Expanding the weekend and public holiday clinical pharmacy workforce.

Abstract

Background

The Ballarat Health Services (BHS) Pharmacy Department weekend service has traditionally b.ee staffed b two pharmacists working remotely from the dispensary to facilitate clinical review and supply of inpatient, outpatient and discharge medication orders across the organisation; equating to a more than 1 0-times resource reduction compared to weekday services. Support staff include one pharmacy technician and a 4-hour student shift (Saturdays only). Shift duration for pharmacists and technician are not set as staff are required to work until all medication requests are completed.

Objectives/Aims

To implement an expanded weekend clinical pharmacy workforce in response to increasing staff dissatisfaction in the face of a 7 -day service organisational goal.

Method

Following multidisciplinary team feedback identifying the need for additional weekend pharmacy resources, a working group was formed to determine an agreed model for the introduction of an expanded workforce at minimal cost to the organisation. An additional 4-hour clinical pharmacist service was introduced on Saturdays and public holidays (PH) to facilitate discharge at ward level.

Results

Prior to implementation of the expanded workforce, the average total pharmacist hours per Saturday or PH shift (n=2) was 13.1 whilst the average total staff hours (n=4) was 22.8. Four months post implementation of the expanded service, the average total pharmacist hours (n=3) was 15.1, a net increase of 2 hours per shift, however total staff hours (n=5) remained unchanged. Median shift finish time was brought forward from 4 p.m. to 2.30 p.m. and the percentage of patients discharged prior to 12 p.m. increased from 30% to 36%. Staff survey demonstrated a high level of satisfaction with the new work environment.

Implications/Outcomes for Planned Research Project

Reduced clinical services provided by hospitals on weekends are associated with increased risks of patient harm and length of stay. The addition of clinical EFT deployed at ward level improves weekend efficiencies including patient flow with consequent improvements in work conditions for all staff. Enabling improvements in work flow resulted in earlier finish times with total Pharmacy hours worked remaining unchanged.

Final Thoughts

Expanding the weekend clinical pharmacy service provides an excellent example of 'working smarter, not harder' to provide patient and staff focused improvements.