Clinical Pharmacist Resources for Consistent Clinical Services

Abstract

2debated the question of whether clinical pharmacy services should be distributed equally or focused on a limited group of patients. This issue has been debated for many years within most hospital pharmacy departments, given that staffing levels generally preclude the provision of comprehensive pharmaceutical care to all admitted patients. We noted with interest Dr Jorgenson’s comments suggesting that there was no research comparing the 2 approaches to providing clinical services, which brought to mind a situation that we encountered in 1994 when faced with the task of implementing pharmaceutical care at Lion’s Gate Hospital, North Vancouver, British Columbia, in place of a selective drug monitoring service. At first, the institution’s clinical pharmacists were resistant to the change, primarily because they feared that important drug-related problems (DRPs) would be overlooked if we focused on selected patients. The lack of evidence of any benefit of changing from a traditional clinical service to pharmaceutical care was the main point of contention, so, after much debate, we undertook a study to evaluate the impact of changing our clinical program. Pharmaceutical care was a “hot topic” at the time and was the focus of the 1994 Canadian Society of Hospital Pharmacists’ Research and Education Foundation grant competition. We submitted an application and were fortunate to receive funding for the proposed study. We found that focusing clinical services on selected patients and providing comprehensive pharmaceutical care to these patients resulted in the identification and resolution of significantly more DRPs than using equivalent staff to carry out drug-specific or problem-specific monitoring for a larger number of patients. 3