Types of prioritisation tools used in hospitals with examples
| Type of tool | Definition | Example |
| Electronic-based (E) tools, n=12 | ||
| E1 | Fully integrated electronic tools that use algorithms to assign a priority level to a patient. It can extract patient information from an electronic medical record and may calculate a risk score or assign a priority colour automatically. | ‘…every few minutes a report runs in the background and pulls data for all our patients and calculates them a risk score. And that risk score is based on quite a complicated algorithm which has been developed over the years based on clinical pharmacist input.’ (Interview 4) |
| E2 | Software that allows the user to select any electronically recorded patient indicators which should be flagged for the pharmacist. Indicators may be flagged or highlighted to display whether tasks have been completed or require the attention of the pharmacist (ie, red, amber or green). The software presents itself as a tracking board, electronic whiteboard, dashboard or smart board. Pharmacists will use their prioritisation guidelines to assign a priority level for each patient. This is recorded onto the electronic interface to be accessed anywhere throughout the hospital. | ‘The main tool that we use is something that we call the Pharmacist’s Friend …things that are highlighted on that dashboard…medicine reconciliation state…missed doses of critical medicine, or if they are on high risk medicine…acute kidney injury.’ (Interview 17) |
| R | Systems in which a report runs in the background to identify patients with preselected risk factor indicators. This usually relies on the pharmacist proactively obtaining results and prioritising patients accordingly. | ‘…because we have an electronic prescribing system, the medicines information department get a report for therapeutic drug levels…if the results are outside the normal range, they would telephone the pharmacist who would then review the patient with toxic levels.’ (Interview 1) |
| Paper-based (P) tools, n=8 | ||
| P | Relies on pharmacist reviewing indicators associated with patients to assign a risk score or priority level and flag potential issues. Usually documented on a handover document or in the patient notes. | ‘…when patients are seen in the big acute medical unit, we document the colour on the front of the drug chart…but then after that we document it on our clinical handover sheets.’ (Interview 6) |
| Paper-electronic (PE) tools, n=14 | ||
| PE | Pharmacists will review patient indicators using paper-based prioritisation guidelines and assign a priority level. The outcome (ie, risk score, priority level) is then recorded on an electronic whiteboard or similar interface. The pharmacy team can access the electronic interface remotely and update the priority of the patient when needed. | ‘So, the actual categorisation of how you would triage is paper based, but we use an app to record it. We have an electronic system, a patient management system.’ (Interview 20) |