Book 9781585284795 Ch013-Preview

CHAPTER 13
Evaluation and Monitoring

of Clinical Interventions
Kate M. Schaafsma
KEY TERMS
Benchmarking—The practice to evaluate or check by
comparison with a standard.
Clinical Intervention—An action related to the observation
and treatment of patients to improve the patient’s situation
and to avoid an adverse drug event or prevent a medication
error.
Control Plan—A written summary that describes what is
needed to keep an improved process at its current level.
Cycle Time—The total time from the beginning to the end
of your process, as defined by you and your customer. Cycle
time includes process time, during which a unit is acted on
to bring it closer to an output, and delay time, during which
a unit of work is spent waiting to take the next action.
Medication-Use Process—A complex process that
comprises the subprocesses of medication prescribing,
order processing, dispensing, administration, and effects
monitoring.
Process Owner—A person who has ultimate responsibility
for the performance of a process in realizing its objectives.
Scorecard—A statistical record used to measure achieve-
ment or progress toward a particular goal. Dashboard is a
graphical summary of various pieces of important informa-
tion, typically used to give an overview of a business.
Stakeholder—A person with an interest or concern in
something.
Takt Time—The rate at which a finished product needs to
be completed to meet customer demand.
236 Pharmacy Clinical Coordinator’s Handbook
Introduction to Clinical and treatment of actual patients rather than

theoretical or laboratory studies, and interven-
Pharmacy Services tion is defined as actions taken to improve a
Clinical pharmacy services optimize medica- situation.2-4 Combined, clinical intervention is
tion therapy use and promote health, well- an action related to the observation and treat-
ness, and disease prevention.1 The services ment of patients to improve the patients’ situa-
we provide as pharmacists are comprised of tion. It also includes actions taken to prevent a
both distributional and clinical work. Our vision medication error. Your primary role as a clinical
for pharmacists in the health-system setting coordinator is to ensure that you are optimizing
is to be accountable for the medication-use the pharmacist expertise and utilizing resources
process, ranging from distributive to clinical to achieve the best clinical, financial, and
services and beyond. The pharmacists’ exper- humanistic outcome for your patients. To iden-
tise in managing the medication-use process tify, implement, and sustain these outcomes,
provides high-quality, safe, and effective patient you must continuously monitor and evaluate
care. The clinical services offered across and performance as well as processes.
between hospital and health-system settings
vary in what is offered and in the extent of Benefits of Monitoring and
the services offered. Bond and Raehl suggest Evaluating Clinical Interventions
pharmacists must provide clinical pharmacy
services associated with reductions in patient As a clinical coordinator, you may find yourself
mortality, drug and total cost of care, and in asking why you spend so much time gathering,
length of stay and medication errors.2 The collating, analyzing, and stressing over clinical
services they reviewed included drug informa- intervention data and results. The benefits of
tion, adverse drug reaction management, drug monitoring and evaluating clinical interventions
protocol management, participating in medical enable you to provide high-quality and consis-
rounds, and admission drug histories. Over the tent services to your patients. The benefits
past decade, a number of other clinical services include the following:
have demonstrated the value of pharmacists
within the healthcare setting, including phar- • Validate outcome or output based on
macist discharge medication counseling, phar- use of resources dedicated to a service
macokinetics, anticoagulation management, productivity and utilization of allocated
immunization services, and managing drug- resources.
related problems. • Be prepared for consultant visits and
At your hospital or health system, pharma- difficult economic times in which
cists may be participating in numerous clinical resource allocation is questioned.
pharmacy services. To achieve and sustain • Inform key decision makers on the
these services, you must identify how to main- value proposition that pharmacy clin-
tain the pharmacists’ roles to allow for agile ical interventions contribute to the
and responsive meeting of customer or patient patient, organization, and community.
needs. To provide the best clinical services • Involve and engage staff to the purpose
in your practice setting, you must provide and value to patients via the work
key clinical interventions that improve your performed to improve the patients’
patients’ outcomes and guide your peers to experience and avoid an adverse drug
perform best practices, improve processes, and event or prevent a medication error.
demonstrate value.
• Build pharmacists’ awareness of skills,
knowledge, and impact in improving
Defining a Clinical Intervention patients’ outcomes and optimizing
The transition from distributional to clinical patient care.
pharmacy services has manifested over several • Exhibit responsibility and accountability
decades. Clinical pharmacy services are for the medication-use processes.
comprised of a variety of clinical interventions. • Participate in continuous process
Clinical is defined as relating to the observation improvement activities.

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CHAPTER 13

Evaluation and Monitoring

Introduction to Clinical and treatment of actual patients rather than

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