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Hospital data coded in ICD-10 can be used to identify ADEs that occur during hospital stays and also clinical conditions, therapeutic drug classes and treating units where these occur. Using the CHADx algorithm on administrative datasets provides a consistent and economical method for such ADE monitoring.

Background: The Society of Hospital Pharmacists of Australia's (SHPA) Standards of practice for clinical pharmacy list 10 activities pharmacists undertake to provide a comprehensive clinical service to inpatients and the staffing level needed to deliver this service (based on bed type). Time motion data from a recent Australian study could be used to elucidate the number of beds for which a pharmacist can provide clinical services (based on time taken for individual clinical activities). Aim: To calculate the number of patients/inpatient beds for which a pharmacist can provide clinical services. Method: A profile of clinical pharmacy activities and how often they need to be delivered to meet the SHPA Standards was developed for different patient types. Formulae were developed and populated with the time motion data to calculate clinical pharmacist staffing levels. Results: Staffing levels for 7 categories of patients/inpatient beds were elucidated. These calculations suggest the clinical pharmacist to bed type ratios described in the SHPA Standards considerably underestimate the time required to deliver a comprehensive clinical pharmacy service. Conclusion: Times per activity used in this exercise are conservative and provide the maximum number of patients for which a pharmacist can provide clinical services. These staffing levels could be used to allocate resources to achieve agreed clinical pharmacy service delivery in Australian hospitals. J Pharm Pract Res 2010; 40: 217-21.

Aim:To determine the time needed to provide clinical pharmacy services to individual patient episodes for medical and surgical patients and the effect of patient presentation and complexity on the clinical pharmacy workload. Method: During a 5-month period in 2006 at two general hospitals, pharmacists recorded a defined range of activities that they provided for patients, including the actual times required for these tasks. A customised database linked to the two hospitals' patient administration systems stored the data according to the specific patient episode number. The influence of patient presentation and complexity on the clinical pharmacy activities provided was also examined. Results: The average time required by pharmacists to undertake a medication history interview and medication reconciliation was 9.6 (SD 4.9) minutes. Interventions required 5.7 (SD 4.6) minutes, clinical review of the medical record 5.5 (SD 4.0) minutes and medication order review 3.5 (SD 2.0) minutes. For all of these activities, the time required for medical patients was greater than for surgical patients and greater for 'complicated' patients. The average time required to perform all clinical pharmacy activities for 1071 completed patient episodes was 14.4 (SD 10.9) minutes and was greater for medical and 'complicated' patients. Conclusion:The time needed to provide clinical pharmacy services was affected by whether the patients were medical or surgical. The existence of comorbidities or complications affected these times. The times required to perform clinical pharmacy activities may not be consistent with recently proposed staff ratios for the provision of a basic clinical pharmacy service.

Aim:To determine the time spent by pharmacists on components of clinical pharmacy services using chosen recording tools. Method: A 4-week study was conducted at an acute general hospital in early 2006. Pharmacists completed Pharmaceutical Clinical Pathway (PCP) forms and recorded the time needed for its completion. Other activities not associated with completing PCP forms (e.g. medication chart review, clinical review, adverse drug reaction monitoring, therapeutic drug monitoring, provision of drug information) and the time needed to complete these were recorded on Clinical Activity Data Sheets (CADS). Finally, pharmacists recorded their interventions (and the time involved) directly into the Riskman database. Results: 204 PCP forms were completed. Pharmacists completed the medication history component of the PCP form and recorded the time in 92% of completed forms. The most commonly recorded time for this component of the PCP form was 6 to 10 minutes. There were 418 CADS completed with the most recorded activities being clinical review (355 occasions) and medication chart review (351 occasions). The least recorded activity was adverse drug reaction monitoring (20 occasions). The time for these activities was recorded on more than 97% of CADS completed with mean times ranging from 4.9 minutes (therapeutic drug monitoring) to 6.9 minutes (provision of drug information). 202 interventions were entered into the Riskman database and the time was recorded for 98% of these (mean time 8.8 minutes). Conclusion: The chosen recording tools measured the times required for the provision of a range of activities provided by a clinical pharmacy service. J Pharm Pract Res 2007; 37: 102-7.