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Development, implementation and evaluation of a seven-day clinical pharmacy service in a tertiary referral teaching hospital during surge-2 of the COVID-19 pandemic.

Development, implementation and evaluation of a seven-day clinical pharmacy service in a tertiary referral teaching hospital during surge-2 of the COVID-19 pandemic.
Development, implementation and evaluation of a seven-day clinical pharmacy service in a tertiary referral teaching hospital during surge-2 of the COVID-19 pandemic.
Background
Seven-day clinical pharmacy services in the acute sector of the National Health Service are limited. There is a paucity of evidential patient benefit. This limits investment and infrastructure, despite United Kingdom wide calls.

Aim
To optimise medicines seven-days a week during surge-2 of the COVID-19 pandemic through implementation of a seven-day clinical pharmacy service. This paper describes service development, evaluation and sustainability.

Setting
A tertiary-referral teaching hospital, London, United Kingdom.

Development
The seven-day clinical pharmacy service was developed to critical care, acute and general medical patients. Clinical leads developed the service specification and defined priorities, targeting complex patients and transfer of care. Contributing staff were briefed and training materials developed.

Implementation
The service was implemented in January 2021 for 11 weeks. Multidisciplinary team communication brought challenges; strategies were employed to overcome these.

Evaluation
A prospective observational study was conducted in intervention wards over two weekends in February 2021. 1584 beds were occupied and 602 patients included. 346 interventions were reported and rated; 85.6% had high or moderate impact; 56.7% were time-critical.

The proportion of medicines reconciliation within 24-h of admission was analysed across the hospital between November 2020 and May 2021. During implementation, patients admitted Friday-Sunday were more likely to receive medicines reconciliation within 24-h (RR 1.41 (95% CI 1.34–1.47), p < 0.001). Rostered services were delivered sustainably in terms of shift-fill rate and medicines reconciliation outcome.

Conclusion
Seven-day clinical pharmacy services benefit patient outcome through early medicines reconciliation and intervention. Investment to permanently embed the service was sustained.
Cheng, C.
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Walsh, A.
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Jones, S.
a605e48d-b01d-40e1-a469-dc32dbc0e3e6
Weerasooriya, D
958d0189-feb4-441d-a586-39493b94b817
Fernandes, RJ
d3d850dd-d0f4-42dc-b0b1-4490a9e37393
McKenzie, CA
ec344dee-5777-49c5-970e-6326e82c9f8c
Matthews, Sara
2b38ba26-95bf-4a73-832f-4857152338df
Cheng, C.
1ea7d45b-1b31-43d3-a645-bc2ad4359a08
Walsh, A.
8dff26eb-3225-4551-a7f4-3cf2d872bb4f
Jones, S.
a605e48d-b01d-40e1-a469-dc32dbc0e3e6
Weerasooriya, D
958d0189-feb4-441d-a586-39493b94b817
Fernandes, RJ
d3d850dd-d0f4-42dc-b0b1-4490a9e37393
McKenzie, CA
ec344dee-5777-49c5-970e-6326e82c9f8c
Matthews, Sara
2b38ba26-95bf-4a73-832f-4857152338df

Cheng, C., Walsh, A., Jones, S., Weerasooriya, D, Fernandes, RJ, McKenzie, CA and Matthews, Sara (2022) Development, implementation and evaluation of a seven-day clinical pharmacy service in a tertiary referral teaching hospital during surge-2 of the COVID-19 pandemic. International journal of clinical pharmacy. (doi:10.1007/s11096-022-01475-8).

Record type: Article

Abstract

Background
Seven-day clinical pharmacy services in the acute sector of the National Health Service are limited. There is a paucity of evidential patient benefit. This limits investment and infrastructure, despite United Kingdom wide calls.

Aim
To optimise medicines seven-days a week during surge-2 of the COVID-19 pandemic through implementation of a seven-day clinical pharmacy service. This paper describes service development, evaluation and sustainability.

Setting
A tertiary-referral teaching hospital, London, United Kingdom.

Development
The seven-day clinical pharmacy service was developed to critical care, acute and general medical patients. Clinical leads developed the service specification and defined priorities, targeting complex patients and transfer of care. Contributing staff were briefed and training materials developed.

Implementation
The service was implemented in January 2021 for 11 weeks. Multidisciplinary team communication brought challenges; strategies were employed to overcome these.

Evaluation
A prospective observational study was conducted in intervention wards over two weekends in February 2021. 1584 beds were occupied and 602 patients included. 346 interventions were reported and rated; 85.6% had high or moderate impact; 56.7% were time-critical.

The proportion of medicines reconciliation within 24-h of admission was analysed across the hospital between November 2020 and May 2021. During implementation, patients admitted Friday-Sunday were more likely to receive medicines reconciliation within 24-h (RR 1.41 (95% CI 1.34–1.47), p < 0.001). Rostered services were delivered sustainably in terms of shift-fill rate and medicines reconciliation outcome.

Conclusion
Seven-day clinical pharmacy services benefit patient outcome through early medicines reconciliation and intervention. Investment to permanently embed the service was sustained.

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Accepted/In Press date: 17 August 2022
Published date: 11 November 2022

Identifiers

Local EPrints ID: 477913
URI: http://eprints.soton.ac.uk/id/eprint/477913
PURE UUID: 1bcf5393-7b99-4753-966f-082ee4081051
ORCID for CA McKenzie: ORCID iD orcid.org/0000-0002-5190-9711

Catalogue record

Date deposited: 16 Jun 2023 16:37
Last modified: 17 Mar 2024 04:23

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Contributors

Author: C. Cheng
Author: A. Walsh
Author: S. Jones
Author: D Weerasooriya
Author: RJ Fernandes
Author: CA McKenzie ORCID iD
Author: Sara Matthews

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