Time and motion study quantifying the activities of the cardiology, respiratory, and geriatric clinical pharmacist

Abstract

There are few studies evaluating the workforce and the time allocated to tasks performed by clinical specialty pharmacists in Australia. The aim of this study was to quantify the time that clinical specialty pharmacists spend on various activities. A Work Observation Method by Activity Timing (WOMBAT) time and motion study was conducted at a tertiary-referral metropolitan health service with comprehensive unit-based clinical pharmacy services. Direct observations of clinical pharmacists were conducted by researchers during weekdays. Tasks and times observed were categorised into domains of ‘What, Who, How, and Where’, accounting for interruptions and multitasking. Eighteen clinical cardiology, respiratory, and geriatric pharmacists were observed over 171.2 h. The majority of time involved direct patient care activities (76.1% [95% confidence interval 72.6-79.6%]), including admission-related (7.6%), discharge-related (16.2%), and inpatient clinical tasks (52.5%). Activities were undertaken independently (55.9%) with doctors (26.2%), with nurses (10.5%), or with patients (9.6)%; 19.1% of the pharmacist’s day involved multitasking. The tasks most frequently performed together were inpatient clinical activities, including rounding and daily medicine review. This study quantified the typical task allocation of clinical pharmacists in cardiology, respiratory, and geriatric units. It demonstrated that in a hospital setting supported by comprehensive operational pharmacy services, clinical pharmacists working in acute and subacute clinical specialities, predominately undertake direct patient care tasks that have been shown to improve patient safety.