Analysis Implementation of Medication Timeline (ME TIME) on the workload of clinical pharmacy services in inpatient care: A randomized controlled trial

Abstract

Background: The role of hospital clinical pharmacists is to minimize, if not eliminate, errors in drug administration. However, the number of clinical pharmacists employed in a hospital is often limited, which results in a high workload. Visual media assistance can help these professionals track medication timelines, hence reducing their cognitive load. Objective: This study aims to analyze the impact of using medication timelines (ME TIME) on clinical pharmacy workload, i.e., average work time and the ratio of clinical pharmacists to patients. Methods: This study is randomized controlled trial in single center, with single-blind design. Patients are grouped into two: standard and ME TIME. Workload is measured using the work sampling method to determine the time required for clinical pharmacy activities. This requires trained observers to observe experienced clinical pharmacists in their work. Meanwhile, the average workload per patient and the ratio are calculated quantitatively. Statistical analysis of difference tests was carried out to compare the workloads between the two groups. Results: The average time required for a clinical pharmacist to do their job with a medication timeline is 34’15” (9’28”) with a ratio of 14 patients/clinical pharmacy/day. The use of ME TIME did not make any differences between the standard and ME TIME groups in service time and patient ratios (P>α). The time required by the standard and ME TIME groups in the medication and disease history tracing stage was 7’30” (1’55”) and 9’12” (2’33”) respectively (P= < 0.0001). The time to trace the prescription review, and SOAP documentation were 10’22” (2’51”) (standard) and 8’44” (3’37”) (ME TIME) (P= 0.0007). Excessive polypharmacy prescribing patterns and geriatric patients are the factors that contribute to the increased workload. Conclusion: ME TIME can be an alternative educational media in clinical pharmacy services. It can save work time in reviewing prescriptions and SOAP documentation. This study also found that the more drugs prescribed to inpatients, the higher the workloads of clinical pharmacists are.