Characteristics Contributing to a Pharmacy Services Excellence Model in a Large Health System

Abstract

Objective: To identify characteristics that contribute to and promote a pharmacy services center of excellence model in a large health system.

Methods: In 2019, a survey was conducted of 161 acute care pharmacy departments of health system-affiliated hospitals. Information captured included pharmacy practice models, pharmacist resource allocation, training of pharmacy residents, postgraduate training and pharmacist certifications. Results were combined with clinical pharmacy metric performance and centralized electronic data to identify features of top performing pharmacy departments.

Results: Survey results were received from 141 of 161 affiliated hospitals (88%). Hospitals with 100 to 299 beds comprised 54% (n = 16 of 30) of the hospitals "at goal" and 66% (n = 26 of 40) of hospitals with "opportunity". Hospitals with top performing pharmacy services had greater participation in interdisciplinary rounds, reporting "always" participating in Adult Critical Care (67% versus 43%) and Medical/Surgical (30% vs. 8%) rounds. Hospitals that trained pharmacy residents had a greater number of clinical pharmacy metrics at goal (5.89 ± 1.59 versus 4.16 ± 1.86, p < 0.001), employed more board-certified pharmacists (2.32 ± 1.49 versus 1.57 ± 1.62, p = 0.019), more postgraduate year 1 (PGY1) trained pharmacists (2.06 ± 1.33 versus 1.19 ± 1.19, p < 0.001) and more PGY2 trained pharmacists (0.58 ± 0.64 versus 0.19 ± 0.44, p = 0.002). When including several key hospital characteristics into a single model, hospitals that trained pharmacy residents were significantly associated with achieving "at goal" status (p = 0.011).

Conclusion: Defining characteristics of a pharmacy services center of excellence model included "at goal" clinical pharmacy metrics performance, clinical pharmacist time dedicated to patient care activities, accredited pharmacy residency training programs, presence of pharmacists with advanced training or board certification and optimal operations and scheduling.

Keywords: benchmarking; board certification; center of excellence; health care quality indicators; hospital pharmacy service; internship and residency; metrics; pharmacist to patient ratio; pharmacy.