The medicines management pathway describes the cognitive and physical steps involved in the use of medicines, with a focus on the consumer. There are 9 steps and 3 background processes. The steps and processes are interdependent and influence each other. Documentation of the pathway provides a framework to identify how the steps are related, the potential for any errors and safety system improvements. The pathway is applicable to all medicines, independent of the setting, health professionals involved and funding source. An understanding of the pathway and human factors associated with each step are necessary to ensure safe, effective and efficient use of medicines. The pathway can assist consumers and health professionals to understand their role and how their actions can improve medicine safety. Hospital pharmacists have an established role at all steps. With more professional services being offered via community and other pharmacy practice settings, the medicines management pathway concept will play an increasingly greater role across the continuum of care.
In 2007, a workforce questionnaire was sent to 236 Australian public hospitals with more than 50 beds. This report details the data received from 108 public hospital pharmacy services and compares the results to the earlier surveys performed at the same time of year in 2001, 2003 and 2005. Key findings of the 2007 snapshot of the Australian public hospital pharmacy workforce are that: overall, 84 of the 1256 (7%) establishment pharmacist full‐time equivalent positions were vacant (similar to 2005); there has been a considerable increase in establishment pharmacist full‐time equivalent positions in public hospitals in the past 2 years. 35 respondents indicated the need for additional 133 pharmacist full‐time equivalent positions (or an increase of 11%) in the next 2 years. The majority of these positions were needed because of the expansion of clinical services, improving pharmaceutical review initiatives and the introduction of the Pharmaceutical Benefits Scheme. 30 of the 84 vacancies are in New South Wales (vacancy rate 11%). New South Wales also has a substantial gap between the actual and required number of pharmacist full‐time equivalent positions and a relatively low number of establishment pharmacist full‐time equivalent positions; on average pharmacists spent (similar to 2005) 47% of their time providing clinical services, drug information services, and training and education; 38% of their time acquiring, manufacturing and dispensing medicines; and 15% of their time managing the medicine and personnel resources of the pharmacy service and hospital‐wide activities, such as institutional drug policy management; the number of available pharmacy intern positions has only increased slightly despite a large increase in the number of pharmacy graduates; and the percentage of hospital pharmacy technicians with formal qualifications as a pharmacy technician or overseas pharmacist has increased to over 50% (26% Certificate 111, 11% Certificate 1V, 13% with other qualifications).
Aim:To update the survey of the Australian hospital pharmacy workforce undertaken in 2001. Method: A questionnaire was sent to 303 Australian hospitals with an identified hospital pharmacy service. Data returned from 128 public hospital pharmacy services were analysed and compared to the earlier study. Results: Key findings were: 1. 107 (10%) of the 1054 establishment pharmacist full-time equivalent positions were vacant (an improvement from 14%); 2. the vacancy rate for pharmacists had decreased in South Australia (23 to 2%) and increased in Queensland (11 to 17%); 3. 1 in 3 hospital pharmacists worked part-time; 4. 1 in 3 hospital pharmacists had postgraduate qualifications; 5. the number of pre-registrant positions had increased with the greatest growth in New South Wales; 6. less than 40% of pharmacy technicians had any formal qualification; and 7. more than half of the hospital pharmacy services were planning to introduce new services in the next 2 years; mostly related to improving clinical services and medication safety. This would require an additional 100 pharmacist positions. Conclusion:The percentage of vacant positions had fallen slightly since the earlier survey. While there had been some improvement in the vacant establishment pharmacist full-time equivalent positions, over 100 pharmacist positions remain unfilled. Ongoing retention and recruitment strategies to meet anticipated demand and further reduce the number of vacancies in hospital pharmacy will be required.
