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

Author(s):  
Hugo Lopes ◽  
Andrea Rodrigues Lopes ◽  
Helena Farinha ◽  
Ana Paula Martins

AbstractBackground 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.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Loai M. Saadah ◽  
Amer H. Khan ◽  
Syed Azhar Syed Sulaiman ◽  
Iman A. Bashiti

Abstract Background Clinical pharmacy interventions (CPI) usually require prior medical authorization. Physicians approve 80% of CPI and reject 20%. If pharmacists show that physicians should authorize all 100% CPI, the profession will step closer to a fully independent prescriber status. This study used an artificial neural network (ANN) model to determine whether clinical pharmacy (CP) may improve outcomes associated with rejected CPI. Method This is a non-interventional, retrospective analysis of documented CPI in a 100-bed, acute-care private hospital in Amman, Jordan. Study consisted of 542 patients, 574 admissions, and 1694 CPI. Team collected demographic and clinical data using a standardized tool. Input consisted of 54 variables with some taking merely repetitive values for each CPI in each patient whereas others varying with every CPI. Therefore, CPI was consolidated to one rejected and/or one accepted per patient per admission. Groups of accepted and rejected CPI were compared in terms of matched and unmatched variables. ANN were, subsequently, trained and internally as well as cross validated for outcomes of interest. Outcomes were length of hospital and intensive care stay after the index CPI (LOSTA & LOSICUA, respectively), readmissions, mortality, and cost of hospitalization. Best models were finally used to compare the two scenarios of approving 80% versus 100% of CPI. Variable impacts (VI) automatically generated by the ANN were compared to evaluate the effect of rejecting CPI. Main outcome measure was Lengths of hospital stay after the index CPI (LOSTA). Results ANN configurations converged within 18 s and 300 trials. All models showed a significant reduction in LOSTA with 100% versus 80% accepted CPI of about 0.4 days (2.6 ± 3.4, median (range) of 2 (0–28) versus 3.0 ± 3.8, 2 (0–30), P-value = 0.022). Average savings with acceptance of those rejected CPI was 55 JD (~ 78 US dollars) and could help hire about 1.3 extra clinical pharmacist full-time equivalents. Conclusions Maximizing acceptance of CPI reduced the length of hospital stay in this model. Practicing Clinical Pharmacists may qualify for further privileges including promotion to a fully independent prescriber status.


1993 ◽  
Vol 27 (10) ◽  
pp. 1278-1282 ◽  
Author(s):  
Hong-Chen Wang ◽  
Lan-Ying Chen ◽  
Alan H. Lau

OBJECTIVE: To describe the pharmacy profession and the education programs available to train pharmacists in the People's Republic of China (PRC). The practice of pharmacy in the hospital setting and the current development of clinical services are also described. BACKGROUND: There are two streams of medical practices in the PRC: traditional Chinese medicine and Western medicine. Hospital and community pharmacies are responsible for the dispensing of medicinals used for both streams of medical practices. Forty-two colleges of pharmacy offer pharmacy education, half of which provide a Western medicine approach and the other half traditional Chinese medicine. Both types of colleges offer a four-year curriculum with options for specialization. Opportunities for graduate study are also available. Most of the graduates work in hospital pharmacies. Hospital pharmacies participate in the bulk manufacture of drugs and parenteral fluids. A bulk dispensing system is used by some hospitals; individual patient doses are dispensed in others. Recently, the need to develop clinical pharmacy services in PRC was recognized and training courses were begun. Curricula with specialization in clinical pharmacy are being considered by colleges of pharmacy. CONCLUSIONS: It is anticipated that through increased awareness of the potential contribution of pharmacists in the PRC healthcare system, more opportunities for educating pharmacists will be made available to satisfy the vast need of the country. Development of clinical pharmacy services also will be expected to improve the quality of care provided.


2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Nagwa Ibrahim

Key performance indicators (KPIs) are measurable tools to keep track of progress on a specific performance objective of an institution. By selecting the proper KPI, we can identify the area of improvement in structure, process and outcome. KPIs should be SMART (Specific, Measurable, Attainable, Relevant, and Time bound). In addition, KPIs should be easy to understand, evidence based, reliable, acceptable and feasible. Clinical pharmacy key performance indicator (cp KPI) is a standard quantitative measure of progress for a specific clinical activity performed by clinical pharmacist. These cp KPIs serve as objective indicators to measure the efficiency of delivery of evidence-based patient care. The clinical services provided might be upon patient admission, during admission and at discharge in addition to outpatient services. Medication reconciliation at admission, pharmaceutical care plan and patient counseling at discharge are examples for process KPI for clinical services provided by pharmacist, while rate of adverse drug reaction and patient re admission are examples for outcome KPI. In conclusion application of cp KPI and quality metric is a great opportunity to give the general public a valuable insight into the contributions of clinical pharmacists to improve the overall quality of clinical care. This could help the profession demonstrate how pharmacy knowledge and skills are used to deliver patient outcomes rather than the supply of medicines. Selecting the suitable cp KPI will help us improve clinical pharmacy services and patient outcome.


