Enhancing the clinical pharmacy service of a large teaching hospital: Development of a new clinical prioritisation tool
Background: The number and complexity of patients being admitted to hospitals is rising and some patients may not receive a full clinical pharmacy review or be reviewed as regularly as needed during their inpatient stay. This is a risk factor for medication errors. Clinical prioritisation identifies...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | Exploratory Research in Clinical and Social Pharmacy |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667276623001166 |
| _version_ | 1827582725303828480 |
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| author | Rebecca Clarke Maeve Colleran Gail Melanophy Margaret Bermingham |
| author_facet | Rebecca Clarke Maeve Colleran Gail Melanophy Margaret Bermingham |
| author_sort | Rebecca Clarke |
| collection | DOAJ |
| description | Background: The number and complexity of patients being admitted to hospitals is rising and some patients may not receive a full clinical pharmacy review or be reviewed as regularly as needed during their inpatient stay. This is a risk factor for medication errors. Clinical prioritisation identifies patients who are high-risk and most in need of a pharmacist review, targeting finite pharmacy resources to patients who will benefit the most. Objectives: Assess and enhance clinical prioritisation within a hospital pharmacy department. Methods: The study was conducted in a large urban academic teaching hospital. A cross-sectional survey of clinical pharmacists in the hospital was conducted to establish the patient clinical criteria they prioritise in their work. A clinical prioritisation tool was developed based on survey findings and was integrated into an existing electronic pharmacy care interface. A pre- and post-intervention study was conducted, consisting of data collection for five days pre- and five days post-implementation of the tool. Quantitative data were analysed using descriptive and inferential statistics. Qualitative data were analysed by thematic analysis. Results: Of 39 eligible pharmacists, 37 (95%) responded to the survey. The top-rated prioritisation criteria, including medicines reconciliation tasks and high-risk medicines, helped to inform the content of the clinical prioritisation tool. Post-intervention, there were more Level 1 complex patients reviewed by pharmacists and fewer Level 3 stable patients compared to pre-intervention. Tool sensitivity ranged from 51 to 88%, depending on the experience of the pharmacist using the tool. High levels of satisfaction with clinical prioritisation were reported by those using the tool. Conclusion: This newly developed clinical prioritisation tool has the potential to support pharmacists in identifying and reviewing patients in a more targeted manner than practice prior to tool development. Continued development and validation of the tool is essential, with a focus on developing a fully automated tool. |
| first_indexed | 2024-03-08T22:55:49Z |
| format | Article |
| id | doaj.art-a1d5953fcc0544cb86a27377222ddf49 |
| institution | Directory Open Access Journal |
| issn | 2667-2766 |
| language | English |
| last_indexed | 2024-03-08T22:55:49Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Exploratory Research in Clinical and Social Pharmacy |
| spelling | doaj.art-a1d5953fcc0544cb86a27377222ddf492023-12-16T06:10:37ZengElsevierExploratory Research in Clinical and Social Pharmacy2667-27662023-12-0112100335Enhancing the clinical pharmacy service of a large teaching hospital: Development of a new clinical prioritisation toolRebecca Clarke0Maeve Colleran1Gail Melanophy2Margaret Bermingham3Pharmacy Department, St James's Hospital, Dublin 8, Ireland; Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, IrelandPharmacy Department, St James's Hospital, Dublin 8, IrelandPharmacy Department, St James's Hospital, Dublin 8, IrelandPharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland; Corresponding author at: School of Pharmacy, University College Cork, Cork, Ireland.Background: The number and complexity of patients being admitted to hospitals is rising and some patients may not receive a full clinical pharmacy review or be reviewed as regularly as needed during their inpatient stay. This is a risk factor for medication errors. Clinical prioritisation identifies patients who are high-risk and most in need of a pharmacist review, targeting finite pharmacy resources to patients who will benefit the most. Objectives: Assess and enhance clinical prioritisation within a hospital pharmacy department. Methods: The study was conducted in a large urban academic teaching hospital. A cross-sectional survey of clinical pharmacists in the hospital was conducted to establish the patient clinical criteria they prioritise in their work. A clinical prioritisation tool was developed based on survey findings and was integrated into an existing electronic pharmacy care interface. A pre- and post-intervention study was conducted, consisting of data collection for five days pre- and five days post-implementation of the tool. Quantitative data were analysed using descriptive and inferential statistics. Qualitative data were analysed by thematic analysis. Results: Of 39 eligible pharmacists, 37 (95%) responded to the survey. The top-rated prioritisation criteria, including medicines reconciliation tasks and high-risk medicines, helped to inform the content of the clinical prioritisation tool. Post-intervention, there were more Level 1 complex patients reviewed by pharmacists and fewer Level 3 stable patients compared to pre-intervention. Tool sensitivity ranged from 51 to 88%, depending on the experience of the pharmacist using the tool. High levels of satisfaction with clinical prioritisation were reported by those using the tool. Conclusion: This newly developed clinical prioritisation tool has the potential to support pharmacists in identifying and reviewing patients in a more targeted manner than practice prior to tool development. Continued development and validation of the tool is essential, with a focus on developing a fully automated tool.http://www.sciencedirect.com/science/article/pii/S2667276623001166PharmacyPharmacy serviceHospitalClinical pharmacy information systemsPharmacists |
| spellingShingle | Rebecca Clarke Maeve Colleran Gail Melanophy Margaret Bermingham Enhancing the clinical pharmacy service of a large teaching hospital: Development of a new clinical prioritisation tool Exploratory Research in Clinical and Social Pharmacy Pharmacy Pharmacy service Hospital Clinical pharmacy information systems Pharmacists |
| title | Enhancing the clinical pharmacy service of a large teaching hospital: Development of a new clinical prioritisation tool |
| title_full | Enhancing the clinical pharmacy service of a large teaching hospital: Development of a new clinical prioritisation tool |
| title_fullStr | Enhancing the clinical pharmacy service of a large teaching hospital: Development of a new clinical prioritisation tool |
| title_full_unstemmed | Enhancing the clinical pharmacy service of a large teaching hospital: Development of a new clinical prioritisation tool |
| title_short | Enhancing the clinical pharmacy service of a large teaching hospital: Development of a new clinical prioritisation tool |
| title_sort | enhancing the clinical pharmacy service of a large teaching hospital development of a new clinical prioritisation tool |
| topic | Pharmacy Pharmacy service Hospital Clinical pharmacy information systems Pharmacists |
| url | http://www.sciencedirect.com/science/article/pii/S2667276623001166 |
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