPIs was established to allow for benchmarking within and between Portuguese hospital Pharmacies and to elevate professional accountability and transparency. Future perspectives include the use of both cpKPIs and saKPIs on a national scale to identify the most efficient performances and areas of possible improvement.
Collapse
|
4
|
Development of Key Performance Indicators for Capturing Impact of Pharmaceutical Care in Palestinian Integrative Healthcare Facilities: A Delphi Consensus Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:7527543. [PMID: 32714418 PMCID: PMC7334769 DOI: 10.1155/2020/7527543] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 05/27/2020] [Accepted: 06/10/2020] [Indexed: 12/15/2022]
Abstract
Background The current study was performed to develop a consensus-based core inventory of key performance indicators (KPIs) to be used in capturing the impact of pharmaceutical care in healthcare facilities that employ integrative medicine paradigm in Palestine. Methods A panel of healthcare professionals and risk/quality assurance managers was composed employing a judgmental sampling technique. The study tool was a questionnaire. Views and opinions of the panelists on the roles of pharmacists in caring for patients admitted to or visiting healthcare facilities that employ integrative medicine were collected using 11 statements. An initial inventory of activities and services that potentially can be used as KPIs was compiled from the literature and interviews with key contact experts in the domain. Three iterative Delphi rounds were conducted among the panelists (n = 50) to achieve formal consensus on the KPIs that should be used. The consensus-based KPIs were ordered by the scores of the panelists. Results A total of 8 consensus-based KPIs were developed. The KPIs related to the number of problems related to medications and complementary and alternative medicine (CAM) that were resolved by pharmacists and CAM practitioners (p < 0.0001), number of patients for whom reconciliations were documented (p < 0.0001), number of patients receiving direct, comprehensive, and/or collaborative care (p < 0.0001), and number of patients for whom pharmacists and CAM practitioners were involved in implementing a therapeutic plan (p < 0.05) were rated significantly higher than the KPI (#8) related to the participation in multi-healthcare provider discussions/deliberations. Conclusions Consensus-based KPIs that can be used in capturing the impact of evidence-based CAM and pharmaceutical care of patients in healthcare facilities that employ integrative medicine paradigm were developed. Future studies are still needed to investigate if implementing these KPIs might promote evidence-based CAM and pharmaceutical care in healthcare facilities that employ the integrative medicine paradigm.
Collapse
|
5
|
Quality Indicators of Pharmaceutical Care in Palestinian Integrative Healthcare Facilities: Findings of a Qualitative Study among Stakeholders. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:4520769. [PMID: 32454859 PMCID: PMC7238345 DOI: 10.1155/2020/4520769] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 04/30/2020] [Indexed: 12/25/2022]
Abstract
Background Recently, there has been shifts from providing large volumes to providing higher quality of healthcare services. This qualitative exploratory study was conducted to explore the views of different stakeholders on activities and services that could serve as quality indicators of pharmaceutical care in Palestinian integrative healthcare facilities. Methods A judgmental sampling technique was used to invite and recruit stakeholders for this study. Semistructured in-depth interviews were conducted with the stakeholders. Data collected during the interviews were qualitatively analyzed using the interpretive description methodology. Themes, subthemes, and patterns were recognized using the Qualitative Analysis Guide of Leuven. The data were coded using RQDA software. Results Interviews (n = 22) were conducted with 9 complementary and alternative medicine practitioners, 8 pharmacists, 2 physicians, 2 nurses, and 1 risk/quality assurance manager. The interview median duration was 41 with an IQR of 22 min. Following the thematic analysis adopted to achieve the objectives of this study, six major themes emerged from the data collected from the interviews. The themes emerged from the data were (1) provision of collaborative, direct, and comprehensive patient care services; (2) common services and activities at the time of admission, during stay, at transition between wards/services/hospitals, and at discharge to home or community care; (3) screening for, identifying, and resolving problems; (4) collaboration with other healthcare providers; (5) professional development; and (6) performance and efficiency. Conclusions Quality indicators are invaluable for informing decisions relevant to justifying allocation of scarce resources, securing funds, and demonstrating value in activities and services within integrative healthcare facilities. Further studies are still needed to develop a set of measurable indicators to measure the impact of pharmaceutical care in integrative healthcare facilities.
