Properly Prioritizing Tasks Can Lead to Better Outcomes

Properly Prioritizing Tasks Can Lead to Better Outcomes
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Pharmacy managers must be knowledgeable of health systems, health policy, the policies of their organization, and epidemiological issues surrounding patient care. With burgeoning health care costs for all stakeholders, organizations and payers are looking to streamline operations, keep patients healthy, and prioritize resources. Among the elements continuing to confound our system and resources are patients at risk for harm who are not treated effectively. This can occur in any venue, but is especially problematic in the hospital setting given the complex type of care required for patients suffering from serious, comorbid conditions.

Falconer et al examined how hospital pharmacists prioritize patients at high risk for harm.1 Their initial literature review found that hat approximately 30% of patients experience medication harm, of which 7% are severe. Their study used mixed methods (qualitative interviews and a survey) and found 3 central themes underlying this phenomenon: (1) prioritization criteria; (2) barriers to; and (3) facilitators of patient prioritization. The prioritization criteria included clinical factors (eg, comorbidities, high-risk medications, multiple medications, high-risk transfer) and patient factors (age, frailty, social risk, length of stay, frequent presenter). Barriers included competing priorities (eg, time pressures, mismatched expectations, handover information) and practical considerations (eg, specialist review, patient availability). Facilitators were technology, communication, and mentoring. Falconer et suggested that their findings can assist in the development of risk scores for the provider organization and for pharmacy managers.

The above study also concluded that it is essential to find effective and efficient methods to identify those at high risk for targeted pharmacist services. If high-risk patients are identified in a timely manner and drug-related problems are prevented or mitigated, this will optimize medication safety and ensure the best outcomes. They also found a key barrier to prioritization was the lack of handover information, which was further exacerbated by communication gaps or mishaps between pharmacists and other health professionals. Pharmacy managers must be proactive in identifying strategies that elevate the practice of pharmacy personnel, minimize patient risks, and avoid costs for their employers. Doing so will benefit patients, the profession, and the career mobility of the pharmacist.

Additional information about Operational Management and Risk Management in Contemporary Pharmacy Practice can be found in Pharmacy Management: Essentials for All Practice Settings, 5e. If you or your institution subscribes to AccessPharmacy, use or create your MyAccess Profile to sign-in to Pharmacy Management: Essentials for All Practice Settings, 5e. If your institution does not provide access, ask your medical librarian about subscribing.

1Falconer N, Barras M, Cottrell N. How hospital pharmacists prioritize patients for high risk of medication harm. Res Social Adm Pharm. 2019;15(10):1266-1273.

Authored by:

Shane P. Desselle, RPh, PhD, FAPhA, Professor of Social/Behavioral Pharmacy at Touro University California College of Pharmacy

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