Documentation of cost savings from decentralized clinical pharmacy services at a community hospital.

A pilot program designed to justify the costs of clinical pharmacy services through the use of workload documentation cards is described. At this community hospital, defining a philosophy of care was the first step in developing and implementing decentralized services. A patient-specific care model was chosen, and principles of patient-oriented service were outlined. Daily workload documentation cards were designed for recording pharmacist activities; distribution functions were noted on one side, clinical activities on the other. Direct cost savings that could be attributed to the clinical pharmacists' drug therapy recommendations were quantified and recorded on a second form. Sixty-three beds in four hospital units were chosen as sites of the pilot effort. At the end of the six-month study, an analysis of the cost-savings forms documented that clinical pharmacist activities produced an average savings of $1.49 per patient day. The break-even point at which pharmacist salary expenses would equal direct cost savings was determined to be one clinical pharmacist per 80 patient beds. A request to expand clinical services at the hospital was granted. By documenting clinical and distributive activities on a simple form and quantifying the savings associated with clinical interventions, this pilot program demonstrated the cost-effectiveness of clinical pharmacy services.