Care Providers’ Satisfaction with Restructured Clinical Pharmacy Services in a Tertiary Care Teaching Hospital
Bibliographic record
Abstract
Background: At the time this study was undertaken, clinical pharmacy services at the authors’ institution, a tertiary care teaching hospital, were largely reactive in nature, with patients and units receiving inconsistent coverage.Objective: To develop an evidence-based model of proactive practice and to evaluate the satisfaction of pharmacists and other stakeholders after restructuring of clinical pharmacy services.Methods: The literature was reviewed to determine a core set of pharmacist services associated with the greatest beneficial impact on patients’ health. On the basis of established staffing levels, the work schedule was modified, and pharmacists were assigned to a limited number of patient care teams to proactively and consistently provide these core services. Other patient care teams continued to receive reactive troubleshooting-based services, as directed by staff in the pharmacy dispensary. A satisfaction survey was distributed to all pharmacists, nurses, and physicians 18 months after the restructuring.Results: Of the 26 pharmacists who responded to the survey, all agreed or strongly agreed that the restructuring of services had improved job satisfaction and patient safety and that other health care professionals valued their contribution to patient care. Nurses and physicians from units where pharmacists had been assigned to provide proactive services perceived pharmacist services more favourably than those from units where pharmacist services were reactive. Pharmacists, nurses, and physicians all felt that proactive pharmacist services should be more widely available. Challenges reported by pharmacists included increased expectations for documentation and guilt about “cutting back” services where they had previously been provided.Conclusions: Restructuring clinical pharmacy services in an evidencebased manner improved pharmacists’ satisfaction and created demand from other stakeholders to provide this level of service for all patients.RÉSUMÉContexte : Au moment où cette étude a été menée, les services de pharmacie clinique à l’établissement des auteurs, un hôpital universitaire de soins tertiaires, étaient en grande partie de nature réactive, les patients et les unités recevant des services inégaux.Objectif : Créer un modèle de pratique proactive, fondé sur des données probantes, et évaluer la satisfaction des pharmaciens et des autres parties prenantes après la restructuration des services de pharmacie clinique.Méthodes : On a effectué une revue de la littérature pour déterminer une série de services de pharmacie de base associés aux plus importantes répercussions bénéfiques sur la santé des patients. À partir des niveaux d’effectifs établis, l’horaire de travail a été modifié, et les pharmaciens ont été assignés à un nombre limité d’équipes de soins aux patients pour assurer de façon proactive et constante ces services de base. D’autres équipes ont continué à recevoir des services de dépannage de nature réactive, aiguillés par le personnel à la pharmacie. Un sondage sur la satisfaction a été distribué à tous les pharmaciens, médecins, infirmières et infirmiers, 18 mois après la restructuration.Résultats : Des 26 pharmaciens ayant répondu au sondage, tous étaient d’accord ou tout à fait d’accord pour dire que la restructuration des services avait amélioré la satisfaction au travail et la sécurité des patients et que les autres professionnels de la santé reconnaissaient leur contribution aux soins aux patients. Le personnel infirmier et les médecins des unités où les pharmaciens avaient été assignés pour fournir des services de nature proactive avaient une perception plus favorable de leurs services que ceux des unités retenues pour y fournir des services de nature réactive. Les pharmaciens, le personnel infirmier et les médecins ont tous estimé que les services pharmaceutiques proactifs devraient être offerts à plus grande échelle. Les défis soulignés par les pharmaciens incluaient des attentes plus élevées en matière de consignation et le fait de se sentir coupables de « couper » des services auparavant offerts.Conclusions : La restructuration des services de pharmacie clinique fondée sur des données probantes a amélioré la satisfaction des pharmaciens et créé une demande de la part des autres parties prenantes pour la prestation de ce niveau de services pour tous les patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".