Hospitals with (W) Pharmacy Residency Programs N=119; Hospitals without (WO) N=489 Percentage of Respondents

Hospitals with (W) Physician Residency Programs N=236; Hospitals without (WO) N=372 Percentage of Respondents

Hospital Type General Hospital (G) N=461; Specialty Hospital (S) N=68 Percentage of Respondents

Effectiveness of factors related to pharmacist's ability to perform interventions

Factors that facilitate the pharmacist's ability to perform interventions

1 = NOT Present in facility 5 = Present in facility

Bed Size Hospitals under 100 beds (A) N =166; Hospitals 100-299 beds (B) N=223; Hospitals 300-499 beds (C) N=99; Hospitals over 500 beds (D) N=77

Percentage of Respondents

Factors	1				2				3				4				5
	A	B	C	D	A	B	C	D	A	B	C	D	A	B	C	D	A	B	C	D
a) easy access to patient information	2	0	2	5	4	3	3	1	12	12	14	21	28	25	20	25	54	60	60	48
b) easy access to drug information	2	0	1	0	1	3	1	4	4	11	5	6	19	20	15	18	74	66	77	71
c) proper technological support	10	9	9	8	18	13	12	17	15	26	26	22	27	25	26	27	30	27	25	26
d) sufficient clinical skill	0	0	0	5	2	8	4	5	23	23	21	26	43	41	49	34	31	28	24	30
e) adequate staffing levels	7	7	9	12	14	19	15	17	28	32	19	31	25	28	42	29	23	13	12	12
f) positive staff motivation	1	3	9	5	5	9	15	13	22	23	19	23	30	35	42	35	41	30	12	23
g)availability of drug appropriateness criteria	4	2	3	3	14	13	8	6	30	28	29	25	30	39	44	44	22	18	14	22
h)leadership commitment, facilitative organizational culture	2	4	3	6	6	9	7	6	23	22	12	13	36	31	41	45	31	34	33	29
i) efficient process to document interventions	14	7	7	18	13	11	10	13	28	24	26	12	20	26	29	27	23	32	25	29

Part II - Types of Pharmacy Intervention Services Provided by Hospitals

From the July 10, 2002 issue

All Responses N=608 Percentage of Respondents

Intervention Categories	Not Performed	Routine Activities	Targeted Activities
a) antimicrobial therapy	16	50	31
b) anticoagulation therapy	40	30	28
c) narcotics/pain management	42	30	26
d) drug dose verification	4	86	9
e)appropriateness of drug selection	15	66	15
f) renal dosing	15	53	30
g) monitor special populations (pediatrics, oncology, elderly)	20	48	29
h) detect patient allergies related to prescribed therapy	2	87	9
i) verify order completeness	2	89	7
j) identify dangerous abbreviations, dose expressions	13	69	16

Hospitals with (W) Pharmacy Residency Programs N=119; Hospitals without (WO) N= 489 Percentage of Respondents

Intervention Categories	Not Performed		Routine Activities		Targeted Activities
Intervention Categories	W	WO	W	WO	W	WO
a) antimicrobial therapy	12	17	41	53	45	28
b) anticoagulation therapy	20	45	34	29	45	24
c) narcotics/pain management	28	46	31	30	40	22
d) drug dose verification	1	4	83	86	15	7
e)appropriateness of drug selection	8	17	69	66	22	14
f) renal dosing	13	15	44	55	42	27
g) monitor special populations (pediatrics, oncology, elderly)	12	22	45	49	43	25
h) detect patient allergies related to prescribed therapy	2	3	86	87	13	8
i) verify order completeness	3	1	86	90	10	6
j) identify dangerous abbreviations, dose expressions	12	13	73	68	15	16

Hospitals with (W) Physician Residency Programs N=236; Hospitals without (WO) N=372 Percentage of Respondents

Intervention Categories	Not Performed		Routine Activities		Targeted Activities
Intervention Categories	W	WO	W	WO	W	WO
a) antimicrobial therapy	15	17	44	54	40	26
b) anticoagulation therapy	33	44	30	30	36	23
c) narcotics/pain management	43	42	31	29	25	26
d) drug dose verification	3	4	87	85	9	8
e)appropriateness of drug selection	12	17	71	64	15	16
f) renal dosing	14	15	51	54	35	27
g) monitor special populations (pediatrics, oncology, elderly)	17	23	48	48	34	25
h) detect patient allergies related to prescribed therapy	3	2	87	86	10	9
i) verify order completeness	1	2	90	88	8	6
j) identify dangerous abbreviations, dose expressions	11	15	74	66	15	17

Hospital Type General Hospital (G) N=461; Specialty Hospital (S) N=68 Percentage of Respondents

Intervention Categories	Not Performed		Routine Activities		Targeted Activities
Intervention Categories	G	S	G	S	G	S
a) antimicrobial therapy	12	21	52	50	35	26
b) anticoagulation therapy	39	41	30	34	30	21
c) narcotics/pain management	44	40	28	34	26	24
d) drug dose verification	3	4	88	81	8	12
e)appropriateness of drug selection	15	16	67	71	16	12
f) renal dosing	8	25	57	49	34	24
g) monitor special populations (pediatrics, oncology, elderly)	19	16	48	62	31	21
h) detect patient allergies related to prescribed therapy	2	0	88	88	9	10
i) verify order completeness	2	0	91	87	7	10
j) identify dangerous abbreviations, dose expressions	13	6	68	81	18	12

