Download By 2019 your hospital pharmacy department will have a formal

Future Trends In Hospital
Pharmacy Practice
Hospital Pharmacy In Canada Report
2013/14
Kevin Hall and Jean-Francois Bussieres
The Wisdom of Crowds
Why the many are smarter than the few
Surowiecki argues that aggregated data from
groups of informed, independent individuals
can result in better predictions and decisions
than those of individual experts.
Informed, independent individuals = Hospital
Pharmacy directors and managers who respond
to the HPC survey.
Assessing future trends in hospital
pharmacy practice in Canada - Methods
• Forty (40) statements were developed
• Each statement addressed a pharmacy practice
issue that had been identified by members of the
HPC Board as a potential future challenge
• Statements covered 5 domains of pharmacy
practice
The 5 domains of pharmacy practice
• Hospital pharmacy leadership
• Pharmacy practice models
• Ambulatory care services
• Pharmacy Informatics
• The pharmaceutical
marketplace
Statement Examples
“By 2019, your hospital pharmacy
department will have a systematic
strategic planning process in place that
includes the establishment of explicit
goals, a system for tracking the
achievement of those goals, and an
annual report to senior management”
Response options
Probability that the statement will reflect the
reality in your hospital by 2019 (five years in the
future)
•
•
•
•
Very likely
Somewhat likely
Somewhat unlikely
Very Unlikely
Results reported:
1. For each of the four response options
1. For the combined responses of :
Very likely and somewhat likely, that were
combined to create a “likely” measure
Very unlikely and somewhat unlikely, that were
combined to create an “unlikely” measure
Results and comments
Typical response rates for many of the
statements:
Very likely:
Somewhat likely:
Unlikely:
Very unlikely:
15% to 25%
20% to 50%
15% to 30%
5% to 15%
Results and comments
Typical response rates for many of the
statements, compared to Kotter’s Change
Model
Very likely:
Somewhat likely:
Unlikely:
Very unlikely:
Early adopters
Early majority
Late adopters
Laggards
Pharmacy Leadership Domain Example:
 “By 2019 your hospital pharmacy department will have a
formal, documented succession plan for key pharmacy
leadership positions”
 Very likely
 Somewhat likely
 Combined “Likely”
26%
37%
63%
Pharmacy Leadership Domain Example:
 “By 2019, your hospital pharmacy department will
have a systematic strategic planning process in place
that includes the establishment of explicit goals, a
system for tracking the achievement of those goals,
and an annual report to senior management”
 Very likely
 Somewhat likely
63%
29%
 Combined “Likely”
92%
Pharmacy Practice Model Domain Example:
 “By 2019, at least 75% of your pharmacists will function in a clinical
practice-centred model, defined as one in which pharmacists
function largely in clinical roles, with less than 20% of their time
spent performing distributive activities (e.g product preparation,
order-verification, checking the distributive work of other
pharmacists and technicians, etc.)”
 Very likely
 Somewhat likely
 Combined “Likely”
44%
39%
83%
Note: In 2013/14 report, the average percentage of pharmacists
practicing in a clinical practice centred model was only 19%. This
was actually a drop from the results in 2011/12 2here 20% of
pharmacists were re reported to be practicing in a clinical practice
centred model. Can that gap be closed? How?
Pharmacy Practice Model Domain Example:
 “By 2019, pharmacy students in the experiential training
component of their pharmacy program will be active,
regularly scheduled participants in the delivery of essential
patient care services at your hospital, to the extent that if
the students were not there, additional pharmacist staff
would have to be hired to perform those essential services”
 Very likely
4%
 Somewhat likely 42%
 Likely
46%
Note: ASHP and AACP have placed considerable emphasis
on this , as part of their pharmacy practice model initiative
Ambulatory Care Domain Example:
 By 2019, pharmacists in your hospital will have the authority
to write discharge prescription orders in order to reconcile
mediations taken before admission, medications
discontinued while in hospital and new medications started
during hospitalization.”
 Very likely
 Somewhat likely
 Combined Likely
Is this achievable?
20%
43%
63%
Ambulatory Care Domain Example:

 ”By 2019, in your hospital, pharmacists will provide ongoing
medication therapy management (MTM) services for
selected groups of ambulatory patients who are receiving
multiple medications or high risk medication therapy and
have been identified by the hospital or health system as
frequent users of the emergency department or inpatient
beds”
 Very likely
 Somewhat likely
23%
48%
 Combined Likely
71%
Pharmacy Informatics Domain Example:
“By 2019, your hospital will use a validated, automated
method for identifying patients most likely to benefit
from pharmacy-based patient care services, including
medication therapy monitoring
 Very likely
18%
 Somewhat likely 49%
 Likely
67%
 Note: How many hospitals have this now? How many
are seriously pursuing it?
Pharmacy Operations Domain Example:
” “By 2019, sterile products will be compounded in a USP
Chapter 797 compliant program operated by your hospital, or
will be outsourced to another hospital or commercial
compounding centre that is USP Chapter 797 compliant”
 Very likely
 Somewhat likely
 Likely
69%
20%
89%
 Note: How many hospital pharmacies are USP Chapter 797
compliant now?
Pharmacy Operations Domain Example:
“By 2019, your hospital will be part of a group of hospitals
that are serviced by a centralized medication preparation,
repackaging, and distribution systems.
 Very likely
32%
 Somewhat likely 23%
 Combined Likely
55%
 Note: How will this be achieved? Outsourced to
commercial providers?
Pharmacy Informatics Domain Example:
“By 2019, your pharmacy department will have a formal review
process in place that will collect data on how staff responded to
computer generated alerts, assess the appropriateness of alert
over-rides and implement changes that will optimize the value and
minimize the drawbacks of the computerised decision-support
applications that exist in your pharmacy information system”
“Very likely
 Somewhat likely
 Combined “Likely”
15%
52%
67%
 Note: In 2011/12 only 17% of respondents had any kind of policy
dealing with alert over-rides
Pharmaceutical Marketplace Domain Example:
“By 2019, the number of medication shortages that your
hospital will have to manage will have decreased by at least 25%,
as compared to the baseline in 2013/2014”
“Very likely
3%
 Somewhat likely 27%
 Likely
30%
 Note: 47% of respondents indicated that they thought it was
somewhat likely or very likely that medication shortages will
have increased by at least 25%
Pharmaceutical Marketplace Domain Example:
““By 2019, at least 25% of new pharmaceuticals entering the
market every year will have an accompanying diagnostic test
that will enable patient selection or optimal dosing (or both)
based on the patient’s genetic characteristics ”
 Very likely
 Somewhat likely
1%
21%
Combined “Likely”
22%
Is personalized medicine a mirage?
Future Trends
How will you use this
information?