Background The hospital pharmacy (HP) is frequently among the most multitasking departments of the institution. Although administrative tasks, concerning all steps of the medicines supply chain, tend to be a priority for several hospital managers, the key role of medication review that hospital pharmacists play in medicines optimisation (MO) and integrated care (IC) is often ignored.
Purpose The purpose of the present study is to identify the degree of prioritisation in MO steps, among the participating hospital pharmacies (general, paediatric and terminal care) located in the same healthcare region and to assess the impact of infrastructure and human resources on the overall organisation of tasks assigned to the HP.
Material and methods During the first semester of 2018, pharmacists from the participating hospitals registered MO tasks, IC initiatives and relevant attributes (e.g. range, distribution) in semi-structured diaries, on a weekly basis, including relevant time spent on each commitment. Personnel capacity and appropriateness of infrastructure were also recorded. Data were analysed by Excel and SPSS.
Results Great differences concerning the type of daily tasks in each hospital pharmacy were observed, e.g. in compounding, administrative management, procurement and clinical services. The availability of both pharmacists and supportive personnel in combination with the appropriateness of infrastructure had a major impact on time allocated at every task. Administrative responsibilities and supply chain maintenance were highly prioritised in all cases, whereas a variation concerning the provided clinical services from 20% to 50% as a percentage of the overall hospital pharmacy activities was described. Furthermore, given the need for customised dosage forms in paediatric hospitals, a significant amount of time and human resources was dedicated to compounding.
Conclusion Although all aspects of MO are considered essential in providing IC to patients, due to a lack of human resources rather than lack of infrastructure, hospital pharmacists are obliged to prioritise administrative and supply chain services over their clinical ones. Therefore, pharmaceutical care remains fragmented and a multidisciplinary approach to patient care is difficult to achieve.
References and/or acknowledgements None.
No conflict of interest.
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