Effective use of workload and productivity monitoring tools in health-system pharmacy, part 1

Abstract

Challenges with external operational benchmarking and internal productivity monitoring systems are numerous. These systems rarely measure the quality of pharmacy services provided and their effect on patient care outcomes and the total cost of care. Benchmarking vendors must modernize their software and develop internal checks to confirm data integrity in order to make their products more useful and reliable. In addition, data supporting the patient care role of the pharmacist should be integrated into all productivity monitoring systems and be used to demonstrate the positive impact of pharmacy services on the total cost and quality of patient care.

Balanced Scorecards as a Tool for Developing Patient-Centered Pharmacy Services

“…8,9 A dashboard focuses on graphical monitoring of operational processes; a BSC includes detailed measures that closely align with organizational strategic goals and objectives. Based on the considerations discussed earlier in the article, it is recommended that the pharmacy director incorporate Kaplan's four broad perspectives in creating the department's BSC.…”

“…Pharmacy directors are often requested to establish internal benchmarking metrics; internal productivity monitoring systems avoid inappropriate comparison with dissimilar organizations and allow pharmacy departments to accurately assess workload volume related to staff activities and practice changes. 8 Other important operation indicators that a pharmacy director should report through a BSC include STAT and routine verifi cation time, automated dispensing cabinet (ADC) percent capture rate, ADC stock outages, and total inpatient doses dispensed and returned. After establishing goals for each of these internal metrics, the pharmacy department's performance can be tracked on a monthly, quarterly, and yearly basis to ensure compliance.…”

“…A BSC is often structured to measure organizational performance metrics based on specifi c strategic goals, which offer better information for making decisions for the pharmacy department. 8,9 This article highlights the key metrics that pharmacy directors should include in the design of their pharmacy department's BSC. The goal of this article is to provide hospital pharmacy directors with a method to develop a successful BSC that can be used to promote patient-centered pharmacy services.…”

Development of an inpatient operational pharmacy productivity model

“…Separating inpatient and outpatient activities, as well as accounting for differences in the acuity of patients and workloads associated with special patient populations (e.g., emergency department patients), may be difficult. 1,2 To address these limitations, benchmarking or productivity vendors may use metrics from the Centers for Medicare and Medicaid Services Case Mix Index (CMI) or the Action OI Pharmacy Intensity Score (PIS) (Truven Health Analytics, New York, NY). 1 While these metrics help correct and account for patient differences, they do not fully account for department-level differences such as the breadth and scope of pharmacy technology, the structure of the pharmacy practice model, and state laws governing specific pharmacy activities.…”

“…1,2 To address these limitations, benchmarking or productivity vendors may use metrics from the Centers for Medicare and Medicaid Services Case Mix Index (CMI) or the Action OI Pharmacy Intensity Score (PIS) (Truven Health Analytics, New York, NY). 1 While these metrics help correct and account for patient differences, they do not fully account for department-level differences such as the breadth and scope of pharmacy technology, the structure of the pharmacy practice model, and state laws governing specific pharmacy activities. Technology examples include computerized prescriber order entry and the use of automated dispensing cabinets (ADCs) or robotics.…”