2021 ◽  
pp. 112067212199062
Author(s):  
María Cinta Puell ◽  
Inés Contreras ◽  
Isabel Pinilla ◽  
José Juan Escobar ◽  
Antonio Soler-García ◽  
...  

Purpose: To identify patient-reported outcomes (PROs) and other clinical outcome measures (contrast sensitivity (CS), low-luminance visual acuity (LLVA) and reading acuity or reading speed (RA-RS)), relevant to patients with age-related macular degeneration (AMD) or diabetic retinopathy (DR), which would be recommended for use in clinical practice. Methods: The RAND/UCLA Appropriateness Method, based on the synthesis of the scientific evidence and the collective judgment of an expert panel using the two-round Delphi method, was applied. The evidence synthesis was performed by searching for articles on outcome measures for AMD and/or DR published between 2005 and 2018 in English or Spanish. The expert panel consisted of 14 Spanish ophthalmologists, who rated the recommendation degree for each outcome measure on a scale of 1 (extremely irrelevant) to 9 (maximum relevance). The recommended outcome measures were established according to the panel median score and the level of the panelists’ agreement. Results: Through the evidence search, 33 PRO-specific questionnaires (21 for visual function, six for AMD, three for DR, one for AMD and DR) and two treatment satisfaction questionnaires (one on AMD and one on DR) were identified. In addition, 21 methods were found for measuring CS, five for LLVA, and nine for RA-RS. According to the panel ratings, 11 of the 64 outcome measures evaluated for AMD, and seven of the 61 evaluated for DR were recommended. Conclusion: The AMD and DR outcome measures recommended will help ophthalmologists choose the outcome measure most appropriate for their patients. Furthermore, the use of PROs will contribute to shifting clinical practice towards patient-centered medicine.


2021 ◽  
Author(s):  
Tim D. Smithies ◽  
Mark J. Campbell ◽  
Niall Ramsbottom ◽  
Adam J. Toth

Abstract Notational analysis is a popular tool for understanding what constitutes optimal performance in traditional sports. However, this approach has been seldom used in esports. The popular esport “Rocket League” is an ideal candidate for notational analysis due to the availability of an online repository containing data from millions of matches. The purpose of this study was to use Random Forest models to identify in-match metrics that predicted match outcome (performance indicators or “PIs”) and/or in-game player rank (rank indicators or “RIs”). We evaluated match data from 21,588 Rocket League matches involving players from four different ranks. Upon identifying goal difference (GD) as a suitable outcome measure for Rocket League match performance, Random Forest models were used alongside accompanying variable importance methods to identify metrics that were PIs or RIs. We found shots taken, shots conceded, saves made, and time spent goalside of the ball to be the most important PIs, and time spent at supersonic speed, time spent on the ground, shots conceded and time spent goalside of the ball to be the most important RIs. This work is the first to use Random Forest learning algorithms to highlight the most critical PIs and RIs in a prominent esport.


2021 ◽  
Vol 74 (4) ◽  
Author(s):  
Mia Losier ◽  
Douglas Doucette ◽  
Olavo Fernandes ◽  
Sarah Mulrooney ◽  
Kent Toombs ◽  
...  