Collapse
|
6
|
Air ambulance outcome measures using Institutes of Medicine and Donabedian quality frameworks: protocol for a systematic scoping review. Syst Rev 2020; 9:72. [PMID: 32241304 PMCID: PMC7118977 DOI: 10.1186/s13643-020-01316-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 03/01/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Dedicated air ambulance services provide a vital link for critically ill and injured patients to higher levels of care. The recent developments of pre-hospital and retrieval medicine create an opportunity for air ambulance providers and policy-makers to utilize a dashboard of quality performance measures to assess service performance. The objective of this scoping systematic review will be to identify and evaluate the range of air ambulance outcome measures reported in the literature and help to construct a quality dashboard based on a healthcare quality framework. METHODS We will search PubMed, MEDLINE, CINAHL, Scopus, and Cochrane Database of Systematic Reviews (from January 2001 onwards). Complementary searches will be conducted in selected relevant journals. We will include systematic reviews and observational studies (cohort, cross-sectional, interrupted time series) in critically ill or injured patients published in English and focusing on air ambulance delivery and quality measures. Two reviewers will independently screen all citations, full-text articles, and abstract data. The study methodological quality (or bias) will be appraised using appropriate tools. Analysis of the characteristics associated with outcome measure will be mapped and described according to the proposed healthcare quality framework. DISCUSSION This review will contribute to the development of an air ambulance quality dashboard designed to combine multiple quality frameworks. Our findings will provide a basis for helping decision-making in health planning and policy. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019144652.
Collapse
|
7
|
Al-Jazairi AS, Alnakhli AO. Quantifying Clinical Pharmacist Activities in a Tertiary Care Hospital Using Key Performance Indicators. Hosp Pharm 2020; 56:321-327. [PMID: 34381268 DOI: 10.1177/0018578719897074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Key performance indicators (KPIs) are a set of measures used to help an organization in assessing and achieving goals critical to success. The aim of this study was to quantify the clinical pharmacists' contribution to patient care in a tertiary care hospital using predefined clinical pharmacy KPIs. Method: This study was a prospective, observational study conducted by the Pharmaceutical Care Division of a tertiary care hospital. Clinical pharmacy KPIs were submitted by each clinical pharmacist on a monthly basis for 12 months during 2017. All clinical pharmacists up to the managerial level were included in the study. Data were analyzed, stratified, and correlated using Microsoft Excel, JMP statistical software, and Spearman correlation. The study was approved by the hospital's Office of Research Affairs, RAC number 2171-080. Results: A total of 42 clinical pharmacists reviewed 104 728 patient encounters. They performed an adjusted average of 1221 interventions with an acceptance rate of 91.5%, 273 medication reconciliations, 325 discharge consultations, 332 pharmacokinetic consultations, 700 total parenteral nutrition consultations and follow-ups, and 12 688 electronic order verifications per clinical pharmacist per year. These interventions collectively resulted in a cost saving of $316 087.65 per clinical pharmacist per year. Statistical significance with positive correlation was noted for a number of precepted residents/students and clinical pharmacists' experience (R = 0.382, P = .013) and board certification (R = 0.428, P = .0047). Conclusion: Clinical pharmacy KPIs were able to quantify the clinical pharmacists' contributions to patient care and cost savings, which may lead to improve, standardize, and benchmark clinical pharmacy activities in the region.
