Design and development of the clinical pharmacy key performance indicators dashboard for equity of service provision at regional and rural hospitals in North Queensland, Australia

IF 1 Q4 PHARMACOLOGY & PHARMACY
Sanja Mirkov BPharm, PGDipPH, Rhondda Jones BSc, BInfTech, PhD, Alexander Ison BPharm, Allan Wilesmith CertIVInfoTech, Jason Black BScPharm (Hons), ClinDipPharm
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Abstract

Background

Provision of a Medication Action Plan (MAP) on admission and a Discharge Medication Record (DMR) are associated with reduced medication-related harm.

Aim

To report factors associated with the provision of MAPs and DMRs in rural and regional hospitals in Queensland, Australia.

Method

A literature search, environmental scan and department consultations were conducted to develop Clinical Pharmacy Key Performance Indicators (cpKPIs) and design a cpKPI dashboard. Two of the five KPIs included in the dashboard, relating to medication action plans on admission and medication records on discharge, were reported for all the hospitals and were included in the study. A retrospective, period-prevalence study was conducted to evaluate the coverage and equity of clinical pharmacy service provision for patients admitted for longer than 24 h. The proportions of patients who received MAPs and DMRs were stratified by age, gender, Indigeneity and hospital type. Statistical analysis used chi-squared tests and logistic regression in R. This project was exempt due to the local policy requirements that constitute research by the Far North Queensland Human Research Ethics Committee (Reference no: EX/2023/QCH/94383-1684QA). The justification for this exemption is as follows: the project was determined to be negligible risk research and involved the use of existing collection of data or records that contain only non-identifiable data about human beings.

Results

In total, 13 818 patients (37.9% of admissions) received a MAP and 11 631 patients (32.7% of discharges) received a DMR. The proportion of MAPs and DMRs was significantly higher in rural hospitals than in regional hospitals (MAP 50.6% vs 34.6%, DMR 33.1% vs 31.3%) and for male patients than female patients (MAP 42.2% vs 33.7%, DMR 36.4% vs 29.2%). When stratified by age, First Nations patients received a higher proportion of MAPs and DMRs in each age group, except for age 85 years and over. The proportion of First Nations patients aged 50 years and over who received MAP was lower compared to that for non-Indigenous patients aged 65 years and over (56.3% vs 59.8%), whilst the proportion for DMRs was similar (50.4% vs 49.3%).

Conclusion

The study defined the clinical pharmacy key performance indicators for measuring equity of clinical pharmacy service provision in Australia. When adjusted for a difference in life expectancy, the proportion of MAPs for First Nations patients was lower compared to the proportion of MAPs for non-Indigenous patients. Further improvements are required to achieve equity of service provision for First Nations patients and female patients.

设计和开发临床药学关键绩效指标仪表板,以促进澳大利亚北昆士兰地区和农村医院服务提供的公平性
通过文献检索、环境扫描和部门咨询,制定了临床药学关键绩效指标(cpKPIs)并设计了cpKPI仪表板。在仪表板中包含的五项关键绩效指标中,有两项涉及入院时的用药行动计划和出院时的用药记录,这两项指标在所有医院都有报告,因此也被纳入了研究范围。研究采用回顾性、阶段性流行病学研究的方法,对入院时间超过 24 小时的患者提供临床药学服务的覆盖面和公平性进行评估,并按年龄、性别、原住民和医院类型对接受 MAP 和 DMR 的患者比例进行分层。统计分析使用了 R 语言中的卡方检验和逻辑回归。该项目因当地政策要求而获得了远北昆士兰人类研究伦理委员会(Far North Queensland Human Research Ethics Committee)的研究豁免(参考编号:EX/2023/QCH/94383-1684QA)。豁免理由如下:该项目被确定为风险极小的研究,涉及使用现有的数据收集或记录,其中仅包含不可识别的人类数据。农村医院的 MAP 和 DMR 比例明显高于地区医院(MAP 为 50.6% 对 34.6%,DMR 为 33.1% 对 31.3%),男性患者的比例也明显高于女性患者(MAP 为 42.2% 对 33.7%,DMR 为 36.4% 对 29.2%)。按年龄分层时,除 85 岁及以上的患者外,原住民患者在每个年龄组中接受 MAP 和 DMR 的比例都较高。与 65 岁及以上的非土著患者相比,50 岁及以上的原住民患者接受 MAP 的比例较低(56.3% 对 59.8%),而接受 DMR 的比例相似(50.4% 对 49.3%)。根据预期寿命的差异进行调整后,原住民患者的 MAP 比例低于非原住民患者的 MAP 比例。要实现为原住民患者和女性患者提供公平的服务,还需要进一步改进。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Pharmacy Practice and Research
Journal of Pharmacy Practice and Research Health Professions-Pharmacy
CiteScore
1.60
自引率
9.50%
发文量
68
期刊介绍: The purpose of this document is to describe the structure, function and operations of the Journal of Pharmacy Practice and Research, the official journal of the Society of Hospital Pharmacists of Australia (SHPA). It is owned, published by and copyrighted to SHPA. However, the Journal is to some extent unique within SHPA in that it ‘…has complete editorial freedom in terms of content and is not under the direction of the Society or its Council in such matters…’. This statement, originally based on a Role Statement for the Editor-in-Chief 1993, is also based on the definition of ‘editorial independence’ from the World Association of Medical Editors and adopted by the International Committee of Medical Journal Editors.
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