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PubMed · 14728163

Monitoring pharmacy expert system performance using statistical process control methodology.

Joshua A Doherty·Richard M Reichley·Laura A Noirot·Ervina Resetar·Michael R Hodge·Robert D Sutter·Wm Claiborne Dunagan·Thomas C Bailey
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Abstract

Automated expert systems provide a reliable and effective way to improve patient safety in a hospital environment. Their ability to analyze large amounts of data without fatigue is a decided advantage over clinicians who perform the same tasks. As dependence on expert systems increase and the systems become more complex, it is important to closely monitor their performance. Failure to generate alerts can jeopardize the health and safety of patients, while generating excessive false positive alerts can lead to valid alerts being dismissed as noise. In this study, statistical process control charts were used to monitor an expert system, and the strengths and weaknesses of this technology are presented.

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Clinical Pharmacy Information SystemsDrug Therapy, Computer-AssistedElectronic Data ProcessingEquipment FailureExpert SystemsHumansMedical Records Systems, ComputerizedMedication ErrorsQuality ControlStatistics as TopicJournal ArticleResearch Support, U.S. Gov't, P.H.S.

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Joshua A Doherty, Richard M Reichley, Laura A Noirot, Ervina Resetar, Michael R Hodge, Robert D Sutter, Wm Claiborne Dunagan, Thomas C Bailey. 2003. Monitoring pharmacy expert system performance using statistical process control methodology.. https://pubmed.ncbi.nlm.nih.gov/14728163/

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Critical care pharmacy services in United States hospitals.

BACKGROUND: Critical care pharmacy activities have been described as fundamental, desirable, and optimal, but actual services provided have not been evaluated. OBJECTIVE: To characterize the type and level of pharmacy services provided to intensive care units (ICUs). METHODS: A 38 question survey was sent in 2 consecutive mailings to all US institutions (N = 3238) with an ICU. Questions were categorized according to clinical, educational, administrative, and scholarly activities, with levels of services stratified as fundamental, desirable, or optimal. RESULTS: Completed surveys were received from 382 (11.8%) institutions encompassing 1034 ICUs. Direct clinical pharmacy activities were provided at 62.2% of ICUs. The pharmacists in those programs attended rounds 4.4 +/- 1.5 days/wk, mean +/- SD, and had a workweek that consisted of patient care (43% of hours worked), drug distribution (26.2%), administration (12.6%), education (10.9%), and scholarly activities (7.3%). Fundamental clinical activities performed during at least 75% of patient ICU days were providing drug information, drug therapy evaluation, drug therapy intervention, and pharmacokinetic monitoring. Conducting in-services (92.8%), a fundamental service, was the only educational activity frequently provided. Most respondents were involved with at least one multidisciplinary committee, and 45.5% conducted scholarly activities. Desirable or optimal activities were not frequently provided across all service categories. CONCLUSIONS: Clinical pharmacists are directly involved as caregivers in nearly two-thirds of ICUs in the US. Although they provide a range of clinical and administrative services, involvement in educational and scholarly activities is variable. The level of services provided is consistent with the criteria deemed fundamental for improving patient care. Higher-order services are far less likely to be provided.

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