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Exploring the time required by pharmacists to prepare discharge medicine lists: a time-and-motion study.

ABSTRACT: BACKGROUND : Discharge medicine lists provide patients, carers and primary care providers a summary of new, changed or ceased medicines when patients discharge from hospital. Hospital pharmacists play an important role in preparing these lists although this process is time consuming. AIM : To measure the time required by hospital pharmacists to complete the various tasks involved in discharge medicine handover. METHOD : Time-and-motion study design was used to (1) determine the time involved for pharmacists to produce discharge medicine lists, (2) explore how pharmacists utilise various software programs to prepare lists, and (3) compare the time involved in discharge medicine handover processes considering confounding factors. An independent observer shadowed 16 pharmacists between 22 February and 12 March 2021 and recorded tasks involved in 50 discharge medicine handovers. Relevant information about each discharge was also collected. RESULTS : Pharmacists observed represented a range of practice experiences and inpatient units. Mean time to complete discharges was 26.2 min (SD 13.6), with over half of this time used to check documentation and prepare discharge medicine lists. A mean of 4.0 min was spent on manually retyping and reconciling medicine lists in different software systems. Medical inpatient unit discharges took 4.6 min longer to prepare compared to surgical ones. None of the 50 discharges involved support from pharmacy assistants; all 50 discharges had changed or ceased medicines. CONCLUSION : There is a need to streamline current discharge processes through optimisation of electronic health software systems and better delegation of technical tasks to trained pharmacy assistants.

SUBMITTER: Gjone H

PROVIDER: S-EPMC9243950 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:ImportanceThe United States spends more than $12 billion annually on graduate medical education. Understanding how residents balance patient care and educational activities may provide insights into how the modern physician workforce is being trained.ObjectiveTo describe how first-year internal medicine residents (interns) allocate time while working on general medicine inpatient services.Design, setting, and participantsDirect observational secondary analysis, including 6 US university-affiliated and community-based internal medicine programs in the mid-Atlantic region, of the Comparative Effectiveness of Models Optimizing Patient Safety and Resident Education (iCOMPARE) trial, a cluster-randomized trial comparing different duty-hour policies. A total of 194 weekday shifts were observed and time motion data were collected, sampled by daytime, nighttime, and call shifts in proportion to the distribution of shifts within each program from March 10 through May 31, 2016. Data were analyzed from June 1, 2016, through January 5, 2019.Main outcomes and measuresMean time spent in direct and indirect patient care, education, rounds, handoffs, and miscellaneous activities within a 24-hour period and in each of four 6-hour periods (morning, afternoon, evening, and night). Time spent multitasking, simultaneously engaged in combinations of direct patient care, indirect patient care, or education, and in subcategories of indirect patient care were tracked.ResultsA total of 80 interns (55% men; mean [SD] age, 28.7 [2.3] years) were observed across 194 shifts, totaling 2173 hours. A mean (SD) of 15.9 (0.7) hours of a 24-hour period (66%) was spent in indirect patient care, mostly interactions with the patient's medical record or documentation (mean [SD], 10.3 [0.7] hours; 43%). A mean (SD) of 3.0 (0.1) hours was spent in direct patient care (13%) and 1.8 (0.3) hours in education (7%). This pattern was consistent across the 4 periods of the day. Direct patient care and education frequently occurred when interns were performing indirect patient care. Multitasking with 2 or more indirect patient care activities occurred for a mean (SD) of 3.8 (0.4) hours (16%) of the day.Conclusions and relevanceThis study's findings suggest that within these US teaching programs, interns spend more time participating in indirect patient care than interacting with patients or in dedicated educational activities. These findings provide an essential baseline measure for future efforts designed to improve the workday structure and experience of internal medicine trainees, without making a judgment on the current allocation of time.Trial registrationClinicalTrials.gov identifier: NCT02274818.

Project description:BACKGROUND: Complementary and alternative medicines (CAMs) are being used increasingly across the world. In Australia, community pharmacists are a major supplier of these products but knowledge of the products and interactions with other medicines is poor. Information regarding the use of CAMs by metropolitan pharmacists has been documented by the National Prescribing Service (NPS) in Australia but the views of rural/regional community pharmacists have not been explored. The aim of this pilot study was to explore the knowledge, attitudes and information seeking of a cohort of rural community pharmacists towards CAMs and to compare the findings to the larger NPS study. METHODS: A cross sectional self-administered postal questionnaire was mailed to all community pharmacists in one rural/regional area of Australia. Using a range of scales, data was collected regarding attitudes, knowledge, information seeking behaviour and demographics. RESULTS: Eighty eligible questionnaires were returned. Most pharmacists reported knowing that they should regularly ask consumers if they are using CAMs but many lacked the confidence to do so. Pharmacists surveyed for this study were more knowledgeable in regards to side effects and interactions of CAMs than those in the NPS survey. Over three quarters of pharmacists surveyed reported sourcing CAM information at least several times a month. The most frequently sought information was drug interactions, dose, contraindications and adverse effects. A variety of resources were used to source information, the most popular source was the internet but the most useful resource was CAM text books. CONCLUSIONS: Pharmacists have varied opinions on the use of CAMs and many lack awareness of or access to good quality CAMs information. Therefore, there is a need to provide pharmacists with opportunities for further education. The data is valuable in assisting interested stakeholders with the development of initiatives to address the gaps in attitudes, knowledge and to improve effectiveness of information seeking behaviour.

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Project description:BackgroundThe pharmacy profession has changed enormously in the recent decades. Pharmacist role has been expanded beyond formulating and dispensing medications to include the provision of pharmaceutical care and public health services to patients. Patient-centred care requires sustained competency through improving pharmacist's knowledge, skills, and performance. Such improvements require pharmacist's involvement in continuing education activities although it is optional in Kuwait.ObjectiveTo explore pharmacists' attitudes towards continuing education in Kuwait, and to investigate the perceived barriers that hinder pharmacists from being involved in continuing education activities.Setting.All governmental hospitals and polyclinics and private pharmacies in all the five health regions of Kuwait (Capital, Hawalli, Ahmadai, Farwaniyah, and Jahra).MethodA descriptive cross-sectional study conducted with full licensed pharmacists working in Kuwait. Pharmacists were asked to complete an adapted validated questionnaire composed of 14 items to measure their attitudes towards continuing education. In addition, it contains open-ended questions to obtain the type of learning activity undertaken by the pharmacists, and whether they have barriers that hinder them from being involved in continuing education.ResultsA total of 409 pharmacists completed the questionnaire. The participants had a median score of 44 (interquartile range = 41-47); good to excellent attitudes. Attitude scores were correlated with age and years of experience. Almost 70% of the participants had attended a continuing education activity within one year. The activity undertaken most by pharmacists was attending a seminar, compared to other activities. The main barriers to continuing education were lack of personal time (n = 383), lack of scientific databases and books (n = 187) and conferences are not regularly organized locally (n = 154).ConclusionPharmacists in Kuwait have positive attitudes towards continuing education overall. However, there are many obstacles that avert pharmacists to practice continuing education. Further studies are required to explore how to overcome the reported barriers and provide more feasible and relevant continuing education to pharmacists.

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Exploring the time required by pharmacists to prepare discharge medicine lists: a time-and-motion study.

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