Presenting Authors: Maja Hill, PharmD, Lemon-Holton Cancer Pavilion, Corewell Health, Grand Rapids, MI; and Emily Mackler, PharmD, BCOP, Michigan Oncology Quality Consortium, Michigan Institute for Care Management and Transformation, YesRx, and University of Michigan College of Pharmacy, Ann Arbor, MI
Co-Authors: Maisa Nazzal, PharmD, MS, and Karen Farris, PhD, University of Michigan College of Pharmacy, Ann Arbor, MI; Emily Johengen, PharmD, BCACP, Trinity Health IHA Hematology Oncology, Ypsilanti, MI; Katie Sias, PharmD, BCOP, Pardee Cancer Wellness Center, MyMichigan Health, Midland, MI; Samuel Snowaert, PharmD, BCOP, MBA, Covenant Cancer Care Center, Saginaw, MI; Jennifer VanSickler, PharmD, Herbert-Herman Cancer Center, University of Michigan Health-Sparrow, Lansing, MI; Mark Wagner, PharmD, BCOP, and Colton Zwart, PharmD, BCOP, Cowell Family Cancer Center, Munson Healthcare, Traverse City, MI; Katie Young and David Reyes-Gastelum, Michigan Institute for Care Management and Transformation, Ann Arbor, MI
BACKGROUND: Clinical pharmacists save physicians’ time through interventions and clinical services offered in the emergency department, but studies evaluating time savings in oncology practice have not been done.1 Clinical pharmacists embedded in ambulatory care practices provide a variety of services, such as selecting appropriate chemotherapy regimens and supportive care, reviewing medication lists and laboratory tests, managing adverse events, educating patients, and answering drug information questions. Administratively, they may also build order sets, provide staff education, and release orders. The purpose of this study was to describe the time spent by embedded clinical oncology pharmacists and whom that effort would be attributed to if they were not in the clinic.
METHODS: On 2 different weeks, 7 pharmacists from Pharmacists Optimizing Oncology Care Excellence in Michigan practices recorded their activities using a data collection form that included patient- and non–patient-focused activities.2 The second data collection is the basis for this analysis, and data were collected in July 2024. The 7 pharmacists provided 922 entries grouped into administration, chart review/release orders, care coordination, clinical question, documentation, follow-up, order management, teach, staff education, and other. The number of minutes attributed to the activity and the professional who would do the activity if the clinical pharmacist was not present were recorded. Hours per activity and the substituted professional were determined.
RESULTS: Pharmacists recorded activities for an average of 42 hours per week, and 70% of activities were patient- focused. Among patient-focused activities, pharmacists’ distribution of time was primarily focused on chart reviewing and releasing orders, teaching, and documentation. For patient-focused activities, pharmacists substituted a mean of 5 hours for advance practice practitioners, 3.3 hours for physicians, 1 hour for medical assistants, 11.8 hours for nurses, 4.1 hours for another pharmacist, and 3.7 hours for no one in the clinic on a per-pharmacist-per-week basis. For non–patient-focused activities, the clinical pharmacists substituted 7.3 hours for no one in the clinic and 4.1 hours for another pharmacist, per pharmacist per week.
CONCLUSION: Oncology pharmacists’ time was 70% patient-focused, and they saved on average 20 hours per week per pharmacist for nurses, advance practice practitioners, and physicians.
- Grill J, Bryant C, Markel K, Wisniewski SJ. A study of time saved by emergency medicine physicians through working with clinical pharmacists in the emergency department. Am J Emerg Med. 2019;37:1720-1722.
- POEM program. Accessed October 4, 2024. www.moqc.org/poem