Screening tool could save pharmacists an hour a day per ward, pilot suggests

Up to an hour per 25-bed ward, per day, of pharmacists’ time could be saved by using a hospital clinical pharmacy patient prioritisation tool, the results of a small pilot study show^[1]
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The study, which was conducted at at Barts Health NHS Trust, London, and presented at the International Pharmaceutical Federation congress in Glasgow on 4 September 2018, allowed pharmacists to use the pharmaceutical assessment screening tool (PAST) tool to assig n a patient acuity level (PAL) to determine the level of pharmacy input needed.

One senior pharmacist and four junior pharmacists independently assigned PALs during 217 patient encounters; a chance-corrected agreement statistic (Cohen’s kappa) showed moderate agreement levels between the senior and junior pharmacists (0.59; range 0.38–0.60). The senior pharmacist allocated a lower PAL than the junior pharmacists for 7.8% of patient encounters and a higher level for 11.5% of encounters.

Based on the senior pharmacist’s PAL assignment, the researchers calculated that 45–60 minutes daily could be saved on a 25-bed ward by not seeing patients assigned the lowest PAL score every day.

Raliat Onatade, the pharmacist who presented the study, said: “It is important to target our finite resources where they will do the most good, and our junior pharmacists need support, supervision and guidance in order to provide the best care.”

“Pharmacists used their clinical judgement to override the acuity level … which is not a bad thing since we made it clear when launching the tool that it should not override clinical judgement,” explained Onatade. “However, where the junior pharmacists assigned a lower acuity level than indicated by the tool, it was clear that this may have safety implications if the pharmacist does not assess their own level of expertise appropriately,” she warned.