Assessment of Inpatient Pharmacists' Clinical Intervention Following Implementation of a Pharmacist Intervention Tracking Tool
by Allison R Behrens, PharmD, Melissa E. Ha, PharmD, BCCCP, Berook Addisu, PharmD, BCPS
"Objectives: Pharmacists are highly involved in patient care throughout daily practice. The primary objective of this study was to evaluate the most common disease states in which clinical pharmacists intervene using an intervention-tracking tool called the PhARMD template.
Methods: This was a single-site, prospective evaluation assessing inpatient pharmacist interventions. Baseline data was collected for a six-month period prior to implementation of the template and compared to two post-implementation phases. Phase I included voluntary use of the template for activities that pharmacists were already documenting in the electronic medical record, and Phase II included use of the template for all pharmacist interventions.
Results: The number of documented interventions per day increased from baseline 0.67 interventions per day to 32.54 and 46.8 interventions
per day in Phase I and Phase II, respectively. During Phase II, the
most common categories documented were medication reconciliation, anticoagulation, and inpatient clinical interventions. Of the inpatient clinical interventions, the most common disease states intervened
in included antimicrobial stewardship (16.7%) and “additional pharmacotherapy” (19.7%), which includes ordering tests and labs; addressing adherence; and other non-pharmacological interventions. Actions most frequently performed by pharmacists included initiation of medications (28.6%), adjusting dose/frequency (24.2%), and monitoring of medications (19.7%).
Conclusions: Pharmacists impact patients through independent practices and clinical recommendations resulting in changes to patient care
plans. Use of the PhARMD template provides quantification of these interventions, including the number of disease states that pharmacists may affect, as well as the quality of these interventions."
Keywords: Pharmacists, Medication Reconciliation, Electronic Health Records, Inpatients, Antimicrobial Stewardship, Prospective Studies, Health Services, Patient Care Planning, Goals, Anticoagulants, Patient Care
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2021 May/June Table of Contents
"Objectives: Pharmacists are highly involved in patient care throughout daily practice. The primary objective of this study was to evaluate the most common disease states in which clinical pharmacists intervene using an intervention-tracking tool called the PhARMD template.
Methods: This was a single-site, prospective evaluation assessing inpatient pharmacist interventions. Baseline data was collected for a six-month period prior to implementation of the template and compared to two post-implementation phases. Phase I included voluntary use of the template for activities that pharmacists were already documenting in the electronic medical record, and Phase II included use of the template for all pharmacist interventions.
Results: The number of documented interventions per day increased from baseline 0.67 interventions per day to 32.54 and 46.8 interventions
per day in Phase I and Phase II, respectively. During Phase II, the
most common categories documented were medication reconciliation, anticoagulation, and inpatient clinical interventions. Of the inpatient clinical interventions, the most common disease states intervened
in included antimicrobial stewardship (16.7%) and “additional pharmacotherapy” (19.7%), which includes ordering tests and labs; addressing adherence; and other non-pharmacological interventions. Actions most frequently performed by pharmacists included initiation of medications (28.6%), adjusting dose/frequency (24.2%), and monitoring of medications (19.7%).
Conclusions: Pharmacists impact patients through independent practices and clinical recommendations resulting in changes to patient care
plans. Use of the PhARMD template provides quantification of these interventions, including the number of disease states that pharmacists may affect, as well as the quality of these interventions."
Keywords: Pharmacists, Medication Reconciliation, Electronic Health Records, Inpatients, Antimicrobial Stewardship, Prospective Studies, Health Services, Patient Care Planning, Goals, Anticoagulants, Patient Care
Download PDF
2021 May/June Table of Contents