Development of Clinical Pharmacy Key Performance Indicators for Hospital Pharmacists Using a Modified Delphi Approach: Pharmacotherapy Best Practices Award, sponsored by Pfizer Canada Inc.

摘要

Introduction: There are no published, systematically-derived clinical pharmacy key performance indicators (cpKPIs). The aim was to develop national cpKPIs to advance clinical pharmacy practice and improve patient care. Methods: A working group established a cpKPI definition, eight cpKPI critical activity areas, 26 candidate cpKPIs, 11 cpKPI ideal attributes, and one overall consensus criterion. Over a 3-month period, 26 clinical pharmacists and hospital pharmacy leaders participated in a three-round modified Delphi survey. Using an Internet-based, pre-tested survey instrument, panelists independently rated the 26 candidate cpKPIs using the 11 cpKPI ideal attributes and one overall consensus criterion on a nine-point Likert scale. A meeting was facilitated between rounds two and three to debate the merits of each candidate cpKPI. Consensus was reached if 75% or more of the panelists assigned a score of seven to nine on the consensus criterion during the final round. Results: All panelists completed the three Delphi rounds and 25/26 (96%) attended the meeting. Eight candidate cpKPIs reached consensus: 1) performing admission medication reconciliation; 2) participating in inter-professional patient care rounds; 3) completing pharmaceutical care plans; 4) resolving drug therapy problems; 5) providing in-person disease and medication education to patients 6) providing discharge patient medication education; 7) performing discharge medication reconciliation; and 8) providing bundled, proactive direct patient care activities. Discussion: Strengths of this study were the consensus-making methodology and inclusion of panelists from across Canada with experiences representative of hospital pharmacy practice. A limitation was the inability to reach consensus on drug or disease-specific cpKPIs. Future research should focus on developing drug or disease-specific cpKPIs and on evaluating the real world impact of the cpKPIs on patient outcomes. Conclusions: A Delphi panel of hospital pharmacists was successful in determining eight consensus cpKPIs. Measurement and assessment of these cpKPIs should advance clinical pharmacy practice and improve patient care.