Analysis of Clinical Pharmacy Services and Development of a Model to Inform the Appropriate Skill Mix for a Clinical Pharmacy Workforce to Achieve the Optimisation of both Patient Outcomes and Cost-Effectiveness.

Abstract

Objective
to quantitatively measure and analyse the different types of daily clinical pharmacy services and develop an appropriate skill mix model for the clinical pharmacy workforce.
Method
Data was collected from 8 medical and surgical wards for two weeks each in addition to 129 days for the analysis of in-patient clinical pharmacist interventions. The duties were compared between different staff grades and ward specialties. Also, daily in-patient clinical pharmacists` interventions over 129 days, were collected, analysed and compared. Two potential elements were identified to develop a skill mix model. The first was relocation of two senior clinical pharmacy technicians CPTs to complete the medication histories for newly admitted patients. The second was assigning another senior CPT to complete any final check requests from hospital wards.
Main results
Clinical Pharmacy Technicians (CPTs) undertaken seven different clinical pharmacy related activities throughout the day while completing medicines reconciliation by ward pharmacists was the main activity provided during hospital admission and discharge which required more than half of pharmacist daily time and supported only 30% of the patients within each ward. Also, eight daily interventions were made by each ward pharmacist during in-patient stay. These equated to an estimated reduction in daily costs between £520 and £1200 in each ward. Four accurate and complete medicines histories were completed by each senior CPTs during the afternoon with similar accuracy and amount of time as junior pharmacist. Also, a reallocated CPT was able to complete 96.83% of all final check requested from 8 wards during afternoon.
Conclusion
Different clinical pharmacy services were delivered by pharmacists and CPTs throughout the patient hospital journey. CPTs roles can be enhanced to release more time allowing pharmacists to focus on more therapeutic issues. Reallocation of numbers, staff grades and competency will ensure best use of staff resources and improve the provided clinical pharmacy services, patient outcomes and cost-effectiveness

Date of Award	Mar 2020
Original language	English
Supervisor	Mamoon Aldeyab (Supervisor) & Kathryn Burnett (Supervisor)