Further Defining Optimal Pharmacist-to-Patient Ratios to Ensure Comprehensive Direct Patient Care in Medical and Surgical Units across British Columbia Hospitals.

Abstract

Background: Patient care ratios for pharmacists are not well defined in Canada. A recent work-sampling study involving 6 medium and large hospitals within the region served by Lower Mainland Pharmacy Services, British Columbia, reported pharmacist-to-patient ratios of 1:13, 1:26, and 1:14 in internal medicine teaching units, hospitalist or internal medicine nonteaching units, and surgical units, respectively.

Objective: To determine the pharmacist-to-patient ratios required to provide comprehensive pharmaceutical care to adult patients admitted to medical and surgical units in medium and large hospitals in British Columbia.

Methods: In this cross-sectional electronic survey study, participants were asked to provide estimates of the time spent on and the frequency of 17 comprehensive pharmaceutical care tasks identified in the previous study, which was based on a Delphi method. The survey data were used to calculate pharmacy staffing ratios according to the World Health Organization workforce calculator.

Results: Fifty-eight pharmacists responded to the survey, of whom 41 (71%) were from medium and large hospitals. The optimal pharmacist-to-patient ratios were calculated as 1:7 for internal medicine teaching units; 1:10 for internal medicine nonteaching, hospitalist, and family practice units; and 1:14 for surgical units.

Conclusions: The pharmacist-to-patient ratios calculated in this study, using only pharmacists' self-reported information, were lower than those found previously. Further research is required to determine whether completion of every comprehensive care task is necessary, or if staffing ratios should reflect combinations of comprehensive care tasks based on patient complexity. National consensus guidelines on pharmacist staffing ratios may be valuable, given the current lack of standardization of pharmacy staffing ratios in hospitals.