title: Development of clinical pharmacy key performance indicators for hospital pharmacists using a modified Delphi approach.
abstract: BACKGROUND
  Key performance indicators (KPIs) are quantifiable measures of quality. There are no published, systematically derived clinical pharmacy KPIs (cpKPIs).
  
  
  OBJECTIVE
  A group of hospital pharmacists aimed to develop national cpKPIs to advance clinical pharmacy practice and improve patient care.
  
  
  METHODS
  A cpKPI working group established a cpKPI definition, 8 evidence-derived cpKPI critical activity areas, 26 candidate cpKPIs, and 11 cpKPI ideal attributes in addition to 1 overall consensus criterion. Twenty-six clinical pharmacists and hospital pharmacy leaders participated in an internet-based 3-round modified Delphi survey. Panelists rated 26 candidate cpKPIs using 11 cpKPI ideal attributes and 1 overall consensus criterion on a 9-point Likert scale. A meeting was facilitated between rounds 2 and 3 to debate the merits and wording of candidate cpKPIs. Consensus was reached if 75% or more of panelists assigned a score of 7 to 9 on the consensus criterion during the third Delphi round.
  
  
  RESULTS
  All panelists completed the 3 Delphi rounds, and 25/26 (96%) attended the meeting. Eight candidate cpKPIs met the consensus definition: (1) performing admission medication reconciliation (including best-possible medication history), (2) participating in interprofessional patient care rounds, (3) completing pharmaceutical care plans, (4) resolving drug therapy problems, (5) providing in-person disease and medication education to patients, (6) providing discharge patient medication education, (7) performing discharge medication reconciliation, and (8) providing bundled, proactive direct patient care activities.
  
  
  CONCLUSIONS
  A Delphi panel of hospital pharmacists was successful in determining 8 consensus cpKPIs. Measurement and assessment of these cpKPIs will serve to advance clinical pharmacy practice and improve patient care.
authors.affiliation: University Health Network Pharmacy Department, Toronto, ON, Canada University of Toronto, Toronto, ON, Canada.
authors.forename: Olavo
authors.initials: O
authors.lastname: Fernandes
authors.affiliation: Interior Health Pharmacy Services, Kelowna, BC, Canada The University of British Columbia, Vancouver, BC, Canada cpKPICollaborative@gmail.com.
authors.forename: Sean K
authors.initials: SK
authors.lastname: Gorman
authors.affiliation: Interior Health Pharmacy Services, Kelowna, BC, Canada The University of British Columbia, Vancouver, BC, Canada.
authors.forename: Richard S
authors.initials: RS
authors.lastname: Slavik
authors.affiliation: Regina Qu'Appelle Health Region Pharmacy Services, Regina, SK, Canada University of Saskatchewan, Saskatoon, SK, Canada.
authors.forename: William M
authors.initials: WM
authors.lastname: Semchuk
authors.affiliation: The University of British Columbia, Vancouver, BC, Canada Lower Mainland Pharmacy Services, Providence Healthcare, Vancouver, BC, Canada.
authors.forename: Steve
authors.initials: S
authors.lastname: Shalansky
authors.affiliation: Département de pharmacie et unité de recherche en pratique pharmaceutique, CHU Sainte-Justine, Montréal, QC, Canada Université de Montréal, QC, Canada.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Bussières
authors.affiliation: Horizon Health Network Pharmacy Services, Moncton, NB, Canada Dalhousie University, Halifax, NS, Canada.
authors.forename: Douglas
authors.initials: D
authors.lastname: Doucette
authors.affiliation: McMaster University, Hamilton, ON, Canada.
authors.forename: Heather
authors.initials: H
authors.lastname: Bannerman
authors.affiliation: Sunnybrook Health Sciences Centre Pharmacy Department, Toronto, ON, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Lo
authors.affiliation: Foothills Medical Centre Pharmacy Department, Calgary, AB, Canada.
authors.forename: Simone
authors.initials: S
authors.lastname: Shukla
authors.affiliation: St Michael's Hospital Pharmacy Department, Toronto, ON, Canada.
authors.forename: Winnie W Y
authors.initials: WW
authors.lastname: Chan
authors.affiliation: University Health Network-Toronto Rehabilitation Institute Pharmacy Department, Toronto, ON, Canada.
authors.forename: Natalie
authors.initials: N
authors.lastname: Benninger
authors.affiliation: James L Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH, USA.
authors.forename: Neil J
authors.initials: NJ
authors.lastname: MacKinnon
authors.affiliation: University of Toronto, Toronto, ON, Canada Mount Sinai Hospital, Toronto, ON, Canada Institute for Clinical Evaluative Sciences (ICES), Toronto, ON, Canada.
authors.forename: Chaim M
authors.initials: CM
authors.lastname: Bell
authors.affiliation: Alberta Health Services Pharmacy Services, Red Deer, AB, Canada.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Slobodan
authors.affiliation: Canadian Society of Hospital Pharmacists, Ottawa, ON, Canada.
authors.forename: Catherine
authors.initials: C
authors.lastname: Lyder
authors.affiliation: The University of British Columbia, Vancouver, BC, Canada.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Zed
authors.affiliation: Capital District Health Authority Pharmacy Department, Halifax, NS, Canada.
authors.forename: Kent
authors.initials: K
authors.lastname: Toombs
mesh_terms: D032921:Consensus; D003697:Delphi Technique; D006801:Humans; D059065:Medication Reconciliation / Q000379:methods*; D010351:Patient Discharge; D010595:Pharmacists / Q000458:organization & administration* / Q000592:standards; D010607:Pharmacy Service, Hospital / Q000458:organization & administration* / Q000592:standards
keywords: Delphi consensus; clinical pharmacy; key performance indicators; process-of-care indicators