Collapse
Affiliation(s)
| | - Adel O Alnakhli
- King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| |
Collapse
|
8
|
Slavik RS, Khullar M, Gorman SK, Bruchet N, Murray S, Hamilton B, Dalen D. Contribution of Pharmacy Practice Residents to Resolution of Drug Therapy Problems for Patients: RES-DTP Study. Can J Hosp Pharm 2019; 72:353-359. [PMID: 31692538 PMCID: PMC6799968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Canadian pharmacy practice residency programs promote development of key competencies for direct patient care resulting in resolution of drug therapy problems (DTPs), which is 1 of 8 national clinical pharmacy key performance indicators. There are no Canadian data on the contribution of residents to resolution of DTPs, including DTPs for priority diseases covered in disease-state education modules (PD-DTPs) or quality indicator DTPs (QI-DPTs), as assessed through application of evidence-based interventions proven to reduce morbidity, mortality, or health resource utilization. OBJECTIVE To describe the contribution of pharmacy practice residents to direct patient care using 3 process-of-care measures: resident-resolved DTPs, PD-DTPs, and QI-DTPs. METHODS This prospective, observational single-group study was conducted across 5 rotation sites within the authors' health authority from September 2, 2013, to June 13, 2014. The primary outcome was number of DTPs resolved. The secondary outcomes were number of PD-DTPs resolved; number of QI-DTPs resolved; numbers of DTPs, PD-DTPs, and QI-DTPs resolved over time; and residents' satisfaction with electronic tracking of resolved DTPs (in terms of training, usability, efficiency, and time requirements). RESULTS Four residents completed a total of twenty-one 4-week rotations and resolved a total of 1201 DTPs. Of these, 620 (52%) were PD-DTPs and 479 (40%) were QI-DTPs. Overall, the number of interventions increased for rotations 1-3, decreased for rotations 4 and 5, and increased again for rotation 6. The median score for all questions in all domains of the satisfaction survey was 4 out of 5 ("agree"). CONCLUSIONS Pharmacy practice residents were resolving DTPs, PD-DTPs, and QI-DTPs for patients and were contributing significantly to direct patient care. On the basis of literature evidence, the number and type of interventions observed in this study would be expected to improve clinical and health economic outcomes for patients.
Collapse
Affiliation(s)
- Richard S Slavik
- , BSc (Pharm), ACPR, PharmD, FCSHP, is the Manager of Professional Practice, Interior Health Pharmacy Services, Kelowna, British Columbia
| | - Manish Khullar
- , BSc, BSc(Pharm), ACPR, is a Clinical Pharmacist with Lower Mainland Pharmacy Services, Surrey, British Columbia
| | - Sean K Gorman
- , BSc(Pharm), ACPR, PharmD, is the Coordinator of Clinical Quality and Research with Interior Health Pharmacy Services, Kelowna, British Columbia
| | - Nicole Bruchet
- , BSc(Pharm), ACPR, PharmD, is the Coordinator of Residency and Education with Interior Health Pharmacy Services, Kelowna, British Columbia
| | - Sarah Murray
- , BSc(Pharm), ACPR, is a Clinical Pharmacist with Interior Health Pharmacy Services, Kelowna, British Columbia
| | - Brett Hamilton
- , BSc(Pharm), ACPR, is a Clinical Pharmacist with Interior Health Pharmacy Services, Kelowna, British Columbia
| | - Dawn Dalen
- , BSP, ACPR, PharmD, is the Professional Practice Leader with Interior Health Pharmacy Services, Kelowna, British Columbia
| |
Collapse
|
9
|
Cortes D, Leung J, Ryl A, Lieu J. Pharmacy Informatics: Where Medication Use and Technology Meet. Can J Hosp Pharm 2019; 72:320-326. [PMID: 31452544 PMCID: PMC6699873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Daniel Cortes
- BScPhm, RPh, is with the Pharmacy Department and Clinical Informatics, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario BScPhm, RPh, is with the Pharmacy Department and Clinical Informatics, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario BScPhm, RPh, is with the Pharmacy Department, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario BScPhm, ACPR, RPh, is with Clinical Informatics, St Joseph's Health Centre, Unity Health Toronto, Toronto, Ontario
| | - Jodie Leung
- BScPhm, RPh, is with the Pharmacy Department and Clinical Informatics, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario BScPhm, RPh, is with the Pharmacy Department and Clinical Informatics, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario BScPhm, RPh, is with the Pharmacy Department, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario BScPhm, ACPR, RPh, is with Clinical Informatics, St Joseph's Health Centre, Unity Health Toronto, Toronto, Ontario
