Defining clinical pharmacy and support activities indicators for hospital practice using a combined nominal and focus group technique

Hugo Lopes,Ana Paula Martins,Andrea Rodrigues Lopes,Helena Farinha

doi:10.1007/s11096-021-01298-z

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.

Highlights

Hospital pharmacists strive to continuously maintain and improve medication management and patient pharmaceutical care to the highest possible standards. Their roles include participating in medication management, which encompasses the entire way in which medicines are selected, procured, delivered, prescribed, administered and monitored [1, 2]
Clinical pharmacy is deemed an integral component of this process, being responsible for ensuring that patients receive the right medicine at the right time by an efficient and economic system [6]
Traditionally pharmacists were mostly concerned with procuring, dispensing, manufacturing and supplying drugs [2], clinical pharmacy has become so relevant that pharmacists spent an average of 47% of their time on clinical activities, 37% on distribution and 16% on management activities, as shown by an Australian study [7]

Summary

Introduction

Hospital pharmacists strive to continuously maintain and improve medication management and patient pharmaceutical care to the highest possible standards. Their roles include participating in medication management, which encompasses the entire way in which medicines are selected, procured, delivered, prescribed, administered and monitored [1, 2]. These activities are performed whilst ensuring the 7 “rights” are respected: right patient, right dose, right route, right time, and the right drug with the right information and documentation. Clinical pharmacy is a crucial part of hospital pharmacist’s day-to-day activity, its performance is not usually subject to a holistic assessment

Methods

Results

Discussion

Conclusion