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使用标准化关键绩效指标(KPI)对医院临床药学实践进行基准评估。

Benchmarking hospital clinical pharmacy practice using standardised key performance indicators (KPIs).

作者信息

Cossart Amelia R, Canning Martin L, Yong Faith R, Freeman Christopher R

机构信息

Safe and Effective Medicine Research Collaborative, Faculty of Medicine and Faculty of Health and Behavioural Science (School of Pharmacy), University of Queensland, Brisbane, Australia.

Metro North Clinical Governance, Herston, Australia.

出版信息

J Pharm Policy Pract. 2024 Dec 16;17(1):2431181. doi: 10.1080/20523211.2024.2431181. eCollection 2024.

Abstract

Hospital pharmacy services support quality use of medicines and medication safety through clinical pharmacy activities such as medication reviews and patient education. These activities can be measured and monitored using evidence-based and standardised key performance indicators (KPIs), which highlight the value of pharmacy services. Standardisation of KPIs supports long-term benchmarking and inter- and intra-site comparisons to target key areas for improvement in clinical pharmacy services. To describe the type and frequency of clinical pharmacy activity across five hospitals within one metropolitan hospital district. Key Performance Indicator data were collected by pharmacists from five hospital sites at one metropolitan hospital district, in Queensland Australia. Data were collected over one week for the following clinical settings: inpatient, discharge, outpatient clinic, and the dispensary. Data were collected using a manual, paper-based data collection tool previously developed using a co-design process. Across 11,215 inpatient encounters, hospital pharmacy services provided: best possible medication history (BPMH) within 24 h of admission: 69.5%; daily medication chart review: 57.2%; discharge education: 82.7%, discharge reconciliation: 88.2%; and provision of discharge medication record: 82.4%. Across 1,092 outpatient encounters, pharmacists documented BPMH for 33.3% of patients. Pharmacists identified a total of 5,009 drug-related problems (DRPs) across the data collection period, with the rate of identification highest in the outpatient clinic setting (64.8 per 100 patient reviews) followed by discharge (52.6 per 100 patient reviews) and then inpatient (48.1 per 100 patient reviews). Almost 20% of DRPs identified (= 975) were high risk. Reporting and benchmarking clinical pharmacy activity through standardised KPIs supports opportunities to identify service improvements. Future research should focus on larger scale studies using routinely recorded data to monitor clinical pharmacy KPIs across all care settings.

摘要

医院药学服务通过诸如用药评估和患者教育等临床药学活动,支持药物的合理使用和用药安全。这些活动可以使用基于证据的标准化关键绩效指标(KPI)进行衡量和监测,这些指标突出了药学服务的价值。KPI的标准化支持长期的基准测试以及不同机构和同一机构内部的比较,以确定临床药学服务中需要改进的关键领域。为了描述一个大都市医院区五家医院临床药学活动的类型和频率。澳大利亚昆士兰州一个大都市医院区的五家医院的药剂师收集了关键绩效指标数据。在一周内收集了以下临床环境的数据:住院患者、出院、门诊诊所和药房。数据收集使用了先前通过协同设计过程开发的基于纸质的手动数据收集工具。在11215次住院患者诊疗中,医院药学服务提供了:入院后24小时内的最佳用药史(BPMH):69.5%;每日用药图表审查:57.2%;出院教育:82.7%,出院用药核对:88.2%;以及提供出院用药记录:82.4%。在1092次门诊诊疗中,药剂师为33.3%的患者记录了BPMH。在数据收集期间,药剂师共识别出5009个药物相关问题(DRP),识别率在门诊诊所环境中最高(每100次患者评估中有64.8个),其次是出院时(每100次患者评估中有52.6个),然后是住院患者(每100次患者评估中有48.1个)。几乎20%的已识别DRP(=975个)为高风险。通过标准化KPI报告和基准测试临床药学活动有助于发现服务改进的机会。未来的研究应侧重于使用常规记录数据进行更大规模的研究,以监测所有护理环境中的临床药学KPI。

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