A Multi-Center Time Study of Home Infusion Pharmacist Professional Services

Danell J. Haines, PhD | Research Consultant
Ryan Garst, PharmD, MBA, IgCP, BCSCP | NHIA
Connie Sullivan, BSPharm | NHIA
Jennifer Charron, RN, MSN, MBA | NHIA
Abstract

Introduction: Pharmacist professional services are paramount to the success of the home infusion process. Even though there is a general understanding of the type and scope of care that a pharmacist provides, the various tasks and how they differ between therapy types and drug administration method are unknown. Using home infusion pharmacist time utilization data collected in this study, the amount of time the home infusion pharmacist spends managing and caring for the patient was determined. The categories of professional services the pharmacist provides and the time and task differences between therapy types and methods of administration was also determined.

Methodology: This prospective time study analyzed pharmacist recall of time spent on a predetermined list of patient tasks using a formatted Excel® spreadsheet. Data was collected January-October 2021. The goal was to capture time data related to at least 2 dispensing cycles.

Results: The mean pharmacist time per patient per day was 35.85 minutes (SD=35.86). Based on this number, the direct salary costs associated with pharmacist services for the therapy categories described in this study is estimated to be $35.17 per patient per day. Over the course of the study, 400 pharmacist tasks were completed for 30 patients of which 49.30% involved drug preparation and compounding and 20.30% involved care coordination and communications. The mean tasks per patient was 13.33 (SD=7.03) and the mean tasks per patient per day was 1.33 (SD=.85). Anti-infective patients using an ambulatory pump required the most tasks per day (2.77, SD=1.20) and anti-infective patients using an IV push required the least (1.09, SD=.84). The mean time per task was 22.96 minutes (SD=28:29). Even though anti-infective patients who use a pump required the most time per day, they averaged the least number of study days (4.25) while anti-infective patients using an IV push averaged 14.39 study days.  

Discussion: Patient assessments require the most time; 40:48 minutes per task. Assessments ensure that the patient’s therapy is appropriate, evaluates patient safety, and ensures the home environment and caregiver support is sufficient. Sterile drug preparation and compounding comprises half of all pharmacists’ services which is expected since compounding has grown increasingly complex.

Conclusion: This pharmacist time study illustrates the type of tasks and the amount of time dedicated to home infusion professional services. Pharmacist’s average 35.85 minutes per day caring for each patient. Even though the data shows that patient care is highly customized, there are trends that can be applied to understanding a pharmacist’s workflow 

KeywordsPharmacist services, time study, patient assessment, clinical monitoring, sterile compounding, plan of care, care coordination, infusion