Documenting pharmacist's clinical interventions in New Zealand hospitals

Objectives To investigate the perceived value and the recording, storage and use of pharmacists' clinical intervention data in New Zealand hospitals. Methods A questionnaire-based cross-sectional survey of all pharmacy managers in public and privately funded hospitals employing one or more pharmacists. Main outcome measures The number of hospitals collecting information, the collection and storage systems used, and use of the data. Results Twenty-nine hospitals responded (94%). All rated data collection as very important (17) or important (12) but five hospitals, of all sizes, did not record interventions. Of those collecting data, 21 hospitals made daily recordings and three periodic. Pre-printed forms were the most popular initial collection method (18 hospitals), with notebooks used by three hospitals. Almost all the hospitals using a paper-based collection system (15, 83%) transcribed data into an electronic database, but there were unfavourable comments regarding transcription and analysis time. Three hospitals stated they used direct intranet data entry but one also used a backup paper form when ward computer access was limited. Of information frequently recorded, variability in categorising interventions and grading severity, were identified as concerns. The impact on cost savings was not commonly recorded. The most popular uses for intervention data was to provide management activity reports (15), identify pharmacists' impact on patient care (15) and to identify prescribing problems (14); less than half reported use for educational purposes. Five hospitals reported data were underutilised and 15 considered their systems required modification. Conclusions The majority of New Zealand hospitals collect pharmacist intervention data on a daily basis. While a high value is placed on intervention data by pharmacy managers, some hospitals did not meet national data collection requirements. Favouring paper-based systems over direct electronic entry may reflect difficulties in computer access in ward areas. The development of a national system is suggested to aid access to data collection for all hospitals, provided issues of categorising and grading can be resolved. Furthermore we recommend that direct-entry technologies be critically evaluated for reliability, efficiency and cost, and that data be used more frequently for hospital staff education.