ISMP Survey on Pharmacy Interventions

Please take a few minutes to complete the following survey regarding pharmacy interventions at your practice site. Pharmacy interventions involve detecting errors, discrepancies, or opportunities for improved patient care while performing routine pharmacy functions. This survey is designed for pharmacists to determine the environment in which pharmacy interventions occur, the most common types of interventions, processes used to collect and record interventions, and whether the data is used to improve care. Please submit your responses (one survey per pharmacy, please) through our web site, www.ismp.org (or fax at 215-914-1492) by May 24, 2002. Thank you!

1) Please rate the effectiveness of the following factors related to your pharmacists' ability to perform interventions using the following scale: 1 = factor IS NOT present in my facility and poses a significant barrier to interventions, 5 = factor IS present in my facility and clearly facilitates interventions.

Factors related to pharmacy interventions	1 NOT present in my facility	2	3	4	5 present in my facility
a) Easy access to patient information (allergies, labs, height, weight, age, etc.)
b) Easy access to drug information (Internet access, references, etc.)
c) Proper technological support (software to aid in clinical decision making)
d) Sufficient clinical skill (of pharmacists)
e) Adequate staffing levels (allows/does not allow time for interventions)
f) Positive staff motivation to perform pharmacy interventions
g) Availability of drug appropriateness criteria, standards of care
h) Leadership commitment, facilitative organizational culture
i) Efficient process to document interventions (score 1 if no process in place)
j) Other:

2) Please indicate if you provide pharmacy intervention services for the following categories. Please specify if the intervention service is provided as part of the routine daily activities in the pharmacy (often performed in the pharmacy) and/or as a specific targeted clinical program (often performed in patient care units) by placing a check mark in the appropriate box(es). .

Intervention categories	Not performed	Routine activities	Targeted activities
a) antimicrobial therapy
b) anticoagulation therapy
c) narcotics/pain control services
d) drug dose verification
e) appropriateness of drug selection
f) renal dosing
g) monitor special patient populations (pediatrics, oncology, elderly, etc.)
h) detecting patient allergies related to prescribed therapy
i) verify order completeness
j) identify dangerous abbreviations, dose expressions
k) other:

3. Please check yes or no, or fill in the blank, to answer the following questions about your pharmacy interventions.

a) As a whole, does the medical staff respond well to pharmacist's interventions?	Yes  No
b) What % of clinical interventions is communicated directly to the prescriber (vs. delayed notification via paper)?	Please Select 1-20% 21-40% 41-60% 61-80% 81-85% 86-90% 91-95% 96-100%
c) What % of clinical recommendations by pharmacists does the medical staff accept?	Please Select 1-20% 21-40% 41-60% 61-80% 81-85% 86-90% 91-95% 96-100%
d) Are pharmacy interventions included as a measure of performance in evaluating all pharmacists (clinical and dispensing)?	Yes  No
e) Are pharmacy interventions routinely documented? If no, skip to the end.	Yes  No
f) Are factors related to the prescribing errors identified by pharmacists presented to committees/staff for the purpose of improving the prescribing process?	Yes  No
g) Is the documentation of pharmacy interventions detailed enough to drive improvement?	Yes  No
h) In the past year, have pharmacy interventions been used to plan and carry out medical staff education?	Yes  No
i) Excluding prescriber education, have pharmacy interventions been used in the past year to improve the prescribing process (establish guidelines, protocols, standardized order sets, limit choices, etc.)?	Yes  No
j) How are pharmacy interventions documented?	Please Select Paper PDAs Laptops Pharmacy Computers Other

4. Please tell us about your facility

a) Type of facility:	Please Select General Hospital Specialty Hospital Ambulatory Pharmacy Other	d) Pharmacy residency training offered?	Yes  No
b) Size:	Please Select Less than 100 100 to 299 300 to 499 500 and over Not Applicable	e) Physician residency training offered?	Yes  No
c) State:	Please Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming	f) Group Purchasing Organization: