How do Clinical Pharmacists spend their Working Day? A Time‐and‐Motion Study

Abstract

Background Our health service is introducing an electronic medication management system (eMMs). Obtaining baseline data on the work patterns of pharmacists will allow assessment of the impact of the eMMs on pharmacists' work patterns. Aim To quantify the time clinical pharmacists spend on various activities over their working day prior to the implementation of an eMMs. Method During this continuous observational time‐and‐motion study (23 November to 17 December 2009), clinical pharmacists assigned to general medical and surgical wards were shadowed by two independent observers over their entire working days. A customised Access application was used to log times and calculate average times spent on each activity. Other data collected included time from admission to interview and opportunities for medication chart review. Results 9 pharmacists were observed for 265.3 hours over 30 separate pharmacist observation days. Clinical activities (56% of total time) included professional communication (20%), medication chart review (9.6%), medication history interview (9.5%), clinical review (9.1%), providing information to patients/carers (5.5%), ascertaining discharge drugs required (1.6%), and obtaining drug information (0.5%). Non‐clinical activities (44% of total time) included social activities/breaks (13%), meetings (6.9%), ordering/distribution (6.6%), discharge dispensing (6.3%), walking between wards/pharmacy (5.2%), looking for something (3.1%), and other activities (2.8%). On an average day, each pharmacist reviewed 21 of a possible 38 medication charts (55%), spent 20 minutes on clinical interventions and completed 4.5 medication history interviews. Average time from admission to interview was 67 hours. 18% of pharmacists' time was taken up with discharge/transfer of patients. Most patients 130/141 (93%) at discharge did not require further medication history clarification. Conclusion This study provides baseline data for comparison of the impact of the eMMs on pharmacist workflow.

Considering pharmacy workflow in the context of Australian community pharmacy: A pilot time and motion study

“…Time and motion studies provide a method for obtaining quantitative data on workflow and work practices, and have been recently used in some healthcare settings including in Australian hospital pharmacies, 11,12 and non-Australian community pharmacies. 3,13,14 Data collected with this method uses discrete variables and can be more easily compared to standards, between studies, and with future interventions.…”

Comparing the cost-effectiveness and clinical effectiveness of a new community in-reach rehabilitation service with the cost-effectiveness and clinical effectiveness of an established hospital-based rehabilitation service for older people: a pragmatic randomised controlled trial with microcost and qualitative analysis – the Community In-reach Rehabilitation And Care Transition (CIRACT) study

“…Of these, 142 papers were excluded based on the title and abstract, leaving 93 full-text papers to be screened for eligibility. Of these, 75 papers were excluded as they did not fit the inclusion criteria and two papers were unobtainable, even though interlibrary requests were submitted and the authors were contacted, leaving 16 papers [51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66] included in the review ( Table 9). …”

How Hospital Pharmacists Spend Their Time: A Work-Sampling Study

“…A similar approach has previously been used to study the workflow of other health care providers. [6][7][8][9] Vancouver General Hospital is a tertiary care centre with a staff that includes 50 pharmacists working on wards or clinics on any given day, whereas Richmond Hospital is a smaller community hospital, with 7 pharmacists working on wards or clinics daily. The pharmacists at both hospitals cover a variety of inpatient, outpatient, and critical care settings.…”

“…Investigators shadowed pharmacists to see what tasks they performed daily and to determine approximately how much time was spent on each task. [6][7][8] For example, deClifford and others 6 looked at the amount of time hospital pharmacists spent performing clinical and nonclinical activities to gather baseline data on the pharmacists' tasks. They found that 56% of total time was devoted to clinical activities, with the bulk of this time being spent on professional communication, chart reviews, and medication history interviews.…”