| | - Andrea Ryl
- BScPhm, RPh, is with the Pharmacy Department and Clinical Informatics, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario BScPhm, RPh, is with the Pharmacy Department and Clinical Informatics, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario BScPhm, RPh, is with the Pharmacy Department, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario BScPhm, ACPR, RPh, is with Clinical Informatics, St Joseph's Health Centre, Unity Health Toronto, Toronto, Ontario
| | - Jenny Lieu
- BScPhm, RPh, is with the Pharmacy Department and Clinical Informatics, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario BScPhm, RPh, is with the Pharmacy Department and Clinical Informatics, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario BScPhm, RPh, is with the Pharmacy Department, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario BScPhm, ACPR, RPh, is with Clinical Informatics, St Joseph's Health Centre, Unity Health Toronto, Toronto, Ontario
| |
Collapse
|
10
|
Yung J, Nguyen T, MacLean R, Wentzell J. Impact of a Layered Learning Practice Model on Delivery of Clinical Pharmacy Key Performance Indicators under a Tertiary Care Centre Oncology Service. Can J Hosp Pharm 2019; 72:202-210. [PMID: 31258165 PMCID: PMC6592660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND The layered learning practice model (LLPM), within which a pharmacist supervises both a pharmacy resident and a student, mitigates the growing demand for clinical rotations that has accompanied national expansion of Doctor of Pharmacy programs. A Canadian collaborative of hospital pharmacists established consensus on 8 clinical pharmacy key performance indicators (cpKPIs), activities associated with improved patient outcomes. Increased implementation of the LLPM alongside cpKPI measurement offers opportunities to compare the LLPM with standard practice in terms of pharmaceutical care delivery. OBJECTIVE To quantify clinical productivity, as measured by proportions of eligible patients receiving cpKPIs and absolute numbers of completed cpKPIs, across scenarios involving pharmacists working with and without pharmacy learners. METHODS In this retrospective observational study, pharmacy students, pharmacy residents, and pharmacists recorded completion of 7 cpKPIs for oncology inpatients over a total of 6 months in 2017 and 2018. Clinical productivity was described across the following 3 scenarios: presence of one or more pharmacists with one resident and one or more students (P-R-S); presence of one or more pharmacists with one or more students (P-S); and presence of one or more pharmacists only (P; standard practice). RESULTS During the study, there were 685 recorded admissions to the inpatient oncology service. Generally, the proportions of patients who received cpKPIs were similar for scenarios with and without pharmacy learners present. Standardized to 20 pharmacist workdays, the total number of cpKPIs 1, 2, 3, 5, 6, and 7 (255 with P-R-S scenario, 281 with P-S scenario, and 258 with P scenario) and the total number of drug therapy problems resolved (i.e., cpKPI 3; 153 with P-R-S scenario, 180 with P-S scenario, and 149 with P scenario) were similar across the scenarios. Scenario P had fewer admitted patients per pharmacist workday (3.2) than scenarios P-S and P-R-S (3.4 and 3.7, respectively), which may have contributed to a trend toward greater proportions of patients receiving cpKPIs under scenario P. CONCLUSIONS Compared with standard practice, integration of pharmacy learners within an oncology unit did not appear to impair clinical productivity, as demonstrated by the comparable proportions of patients receiving cpKPIs and the total number of completed cpKPIs.
Collapse
Affiliation(s)
- Jason Yung
- , BMSc, PharmD, ACPR, was at the time of this study, with the Department of Pharmacy, The Ottawa Hospital, Ottawa, Ontario, and the Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario. He is now with Toronto Western Hospital, University Health Network, Toronto, Ontario
| | - Tiffany Nguyen
- , BScPhm, ACPR, BCOP, is with the Department of Pharmacy, The Ottawa Hospital, Ottawa, Ontario
| | - Robert MacLean
- , BSc(Pharm), ACPR, PharmD, BCPS, is with the Department of Pharmacy, The Ottawa Hospital, Ottawa, Ontario
| | - Jason Wentzell
- , BScPhm, ACPR, BCOP, is with the Department of Pharmacy, The Ottawa Hospital and the Ottawa Hospital Research Institute, Ottawa, Ontario, and the School of Pharmacy, University of Waterloo, Kitchener, Ontario
| |
Collapse
|
11
|
