Selecting performance indicators for hospital pharmacy practice: A Canadian initiative

Abstract

Activity‐based funding is a method of funding hospitals according to the type and volume of services provided and adjusted to their patient population. Currently, pharmacy practice is mainly evaluated with costs and volumes, which are insufficient to properly measure the contribution of pharmacists. Facing the province of Quebec statewide implementation of activity‐based funding, expert committees were set up to develop a set of indicators using a predefined framework to assess pharmacy performance throughout all hospital activities and patient care. Through consultations, partners and stakeholders showed strong support for the initiative, putting more emphasis on the assessment of appropriateness as well as quality and safety. Among the different roles of pharmacists, respondents favoured the assessment of the pharmaceutical care and education of trainees and colleagues. Of the 150 candidate indicators initially identified, 24 were selected, of which 13 were prioritised for experimentation.

Key performance indicators for pharmaceutical services: A systematic review

“…Studies were carried out in different regions, such as Australia ( n = 3), 22 , 33 , 36 United States of America ( n = 2), 34 , 37 Canada (n = 2), 19 , 32 Poland, 35 Brazil, 20 Portugal, 3 Iran, 38 New Zealand, 39 Indonesia, 40 Israel, 41 and Palestine 42 ( n = 1 each). The purposes of the KPIs were to measure clinical services provided by pharmacists ( n = 9) 19 , 20 , 22 , 33 , 34 , 37 , 39 , 41 , 42 or any services provided by pharmacists, including support activities and clinical services ( n = 6).…”

“…The purposes of the KPIs were to measure clinical services provided by pharmacists ( n = 9) 19 , 20 , 22 , 33 , 34 , 37 , 39 , 41 , 42 or any services provided by pharmacists, including support activities and clinical services ( n = 6). 3 , 33 , 34 , 36 , 38 Nine studies 3 , 19 , 22 , 32 , 33 , 35 , 36 , 38 , 39 developed KPIs for a hospital setting, with two specifically designed for neonatal intensive care units (NICU). 35 , 36 Six studies 20 , 34 , 37 , 40 , 41 , 42 created KPIs for an ambulatory setting; three of them specifically tailored to home care, 37 patients with epilepsy, 41 and integrative medicine.…”

“…Seven studies 3 , 32 , 34 , 35 , 36 , 38 , 39 classified the developed indicators; three of them designed indicators to assess structure, process, and outcomes following the Donabedian model (structure, process, and outcome). 34 , 35 , 36 One study 32 categorized the KPI as appropriateness, quality and safety, efficiency, innovation and continuous improvement, and organizational structure. Another study 40 classified indicators as management, clinical, and performance indicators.…”

“…Additionally, a different study 38 grouped indicators as management, clinical, and financial indicators, while yet another study 3 classified them as clinical and support activity indicators. Most studies used similar domains such as medication review, 3 , 19 , 22 , 32 , 33 , 34 , 35 , 36 , 39 , 40 , 41 , 42 medication reconciliation, 3 , 19 , 22 , 32 , 33 , 34 , 39 patient safety, 3 , 22 , 35 , 36 , 38 costs, 35 , 36 , 38 , 40 patient satisfaction, 20 , 32 , 40 , 41 , 42 and patient counseling. 19 , 33 , 39 , 40 , 41 , 42 However, each study used different indicators to measure these domains.…”

“… 19 , 33 , 39 , 40 , 41 , 42 However, each study used different indicators to measure these domains. The number of KPIs ranged from 2 to 85, and seven studies 3 , 32 , 33 , 34 , 35 , 36 , 40 developed 15 or more indicators. Only three studies 20 , 34 , 37 described clearly the goal/target of the indicator.…”