Impact of Increased Clinical Pharmacy Activities

Abstract

ABSTRACTAimTo assess the impact of increased time spent on clinical pharmacy activities in an Australian hospital.MethodDuring the control period, a pharmacist provided both clinical services and discharge dispensing to a 30‐bed medical ward and a 15‐bed surgical ward. In the test period, the same pharmacist provided only clinical services to the medical ward. The number and type of clinical interventions for patients in the medical ward were compared for the two periods.ResultsThe number of patients discharged, mean length of stay and total number of discharge drug orders were similar in the control and test periods (96 vs 97, 6.4 vs 7.0, 635 vs 633 respectively). The profile, type and complexity of patients in both groups were also similar. In the test period, clinical interventions increased by 57%, the time from admission to first pharmacist interview was reduced from 3.51 (SD 4.10) to 1.28 (SD 1.30) days (p < 0.005), clinical interventions were resolved earlier at pharmacist admission interviews (50% vs 28%, p < 0.001) and inpatient pharmacist rounds (28% vs 2%), resulting in fewer clinical interventions (19% vs 71%, p < 0.001) at discharge. The commonest types of clinical interventions were drugs not prescribed when clinically indicated and prescribing of incorrect doses or strength.ConclusionAn improved pharmacist‐to ‐bed ratio resulted in patients receiving correct drug therapies earlier in their inpatient stay. Fewer clinical interventions encountered at discharge facilitated the dispensing process.