Self reported clinical pharmacist interventions under-estimate their inputto patient care

Objective: Pharmacists' impact on individual patient care is difficult to m easure especially the contribution made by clinical pharmacy ward visits. T his study set out to determine what activities pharmacists actually underto ok on a clinical pharmacy ward visit and compare this with the usual method of measuring clinical pharmacist performance, self-reported pharmacist int erventions. Method: Observational analysis was carried out on 16 pharmacists providing a ward clinical pharmacy service in four acute hospitals. Main outcome measure: Percentage of pharmacist interventions recorded. Results: A total of 34 wards were visited during the study which included b oth medical and surgical specialities. Average time spent per patient was l ess than two minutes for most pharmacists and three-quarters of the pharmac ists checked over 80% of patient drug charts. Interventions represented 68% of pharmacist activities on the wards but on questioning the pharmacists r eported that they would record only 31% of those interventions. Comparison of the interventions the pharmacists stated they would record with an histo rical sample of recorded interventions from the four hospitals showed a sim ilar pattern in each intervention category. However, pharmacists were more likely to record interaction type interventions and less likely to record i nterventions on incomplete/illegal prescriptions, which were regarded as ro utine practice. Conclusion: Pharmacists reported they would record less than one-third of i nterventions observed. If recorded pharmacist interventions continue to be used the main source of evidence of outputs of clinical pharmacy service, a better way of capturing this data needs to be developed.