Pharmacy Clinical and Distribution Service Delivery Models in Australian Public Hospitals

Abstract

An electronic questionnaire was sent to 239 public hospital pharmacy services in Australia to update and expand on a survey undertaken in 2001. The key findings from the 109 respondents (46%) showed that: 1. the average proportion of time pharmacists spent on clinical activities was 47%; 2. the average proportion of time spent on distribution activities was 37% and management activities was 16%; 3. in Victoria, the State with considerable uptake of the Pharmaceutical Benefits Scheme, the proportion of time spent on distribution services by pharmacists had increased slightly in the last 2 years. There had also been a change in the use of pharmacy technicians: 24% of their time was devoted to supporting clinical services and management activities; 4. the role of pharmacy technicians is changing; more than 30 full‐time equivalent positions were involved in supporting clinical pharmacy activities; 5. the vast majority of hospital pharmacy services (94%) offered some form of clinical service to some or all of their overnight patients; however, only 75% offered clinical services to some or all of their same‐day patients; 6. the clinical service delivery model used ranged considerably across and within States and Hospital Peer Groups; 55% of hospital pharmacy services had a mixed clinical service model in their hospital; 7. 7 hospitals offered a 7‐day‐a‐week clinical pharmacy service; 8. 19 hospitals had clinical pharmacy services available in emergency departments and 10 in pre‐admission clinics; 9. 32 hospital pharmacy services offered non‐admitted or discharge patients access to medicines through the Pharmaceutical Benefits Scheme; 10. 32% of hospital pharmacy services offered a comprehensive distribution service to non‐admitted patients and 28% offered a comprehensive service to discharge patients; 11. access to the Pharmaceutical Benefits Scheme was not the only factor driving the level of service delivered; 66% of hospitals with access to the Pharmaceutical Benefits Scheme offered a comprehensive service to non‐admitted patients and 75% a comprehensive service to discharge patients; and 12. the distribution service delivery model used for inpatients ranged considerably across and within States and Hospital Peer Groups. Australian public hospitals generally use a hybrid distribution model for inpatients where a ward‐based system is supported by an individual patient‐based system.