Bullock B, Donovan P, Mitchell C, Whitty JA, Coombes I. The impact of a pharmacist on post-take ward round prescribing and medication appropriateness. Int J Clin Pharm 2019; 41:65-73. [PMID: 30610543 PMCID: PMC6394496 DOI: 10.1007/s11096-018-0775-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 12/17/2018] [Indexed: 11/29/2022]
Abstract
Background Medication communication and prescribing on the post-take ward round following patient admission to hospital can be suboptimal leading to worse patient outcomes. Objective To evaluate the impact of clinical pharmacist participation on the post-take ward round on the appropriateness of medication prescribing, medication communication, and overall patient health care outcomes. Setting Tertiary referral teaching hospital, Brisbane, Australia. Method A pre-post intervention study was undertaken that compared the addition of a senior clinical pharmacist attending the post-take ward was compared to usual wardbase pharmacist service, with no pharmacist present of the post-take ward round. We assessed the proportion of patients with an improvement in medication appropriateness from admission to discharge, using the START/STOPP checklists. Medication communication was assessed by the mean number of brief and in-depth discussions, with health care outcomes measured by comparing length of stay and 28-day readmission rates. Main outcome measures: Medication appropriateness according to the START/STOPP list, number and type of discussions with team members and length of stay and readmission rate. Results Two hundred and sixty patients were recruited (130 pre- and 130-post-intervention), across 23 and 20 post-take ward rounds, respectively. Post-intervention, there was increase in the proportion of patients who had an improvement medication appropriateness (pre-intervention 25.4%, post-intervention 36.9%; p = 0.004), the number of in-depth discussions about patients’ medication (1.9 ± 1.7 per patient pre-intervention, 2.7 ± 1.7 per patient post-, p < 0.001), and the number relating to high-risk medications (0.71 ± 1.1 per patient pre-intervention, to 1.2 ± 1.2 per patient post-, p < 0.05). Length of stay and 28-day mortality were unchanged. Conclusion Clinical pharmacist participation on the post-take ward round leads to improved medication-related communication and improved medication appropriateness but did not significantly improve health care outcomes.
Collapse
Affiliation(s)
- B Bullock
- Pharmacy Department, Royal Brisbane and Women's Hospital, Cnr Butterfield St and Bowen Bridge Rd, Herston, QLD, 4029, Australia. .,School of Pharmacy, University of Queensland, Pharmacy Australia Centre of Excellence, Level 4, 20 Cornwall Street, Woolloongabba, QLD, 4102, Australia. .,Medical Education Unit, Gold Coast Hospital and Health Service, 1 Hospital Blvd, Southport, QLD, 4215, Australia.
| | - P Donovan
- School of Medicine, University of Queensland, Level 5, Building 69, St Lucia, QLD, 4072, Australia.,Department Clinical Pharmacology, Royal Brisbane and Women's Hospital, Cnr Butterfield St and Bowen Bridge Rd, Herston, QLD, 4029, Australia
| | - C Mitchell
- School of Medicine, University of Queensland, Level 5, Building 69, St Lucia, QLD, 4072, Australia
| | - J A Whitty
- School of Pharmacy, University of Queensland, Pharmacy Australia Centre of Excellence, Level 4, 20 Cornwall Street, Woolloongabba, QLD, 4102, Australia.,Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK
| | - I Coombes
- Pharmacy Department, Royal Brisbane and Women's Hospital, Cnr Butterfield St and Bowen Bridge Rd, Herston, QLD, 4029, Australia.,School of Pharmacy, University of Queensland, Pharmacy Australia Centre of Excellence, Level 4, 20 Cornwall Street, Woolloongabba, QLD, 4102, Australia
| |
Collapse
|
12
|
Tkachuk S, Mabasa VH. Lost in Translation: Expanding Clinical Pharmacy Services through a Universal Language. Can J Hosp Pharm 2018; 71:155-156. [PMID: 29736051 PMCID: PMC5931077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Stacey Tkachuk
- Faculty of Pharmaceutical Sciences, The University of British Columbia, Clinical Pharmacist, Children's and Women's Health Centre of BC, Vancouver, British Columbia
| | - Vincent H Mabasa
- Burnaby Hospital, Burnaby, British Columbia, Clinical Associate Professor, Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia
| |
Collapse
|
13
|
Zed PJ. [Not Available]. Can J Hosp Pharm 2016; 69:437-438. [PMID: 28123188 PMCID: PMC5242274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Peter J. Zed
- Adresse de correspondance: D Peter J. Zed, Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver (BC) V6T 1Z3, Courriel:
| |
Collapse
|