Bed Size Up to 299 Beds Percentage of Respondents

Intervention Categories	Not Performed		Routine Activities		Targeted Activities
Intervention Categories	<100	100-299	<100	100-299	<100	100-299
a) antimicrobial therapy	20	12	58	50	22	36
b) anticoagulation therapy	49	43	28	28	22	28
c) narcotics/pain management	40	47	34	26	25	25
d) drug dose verification	6	2	85	88	8	8
e)appropriateness of drug selection	17	16	67	67	13	16
f) renal dosing	19	11	58	55	22	33
g) monitor special populations (pediatrics, oncology, elderly)	25	17	54	51	20	30
h) detect patient allergies related to prescribed therapy	1	3	92	88	7	9
i) verify order completeness	1	2	94	89	4	8
j) identify dangerous abbreviations, dose expressions	14	13	70	72	15	15

Bed Size 300 to >500 beds Percentage of Respondents

Intervention Categories	Not Performed		Routine Activities		Targeted Activities
Intervention Categories	300-499	>=500	300-499	>=500	300-499	>=500
a) antimicrobial therapy	10	17	46	47	40	36
b) anticoagulation therapy	30	26	36	32	31	42
c) narcotics/pain management	30	38	46	39	17	23
d) drug dose verification	0	1	89	88	9	10
e)appropriateness of drug selection	9	14	69	65	20	18
f) renal dosing	7	12	48	55	42	32
g) monitor special populations (pediatrics, oncology, elderly)	20	14	41	43	35	40
h) detect patient allergies related to prescribed therapy	2	4	87	81	9	16
i) verify order completeness	0	1	89	90	7	9
j) identify dangerous abbreviations, dose expressions	9	12	68	69	21	18

Part II - Communication of Interventions and Use to Improve the Prescribing Process ns

All Hospitals and Hospitals by Bed Size

Questions	Percentage of respondents
	All Hospitals		Under 100 beds		100-299 beds		300-499 beds		Over 500 beds
	Yes	No	Yes	No	Yes	No	Yes	No	Yes	No
a) As a whole, does the medical staff respond well to pharmacists' interventions?	94	6	96	4	94	4	94	6	94	6
b) Are pharmacy interventions included as a measure of performance in evaluating all pharmacists (clinical and dispensing)?	47	53	36	64	56	44	49	51	55	45
c) Are pharmacy interventions routinely documented?	78	22	69	31	85	15	83	17	82	18
d) Are factors related to the prescribing errors identified by pharmacists presented to committees/staff for the purpose of improving the prescribing process?	64	36	51	49	74	26	73	27	68	32
e) Is the documentation of pharmacy interventions detailed enough to guide improvement?	61	39	52	48	70	30	60	40	62	38
f) In the past year, have pharmacy interventions been used to plan and carry out medical staff education?	44	56	35	65	48	52	53	47	53	47
g) Excluding prescriber education, have pharmacy interventions been used in the past year to improve the prescribing process (establish guidelines, protocols, standardized order sets, etc.)?	63	38	52	48	70	30	69	31	68	32

Hospitals by Physician and Pharmacy Residency Programs

Questions	Percentage of respondents
	With Pharmacy Residency		Without Pharmacy Residency		With Physician Residency		Without Physician Residency
	Yes	No	Yes	No	Yes	No	Yes	No
a) As a whole, does the medical staff respond well to pharmacists' interventions?	97	3	93	7	96	4	93	7
b) Are pharmacy interventions included as a measure of performance in evaluating all pharmacists (clinical and dispensing)?	55	45	45	55	53	47	44	56
c) Are pharmacy interventions routinely documented?	77	23	78	22	80	20	76	24
d) Are factors related to the prescribing errors identified by pharmacists presented to committees/staff for the purpose of improving the prescribing process?	65	35	64	36	69	31	61	39
e) Is the documentation of pharmacy interventions detailed enough to guide improvement?	59	41	61	39	64	36	59	41
f) In the past year, have pharmacy interventions been used to plan and carry out medical staff education?	48	52	44	56	50	50	41	59
g) Excluding prescriber education, have pharmacy interventions been used in the past year to improve the prescribing process (establish guidelines, protocols, standardized order sets, etc.)?	65	35	62	38	69	31	59	41

Results from Part I of ISMP Survey on Pharmacy Interventions

Factors that facilitate the pharmacist's ability to perform interventions

Effectiveness of factors related to pharmacist's ability to perform interventions

Part II - Types of Pharmacy Intervention Services Provided by Hospitals

Intervention Categories

Intervention Categories

Intervention Categories

Intervention Categories

Intervention Categories

All Hospitals and Hospitals by Bed Size

Questions

Percentage of respondents

Hospitals by Physician and Pharmacy Residency Programs

Questions

Percentage of respondents