Development of a system-wide pharmacy operational weighted workload model at a large academic health system.

PURPOSE: The purpose of this study is to develop a standard operational and distributional weighted workload model that is applicable across an integrated, diverse healthcare system. This model aims to not only demonstrate the operational intensity of pharmacy practice but also to inform opportunities to decrease waste, increase efficiency, facilitate growth, and demonstrate value across operational and distributional pharmacy services. SUMMARY: Time studies were conducted at 8 hospitals within the UNC Health system to objectively measure time spent within each operational process in order to create a system-wide weighted workload model. Time study results informed the development of a system-wide weighted workload model. Data from December 29, 2019, through December 26, 2020, was then applied to this weighted workload model. With this model, acute care hospital and infusion center operational areas were compared in thousands of combinations within single operational areas and across any and all operational areas by dispense code, weighted work, and ratio of weighted work to total sum of dispenses at each site. CONCLUSION: The model successfully achieved the objective to develop a standard operational weighted workload model that is applicable across the integrated, diverse care system. This model provides a foundation for UNC Health to further productivity measurement and fills a gap in the literature by offering a novel method of developing a system-level operational workload model that can be used to evaluate and compare operational workloads across health-system sites.

Identifying health-system pharmacy operational process categories and corresponding tasks across a diverse health system using a modified Delphi process.

PURPOSE: The purpose of this study was to identify and build consensus on operational tasks that occur within a health-system pharmacy. METHODS: An expert panel of 8 individuals was invited to participate in a 3-round modified Delphi process. In the first round, the expert panel independently reviewed an initial list and provided feedback. All feedback was incorporated into the second round and then reviewed and discussed as a group. The expert panel reviewed an updated list based on feedback from the second round and reached consensus on a final list of operational processes and corresponding tasks. RESULTS: All 8 participants agreed to serve on the Delphi expert panel and reviewed an initial list of 9 process categories (hazardous intravenous [IV] medications, nonhazardous IV medications, hazardous oral medications, nonhazardous oral medications, controlled substances, total parenteral nutrition [TPN]/fluid preparations, distribution and delivery, clinical tasks, and miscellaneous operational tasks) and 44 corresponding tasks. Through the Delphi process, 72 new tasks were identified in the first round, while 34 new tasks were identified in the second round. In the third and final round, the expert panel reviewed the updated list of 9 process categories and 150 corresponding tasks, made additional edits, and reached consensus on a final list of 9 processes and 138 corresponding tasks that represented operational work within a health-system pharmacy. CONCLUSION: The modified Delphi process effectively identified operational processes and corresponding tasks occurring within hospital pharmacies in a diverse health system. This process facilitated consensus building, and the findings may inform development of an operational workload model.