Abstract
Objective: Pharmacists' impact on individual patient care is difficult to measure especially the contribution made by clinical pharmacy ward visits. This study set out to determine what activities pharmacists actually undertook on a clinical pharmacy ward visit and compare this with the usual method of measuring clinical pharmacist performance, self‐reported pharmacist interventions.Method: Observational analysis was carried out on 16 pharmacists providing a ward clinical pharmacy service in four acute hospitals. Main outcome measure: Percentage of pharmacist interventions recorded.Results: A total of 34 wards were visited during the study which included both medical and surgical specialities. Average time spent per patient was less than two minutes for most pharmacists and three‐quarters of the pharmacists checked over 80% of patient drug charts. Interventions represented 68% of pharmacist activities on the wards but on questioning the pharmacists reported that they would record only 31% of those interventions. Comparison of the interventions the pharmacists stated they would record with an historical sample of recorded interventions from the four hospitals showed a similar pattern in each intervention category. However, pharmacists were more likely to record interaction type interventions and less likely to record interventions on incomplete/illegal prescriptions, which were regarded as routine practice.Conclusion: Pharmacists reported they would record less than one‐third of interventions observed. If recorded pharmacist interventions continue to be used the main source of evidence of outputs of clinical pharmacy service, a better way of capturing this data needs to be developed.
References
Pharmacy: A report to the Nuffield Foundation. London: The Nuffield Foundation, 1986.
Department of Health. The way forward to hospital pharmacy. HC(88)54. London: Department of Health, 1988.
Cotter SM, Barber ND, McKee M. Survey of clinical pharmacy services in United Kingdom National Health Service hospitals. Am J Hosp Pharm 1994;51:2676-84.
Regional Pharmaceutical Officers' Special Interest Group. Standards for Pharmaceutical Services.West Midlands Regional Health Authority. June 1992
Radley AS, Hall J. The establishment and evaluation of a pharmacist developed anticoagulation clinic. Pharm J 1994;252:91-2
Jones B. Taking the tube home. Nursing Times 1998;94:67-68
Plan sets out how pharmacy can build a future for itself, says Minister. Pharm J 2000;265:397-400.
Department of Health. Pharmacy in the future-Implementing the NHS Plan. London: Department of Health, 2000.
Jenkins D, Cairns C, Barber N. How do ward pharmacists spend their time?: An activity sampling study. Int J Pharm Pract 1992;1:148-51
Hawkey CJ, Hodgson S, Norman A, Daneshmend TK, Garner ST. Effect of reactive pharmacy intervention on quality of hospital prescribing. BMJ 1990;300:986-90.
Batty R, Barber N. Ward pharmacy: a foundation for prescribing audit? Quality in health care 1992;1:5-9.
Lea J, Morgan S. Development of a computerised system to provide audit of pharmaceutical activity. Int J Pharm Pract 1993;2:117-23.
Cousins D, Hatoum H. The development of a computerised quality assurance system for clinical pharmacy. Int J Pharm Pract 1991;1:86-9.
Cousins D, Gerrett D, Luscombe D. Reliability and validity of hospital pharmacists' clinical intervention data. Am J Health-Syst Pharm 1997;54:1596-603.
Roethlisberger FJ, Dickson WJ. Management and the worker. Cambridge, MA: Harvard University Press, 1939.
Hospital pharmacist vacancies rate three times greater than nurses'. Pharm J 1999;262:99
Dosaj R, Mistry R. The pharmacy technician in clinical services. The Hospital Pharmacist 1998;5:26-8
Weiss MC. Clinical Pharmacy: Uncovering the Hidden Dimension. J Soc Admin Pharm 1994;11(2):67-77.
Boardman HF, Fitzpatrick RW. Clinical pharmacists' intervention records-how are they used. Pharmacy World & Science 1999;21(1):A9
Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm 1990;47:533-43
Savage IT. Observing pharmacists at work: quantifying the Hawthorne effect. J Soc Admin Pharm 1996;13:8-19. 59 Volume 23 No. 2 2001 Pharmacy World & Science
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Boardman, H., Fitzpatrick, R. Self reported clinical pharmacist interventions under‐estimate their input to patient care. Pharm World Sci 23, 55–59 (2001). https://doi.org/10.1023/A:1011270507539
Issue Date:
DOI: https://doi.org/10.1023/A:1011270507539