Measuring Pharmacy Department Data: Enhancing Productivity Through a Scorecard

1. PSHP Annual Assembly 2015 Importance of Measuring Pharmacy Department Data: How to Enhance Productivity Through a Scorecard Jill Rebuck, Pharm.D., MBA, BCPS, FCCM, FCCP Director of Clinical Pharmacy Services Penn State Milton S. Hershey Medical Center

2. Objectives • Discuss at least 3 examples of meaningful clinical &operational metrics for a health-system pharmacy department

3. Driving Forces for Change AJHP 2009;66:713

4. Why Measure Performance? • Shift from volume to value-based care • Accountable Care Act • Value based purchasing • Meaningful use • PPMI leaders believe: • Lack of pharmacy resources is barrier to optimal practice models (83%) • Stakeholders have “insufficient recognition” of pharmacy’s value (73%) PPMI Summit 2010; Accessed via ashp.org

5. Pharmacy Department Realities • Limited pharmacy staff • Tighter budgets • Rising drug expenses • Expectation to provide highest quality pharmacy services while decreasing total cost of care • Greater accountability to defined patient outcomes

6. “If you can’t measure it, you can’t improve it” - Peter Drucker

7. Advantages of Pharmacy Scorecard • If adequately constructed & updated frequently: • Represent broad view of performance • Guide for strategic decision making • Improve quality of pharmacy services • Demonstrate impact of pharmacy on organizational alignment Enwere EN, et al. Hosp Pharm 2014;49:579-84

8. Department Alignment Mission Vision Values Strategic Goals Initiatives Department Performance Metrics Adapted by EnwereEN, et al. Hosp Pharm 2014;49:579-84

9. Scorecard Considerations • Tactical indicators of performance metrics based on specific goals • Trend data over time (vs. dashboards) • Monthly or quarterly & YTD • Push vs. pull data considerations • Need to be easily monitored • Resource allocation for data collection

10. Establishing Performance Targets • Obtain institution-specific baseline data • Incorporate external benchmarks • Enhance validity & credibility • Determine frequency of updating info • Monthly, quarterly, annually • Visualization of progress • Evaluate metrics annually

11. Controversy: Scorecard Content • Pharmacy-centric metrics vs. • Organizational wide metrics Examples: • % Med Rec Completed or 30-day Readmission • % Patients receiving anticoagulation or % DVT/PE • % Patients with pain scores < 5 or % Top Box HCAHPS pain control

12. Examples of Med-Related Outcomes Numbers above represent fictitious data for illustrative purposes only

13. Examples: Pharmacy Operations Further consideration on order verification turn-around-time Further consideration of order verification turn-around-time

14. Examples: Pharmacy Operations Further consideration on order verification turn-around-time Further consideration of order verification turn-around-time

15. Examples: Financial & Growth Further consideration on order verification turn-around-time

16. Examples: Employee Talent

17. Productivity Monitoring Indicators • Worked hours per unit of service • Drug (or labor) cost per admission • Labor expense per 1,000 doses billed • RPh worked hours per order • Tech worked hours per dose • Clinical interventions per RPh shift • RPh:Technician skill mix ratio • Rx cost as % of total hospital cost Adapted from Rough SS, et al. AJHP 2010;67:380-8.

18. Pharmacy Intensity Score • Resource-based relative value intensity grouping system • Uses pharmaceutical resource consumption data • Produce DRG-specific drug use weights • Generally preferred over CMI • Example: hip replacement vs. kidney transplant Rough SS, et al. AJHP2010;67:300-11.

19. Scorecards: Summary • Important to promote and justify patient-centered pharmacy services • Update & share regularly with pharmacy employees and stakeholders • Influence ‘right size’ of department

20. Questions