In 2007, a workforce questionnaire was sent to 236 Australian public hospitals with more than 50 beds. This report details the data received from 108 public hospital pharmacy services and compares the results to the earlier surveys performed at the same time of year in 2001, 2003 and 2005. Key findings of the 2007 snapshot of the Australian public hospital pharmacy workforce are that: overall, 84 of the 1256 (7%) establishment pharmacist full‐time equivalent positions were vacant (similar to 2005); there has been a considerable increase in establishment pharmacist full‐time equivalent positions in public hospitals in the past 2 years. 35 respondents indicated the need for additional 133 pharmacist full‐time equivalent positions (or an increase of 11%) in the next 2 years. The majority of these positions were needed because of the expansion of clinical services, improving pharmaceutical review initiatives and the introduction of the Pharmaceutical Benefits Scheme. 30 of the 84 vacancies are in New South Wales (vacancy rate 11%). New South Wales also has a substantial gap between the actual and required number of pharmacist full‐time equivalent positions and a relatively low number of establishment pharmacist full‐time equivalent positions; on average pharmacists spent (similar to 2005) 47% of their time providing clinical services, drug information services, and training and education; 38% of their time acquiring, manufacturing and dispensing medicines; and 15% of their time managing the medicine and personnel resources of the pharmacy service and hospital‐wide activities, such as institutional drug policy management; the number of available pharmacy intern positions has only increased slightly despite a large increase in the number of pharmacy graduates; and the percentage of hospital pharmacy technicians with formal qualifications as a pharmacy technician or overseas pharmacist has increased to over 50% (26% Certificate 111, 11% Certificate 1V, 13% with other qualifications).
Aim:To update the survey of the Australian hospital pharmacy workforce undertaken in 2001. Method: A questionnaire was sent to 303 Australian hospitals with an identified hospital pharmacy service. Data returned from 128 public hospital pharmacy services were analysed and compared to the earlier study. Results: Key findings were: 1. 107 (10%) of the 1054 establishment pharmacist full-time equivalent positions were vacant (an improvement from 14%); 2. the vacancy rate for pharmacists had decreased in South Australia (23 to 2%) and increased in Queensland (11 to 17%); 3. 1 in 3 hospital pharmacists worked part-time; 4. 1 in 3 hospital pharmacists had postgraduate qualifications; 5. the number of pre-registrant positions had increased with the greatest growth in New South Wales; 6. less than 40% of pharmacy technicians had any formal qualification; and 7. more than half of the hospital pharmacy services were planning to introduce new services in the next 2 years; mostly related to improving clinical services and medication safety. This would require an additional 100 pharmacist positions. Conclusion:The percentage of vacant positions had fallen slightly since the earlier survey. While there had been some improvement in the vacant establishment pharmacist full-time equivalent positions, over 100 pharmacist positions remain unfilled. Ongoing retention and recruitment strategies to meet anticipated demand and further reduce the number of vacancies in hospital pharmacy will be required.
An electronic questionnaire was sent to 239 public hospital pharmacy services in Australia to update and expand on a survey undertaken in 2001. The key findings from the 109 respondents (46%) showed that: 1. the average proportion of time pharmacists spent on clinical activities was 47%; 2. the average proportion of time spent on distribution activities was 37% and management activities was 16%; 3. in Victoria, the State with considerable uptake of the Pharmaceutical Benefits Scheme, the proportion of time spent on distribution services by pharmacists had increased slightly in the last 2 years. There had also been a change in the use of pharmacy technicians: 24% of their time was devoted to supporting clinical services and management activities; 4. the role of pharmacy technicians is changing; more than 30 full-time equivalent positions were involved in supporting clinical pharmacy activities; 5. the vast majority of hospital pharmacy services (94%) offered some form of clinical service to some or all of their overnight patients; however, only 75% offered clinical services to some or all of their same-day patients; 6. the clinical service delivery model used ranged considerably across and within States and Hospital Peer Groups; 55% of hospital pharmacy services had a mixed clinical service model in their hospital; 7. 7 hospitals offered a 7-day-a-week clinical pharmacy service; 8. 19 hospitals had clinical pharmacy services available in emergency departments and 10 in pre-admission clinics; 9. 32 hospital pharmacy services offered non-admitted or discharge patients access to medicines through the Pharmaceutical Benefits Scheme; 10. 32% of hospital pharmacy services offered a comprehensive distribution service to non-admitted patients and 28% offered a comprehensive service to discharge patients; 11. access to the Pharmaceutical Benefits Scheme was not the only factor driving the level of service delivered; 66% of hospitals with access to the Pharmaceutical Benefits Scheme offered a comprehensive service to non-admitted patients and 75% a comprehensive service to discharge patients; and 12. the distribution service delivery model used for inpatients ranged considerably across and within States and Hospital Peer Groups. Australian public hospitals generally use a hybrid distribution model for inpatients where a ward-based system is supported by an individual patient-based system.
Background: The Monash Health Hospital Outreach Medication Review (HOMR) service is a pharmacist-led service that targets patients at high risk of medication misadventure in the immediate post-discharge period. Aim: To study the impact of a HOMR service on emergency department attendances and hospital admissions within an Australian hospital network. Method: Information was collected on the total number of emergency department attendances and hospital admissions during the 12-month period prior to, and after, the date a HOMR service was provided to the study group between 1 January 2012 and 22 November 2012. This was compared to a control group who were referred to the service and were eligible, but rejected the service. Patients were stratified by age (≤50, 51-65 and >65 years) to determine any age-related variations and tõhen investigated excluding regular, planned admissions (dialysis, chemotherapy or transfusion-related). Results: The 398 patients in the study group had a total of 1691 admissions in the 12-month period pre-HOMR. The total number of admissions in the 12-month period post-HOMR was higher than during the pre-HOMR period for both the control and study groups. When an age subanalysis was conducted and regular planned admissions were excluded, patients aged 51-65 years exhibited a 25% reduction in hospital admissions (v 2 = 6.14, p < 0.05). There was no significant reduction in admissions for the other age groups or in emergency department attendances. Conclusion: The provision of HOMR outreach services has a valuable role to play in a clearly identified population that is at high risk of medication misadventure.
Background: The Society of Hospital Pharmacists of Australia's (SHPA) Standards of practice for clinical pharmacy list 10 activities pharmacists undertake to provide a comprehensive clinical service to inpatients and the staffing level needed to deliver this service (based on bed type). Time motion data from a recent Australian study could be used to elucidate the number of beds for which a pharmacist can provide clinical services (based on time taken for individual clinical activities). Aim: To calculate the number of patients/inpatient beds for which a pharmacist can provide clinical services. Method: A profile of clinical pharmacy activities and how often they need to be delivered to meet the SHPA Standards was developed for different patient types. Formulae were developed and populated with the time motion data to calculate clinical pharmacist staffing levels. Results: Staffing levels for 7 categories of patients/inpatient beds were elucidated. These calculations suggest the clinical pharmacist to bed type ratios described in the SHPA Standards considerably underestimate the time required to deliver a comprehensive clinical pharmacy service. Conclusion: Times per activity used in this exercise are conservative and provide the maximum number of patients for which a pharmacist can provide clinical services. These staffing levels could be used to allocate resources to achieve agreed clinical pharmacy service delivery in Australian hospitals. J Pharm Pract Res 2010; 40: 217-21.
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