Selecting a Clinical Intervention Documentation System for an Academic Setting
Fox, Brent I., Andrus, Miranda, Hester, E. Kelly, Byrd, Debbie C., American Journal of Pharmaceutical Education
The clinical interventions of pharmacists have a positive impact on patient care and decrease cost. (1-12) Intervention documentation is important for justifying pharmacists' salaries, providing information to healthcare administrators and providers, conducting performance evaluations, and tracking workload. Electronic systems for documentation of clinical pharmacy interventions are more efficient than paper systems. (1) There are several commercial products that can be used in the hospital setting, as well as software packages that allow users to build their own documentation applications.
Although the value of commercial and customized clinical documentation programs in the clinical setting has been demonstrated, (13-28) few studies have described use of these software applications in the academic environment of colleges and schools of pharmacy. Documentation of patient care interventions by student pharmacists, pharmacy residents, and pharmacy faculty members is important for several reasons. As colleges and schools continue to strive for more quality training sites and learning opportunities for their students, it is important to demonstrate to administrators the value of having pharmacy students involved in patient care. Student pharmacists also need to develop the habits of providing appropriate documentation and justification of their work early in their training. Early application of documentation skills can promote this. Students also need to document learning experiences for experiental directors to assess competency achievement, and may choose to include intervention data in a portofolio for certifications, residency applications, or other employment. Having students use a personal digital assistant (PDA) database to document clinical work significantly improved their perception of the value and importance of documentation. (29) The 2007 Accreditation Council for Pharmacy Education (ACPE) Accreditation Standard 14 on Pharmacy Practice Experiences states that student "experiences must include direct interaction with diverse patient populations in a variety of practice settings and involve collaboration with other health care professionals". (30) Documentation of student clinical interventions throughout the experiential curriculum can provide schools with valuable assessment data to ensure ACPE standards are met.
Documentation of the impact of clinical pharmacy services is important to further the profession as a whole. At some clinical sites, faculty members are required to justify their presence by showing their impact on patient care. Additionally, outreach outcomes are important for routine performance evaluations as well as promotion and tenure of most clinical practice faculty members. However, most colleges and schools of pharmacy do not have a central database for capturing interventions at experiential locations, as students and faculty members are placed in multiple institutions with different intervention systems. For these reasons, we explored possible options for school-wide documentation of clinical interventions.
This paper describes our experiences in choosing a school-wide clinical intervention documentation system. It is intended to inform readers of the process of selecting an application to capture data describing the clinical and financial impact of an experiential program. We also provide a review of the literature of intervention documentation and outcomes from an academic perspective.
Only findings from small studies on the value of student pharmacist documentation of interventions at clinical sites have been published. (31-46) The types of documentation methods described included computer software, software for handheld devices, and online documentation systems. The clinical interventions by pharmacy faculty members and students and/or residents using electronic documentation systems have been described qualitatively and quantitatively. …