I recently received an email from the European Association of Hospital Pharmacists (EAHP) describing a project supported by EAHP to define a definition of pharmaceutical acuity which has apparently been published. Sadly, I seem to be unable to obtain a copy; I hope to yet get one.
This made me think about some of the early efforts along this path that have occurred historically. These efforts resulted in models that attempted to look at acuity in terms of the cost of pharmacy services (including the costs of drugs involved) that arose because current general patient acuity models treat disease states with very different use of pharmaceutical services as roughly equal [1],[2],[3].
In my opinion, the need for such acuity definitions is critical because, in their absence, many of us have seen consultants be brought in to reduce headcount with the general lack of understanding of the relationship between pharmacy headcount and drug costs.
It occurs to me that, with the automated systems in current use, we should be able to capture the data to build an alternative model that identifies:
- · the baseline human resources required to just “keep the pharmacy lights on” (the staffing necessary to keep the pharmacy open for its hours of operation).
- · the human resources required to maintain pharmacy automation systems.
- · the human resources necessary to meet the service level agreements the pharmacy has with the facility for delivery of medications for patient use.
- · the human resources necessary to operate agreed-upon clinical functions.
In my opinion, the articulation of such a model would go a long way toward normalizing an acceptable definition of “adequate staffing” and directing attention of organizational management toward sources of cost reduction other than reducing headcount.
The process defined on the EAHP website sounds like a good place to start. What if ASHP were to undertake such a project?
The thoughts of this blog are my own, and not necessarily those of my employer or of ASHP.
Dennis A. Tribble, PharmD, FASHP
Ormond Beach, FL
datdoc@aol.com
[1] Rough SS, McDaniel M, Rinehart JR Effective Use of workload and productivity monitoring tools in health-system pharmacy part 1 Am J Health-Syst Pharm 2010; 67:300-311.
[2] Rough SS, McDaniel M, Rinehart JR Effective use of workload and productivity monitoring tools in health-system pharmacy, part 2 Am J Health-Syst Pharm 2010; 67:380-388.
[3] Naseman RW et al Development of an inpatient operational pharmacy productivity model Amer J Health-Syst Pharm 2015; 72:206-211.