To provide a snapshot of current staff utilisation, a questionnaire was sent to 248 Australian hospitals with an identified hospital pharmacy service. The data returned from 101 hospital pharmacy services provided a snapshot of where hospital pharmacists are currently working, what they spend their time doing, and the role of pre‐registration pharmacists and pharmacy support staff in providing hospital pharmacy services. Key findings of the responses from these 101 hospital pharmacy services showed that in 2000‐2001: 1. 129.16 of the 929.46 pharmacists establishment full‐time equivalent positions (14%) were vacant; 2. one in three hospital pharmacists worked part time; 3. one in three hospital pharmacists had a postgraduate qualification; and 4. on average 41 % of pharmacists' time was devoted to clinical services, 39% to distribution services and 16% to management activities. The full report is available at: http://www.shpa.org.au/documents/snapshotworkforce.pdf
An electronic questionnaire was sent to 239 public hospital pharmacy services in Australia to update and expand on a survey undertaken in 2001. The key findings from the 109 respondents (46%) showed that: 1. the average proportion of time pharmacists spent on clinical activities was 47%; 2. the average proportion of time spent on distribution activities was 37% and management activities was 16%; 3. in Victoria, the State with considerable uptake of the Pharmaceutical Benefits Scheme, the proportion of time spent on distribution services by pharmacists had increased slightly in the last 2 years. There had also been a change in the use of pharmacy technicians: 24% of their time was devoted to supporting clinical services and management activities; 4. the role of pharmacy technicians is changing; more than 30 full-time equivalent positions were involved in supporting clinical pharmacy activities; 5. the vast majority of hospital pharmacy services (94%) offered some form of clinical service to some or all of their overnight patients; however, only 75% offered clinical services to some or all of their same-day patients; 6. the clinical service delivery model used ranged considerably across and within States and Hospital Peer Groups; 55% of hospital pharmacy services had a mixed clinical service model in their hospital; 7. 7 hospitals offered a 7-day-a-week clinical pharmacy service; 8. 19 hospitals had clinical pharmacy services available in emergency departments and 10 in pre-admission clinics; 9. 32 hospital pharmacy services offered non-admitted or discharge patients access to medicines through the Pharmaceutical Benefits Scheme; 10. 32% of hospital pharmacy services offered a comprehensive distribution service to non-admitted patients and 28% offered a comprehensive service to discharge patients; 11. access to the Pharmaceutical Benefits Scheme was not the only factor driving the level of service delivered; 66% of hospitals with access to the Pharmaceutical Benefits Scheme offered a comprehensive service to non-admitted patients and 75% a comprehensive service to discharge patients; and 12. the distribution service delivery model used for inpatients ranged considerably across and within States and Hospital Peer Groups. Australian public hospitals generally use a hybrid distribution model for inpatients where a ward-based system is supported by an individual patient-based system.
A workforce questionnaire was sent to 198 Australian public hospitals with more than 50 beds. This report details the data returned from 99 (50%) public hospital pharmacy services and compares the results to earlier studies performed at the same time of year in 2001 and 2003. Key findings of the 2005 snapshot of the hospital pharmacy workforce in public hospitals in Australia are that: overall 69.95 of the 972.27 (7%) of establishment pharmacist full‐time equivalent positions were vacant—an improvement from the 2003 figure of 10%; 1 in 3 hospital pharmacists work part‐time; almost 1 in 3 hospital pharmacists have a postgraduate qualification; number of pre‐registration positions available has remained steady despite an increase in the number of pharmacy graduates; percentage of hospital pharmacy technicians with formal qualifications as a pharmacy technician or pharmacist has increased to over 45%; 66 respondents indicated the need for additional 154.68 pharmacists full‐time equivalent (or an increase of 16%) in the next two years. The majority of these related to extending clinical pharmacy services and the ongoing introduction of the Pharmaceutical Benefits Scheme in public hospitals.
Background Pharmaceutical review requires a facility‐wide approach and multidisciplinary collaboration between all involved in the use of medicines. Standards of practice for clinical pharmacy services and distribution of medicines, provide a blueprint for two activity groups provided by pharmacy services that contribute to pharmaceutical review. Aim To explore the pharmacy components required to deliver pharmaceutical review in Australian public hospitals and examine the resource implications to meet these objectives. Method Workforce data were collected from a questionnaire sent to hospital pharmacy managers in 2005. Respondents were asked to detail the pharmacist full‐time equivalents (FTEs) devoted to clinical, distribution and management activities. They were also asked to detail clinical service delivery models and the number of beds at their facility according to clinical pharmacy categories. Ratios of the number of pharmacists to clinical pharmacy bed type were used to calculate the national workforce requirements estimated after extrapolation. Results Approximately 768 pharmacist FTEs would be required to provide a basic clinical pharmacy service (3 clinical pharmacy activities: accurate medication history, assessment of current medication management, provision of medicines information to patients) for all patients in Australian public hospitals; approximately 1300 pharmacist FTEs would be required for a comprehensive clinical pharmacy service. This equates to 58 minutes of pharmacist time during an inpatient stay, for each overnight admission. At least 40% of clinical pharmacy services are required for general medical type beds and this should be considered when identifying the skills base required in the hospital pharmacy workforce. Conclusion Retaining the current highly skilled pharmacist workforce and attracting pharmacists into the hospital sector to fill vacant establishment positions is the first step. The number of establishment positions will then need to be increased nationally to fully deliver pharmaceutical review in Australia's public hospitals.
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