Background: The clinical pharmacy key performance indicators (cpKPIs) are quantifiable measures of quality to advance clinical pharmacy practice and improve patient care. Although when delivered in combination they have been linked to important patient outcomes, no data are available relating to their impact on hospital pharmacists’ job satisfaction. Objectives: To determine the level of job satisfaction among Canadian hospital pharmacists and whether participation in cpKPI activities contributes to hospital pharmacists’ job satisfaction. Methods: A mixed-methods study was conducted. An electronic survey, consisting of 36 questions, was developed using a validated pharmacist job satisfaction tool and was then distributed nationally to hospital pharmacists between January 30 and March 14, 2019. Focus groups were conducted with pharmacists at Horizon Health Network in New Brunswick to further explore activities that contribute to their job satisfaction. Results: Overall, 284 pharmacists from 9 provinces completed the electronic survey. The mean job satisfaction score among hospital pharmacists was 3.93 (standard deviation 0.85) out of 5. Job satisfaction scores increased with increases in self-identified time spent performing cpKPI activities (r = 0.148, p = 0.014). Pharmacist satisfaction increased with time spent performing medication reconciliation on admission (β = 0.140, p = 0.032) and decreased with time spent identifying and resolving drug therapy problems (β = –0.153, p = 0.030). Three focus groups, comprising a total of 13 pharmacists, were conducted; during these sessions, some cpKPIs were highlighted favourably, although pharmacists described some ambivalence toward patient education. The importance of having an impact and receiving appreciation was highlighted. Conclusions: Canadian hospital pharmacists are generally satisfied with their jobs, and participation in cpKPI activities was found to be positively associated with hospital pharmacists’ job satisfaction. RÉSUMÉ Contexte : Les indicateurs clés de performance de la pharmacie clinique (ICPpc) sont des mesures quantifiables de la qualité qui permettent de faire avancer la pratique en pharmacie et d’améliorer les soins du patient. Bien qu’ils aient été associés à des résultats importants pour les patients lorsqu’ils sont utilisés conjointement, aucune donnée concernant leur impact sur la satisfaction professionnelle des pharmaciens d’hôpitaux n’est disponible. Objectifs : Déterminer le degré de satisfaction professionnelle des pharmaciens d’hôpitaux canadiens et noter si la participation aux activités liées aux ICPpc y contribue. Méthodes : Une étude à méthodologie mixte a été menée. À l’aide d’un outil validé mesurant la satisfaction professionnelle du pharmacien, les investigateurs ont préparé une enquête électronique comprenant 36 questions, qui a été distribuée à l’échelle nationale aux pharmaciens d’hôpitaux entre le 30 janvier et le 14 mars 2019. Des groupes de travail comprenant des pharmaciens au Réseau de santé Horizon au Nouveau-Brunswick ont exploré plus en profondeur les activités qui contribuaient à leur satisfaction professionnelle. Résultats : Globalement, 284 pharmaciens de neuf provinces ont répondu à l’enquête électronique. Le score moyen de satisfaction des pharmaciens d’hôpitaux était de 3,93 (écart type 0,85) sur 5. Les scores relatifs à la satisfaction professionnelle augmentaient lorsque le temps passé à faire des activités liées aux ICPpc augmentait (r = 0,148, p = 0,014). La satisfaction du pharmacien augmentait quand il passait du temps à faire le bilan comparatif des médicaments au moment de l’admission (β = 0,140, p = 0,032) et diminuait quand il devait déterminer et résoudre des problèmes de pharmacothérapie (β = –0,153, p = 0,030). Trois groupes de discussion comprenant 13 pharmaciens au total se sont penchés sur la question. Pendant leurs séances, ils ont mis en valeur certains ICPpc, bien que les pharmaciens aient décrit des ambivalences concernant les instructions données au patient. Ils ont aussi souligné l’importance d’avoir un effet positif et d’être apprécié. Conclusions : Les pharmaciens d’hôpitaux canadiens sont généralement satisfaits de leur travail et la participation à des activités liées aux ICPpc est associée à leur satisfaction professionnelle.


Author(s):  
Anat Ratnovsky ◽  
Shai Rozenes ◽  
Pinchas Halpern

The overall quality of an emergency department (ED) can be measured by its ability to provide fast, efficient yet high-quality medical treatments to its patients. The objective of the present study was to derive a common set of key indicators that could be used to assess the quality of the performance of EDs. A modified Delphi process was employed to achieve this. This consisted of a detailed literature review followed by a three-round expert panel interaction, which was used to reduce and refine the list of indicators. The members of the panel comprised ED physicians, ED nurses and hospital and ED administrators drawn from six EDs. This process yielded 47 essential performance indicators and 12 recommended indicators. The performance indicators were classified into 7 main groups according to their characteristics. The chosen indicators comprise a core set that will be used in an ongoing study on a representative sample of EDs.


Author(s):  
Arezoo Dehghani Mahmoodabadi ◽  
Mostafa langarizadeh ◽  
Mohammad Hossein Mosaddegh Mehrjardi ◽  
Sima Emadi

Aim: This study aimed to determine the performance indicators required for hospital pharmacies and design a hospital pharmacy dashboard through defining requirements. Methods: This study was conducted in three phases in 2017. A qualitative approach was employed to collect and formulate key performance indicators (KPIs) for hospital pharmacies. A semi-structured questionnaire was constructed to determine KPIs. The data were analyzed using framework analysis. The classic Delphi technique was used to determine the dashboard requirements. Finally, the Dashboard was designed using QlikView12 and implemented in the selected hospital. The data displayed on the pharmacy dashboard was driven by the hospital information system (HIS). Results: The KPIs consisted of three domains including managerial, clinical, and financial indicators. Conclusion: Pharmacy services have been affected by the complexity and diversity of drugs, clinical concerns, and costs. The dashboard can help pharmacies' managers by monitoring. The dashboard design process begins by identifying KPIs that are important to decision-makers.


2021 ◽  

Background: Today, organization management in healthcare organizations needs to monitor and evaluate performance for better decision and policy making. Objectives: This study aimed at determining the Key Performance Indicators (KPIs) using software and a management dashboard. Methods: This study searched several articles discussing KPIs of emergency departments. A comprehensive list of indicators was obtained and presented to an expert panel with a wide range of experiences. The experts finalized the KPIs. A second round was performed to confirm the performance using Smart Pilates software. Based on the final panel’s rating, a list of KPIs was developed to be used. The extracted data was prepared to be entered into the computer system to design the dashboard using QlickView software. Subsequently, according to the type of indicator, the dashboard was designed with special software. Results: The extracted 14 KPIs of emergency departments were determined in three dimensions of input, process, and output. Following that, the project team designed a dashboard with 14 KPIs. Conclusion: To design and develop a dashboard, the management of information was essential for organizations. It is recommended that managers use KPIs for evaluating and monitoring emergency departments. Moreover, it can be used for planning and evaluating the performance in emergency departments.


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