Documentation of Clinical Activities Using a Web-Based Application within an Eight Hospital Integrated Health Care System: A Six-Year Experience

Abstract

Purpose: To assess the first 6 years of documented clinical interventions and activities by a health care system pharmacy department after implementation of a Web-based documentation tool. Methods: Saint Barnabas Health Care System (SBHCS) implemented the Quantifi Web-based documentation tool in October of 2002. Nine global intervention categories were developed, and the activities of SBHCS's pharmacists were tracked from January 2003 to December 2008. The following data were monitored: total number of interventions per category, number of interventions per category stratified by year, total cost savings, cost savings by global category, top 5 activities documented each year, top 5 cost-saving interventions documented each year, and top 5 intervened medications each year.Results: A total of 760,555 clinical activities were documented during the study period, with the greatest number of interventions being from the order clarification category (30%) from 2003 through 2005 and the laboratory analysis category (25% to 30%) from 2006 to 2008. The total number of documented activities trended upward each year, as a whole and in nearly every individual category. The total documented direct cost savings during the study period was $6,169,593, with the therapeutic interventions category ($1,993,490) being the most influential. The total cost savings generally trended upward over the 6-year period. Conclusions: Implementation of the Web-based documentation tool had a positive impact on pharmacists' documentation rates. The tool is a practical and convenient method for documenting clinical activities and interventions in real-time, with corresponding cost-savings information, for a pharmacy department within an integrated health care system.

Documentation and classification of hospital pharmacist interventions: A scoping review

“…More than half of the studies were descriptive retrospective, 24,30,42,44 two were descriptive prospective 25,26 and the other was cross‐sectional retrospective 41 . Most of the studies were from European countries, France, 25,26,30 Germany 41,42 and Switzerland, 44 and one was from the United States 24 . The documentation and/or classification methods referred in these studies were externally developed for hospital use.…”

“…The documentation and/or classification methods referred in these studies were externally developed for hospital use. Such methods comprised systems created by or in collaboration with national hospital pharmacy associations 25,26,30,41,42,44 and a commercial solution 24 …”

“…Quantifi® is a web‐based commercially available solution to document and classify clinical activities, including PIs. Clinical activities and PIs were assessed after the implementation of Quantifi® in a healthcare system pharmacy department in the United States 24 . The tool enabled the standardization of the data and calculation of cost savings ($6 169 153 during the study period, all direct costs, since indirect cost only were possible later), and had a positive impact on the PI documentation rate (from 31 340 to 234 988 PIs).…”

“…41 Most of the studies were from European countries, France, 25,26,30 Germany 41,42 and Switzerland, 44 and one was from the United States. 24 The documentation and/or classification methods referred in these studies were externally developed for hospital use. Such methods comprised systems created by or in collaboration with national hospital pharmacy associations 25,26,30,41,42,44 and a commercial solution.…”

“…Such methods comprised systems created by or in collaboration with national hospital pharmacy associations 25,26,30,41,42,44 and a commercial solution. 24 The French studies used the validated French Society of Clinical Pharmacy (SFPC) report form to document and classify PIs, which were later enhanced and made web-accessible: the Act-IP ® . 25,26,30 The SFPC report form was developed and validated by the SPFC special interest group 50 based on the classification proposed by Strand et al 51 and guidelines by Van Mil et al 52 Act-IP ® is a tool for PI documentation that is freely available to any French-speaking pharmacist on the SFPC website.…”