What Clinical Pharmacy Key Performance Indicator Processes of Care Were Patients Receiving across Canada in 2018? A National Patient Registry and Pooled Analysis.

Background: National consensus-based clinical pharmacy key performance indicators (cpKPIs) are health quality indicators representing processes of care associated with an impact on meaningful patient outcomes. Canadian hospitals are measuring cpKPIs at the local level. However, variations exist regarding which cpKPIs are measured and the associated cpKPI practice profiles. At the time this study was undertaken, a national registry did not exist to capture real-world cpKPI patient data and to track pooled national progress. Objectives: To develop a national cpKPI patient registry, to characterize cpKPI-related care delivered, and to generate pooled national summary cpKPI reports to inform the advancement of pharmacy practice and improve patient outcomes. Methods: In this national, retrospective, observational quality improvement study, hospitals measuring at least one cpKPI in at least one inpatient area were enrolled and submitted aggregated, de-identified cpKPI patient data for the calendar year 2018 (January to December). Patient-proportion cpKPI data for individual hospitals were summarized, and pooled national reports were generated. Results: Overall, 32 Canadian health care organizations were enrolled, capturing 275 896 patient visits. The core analysis focused on 25 acute care institutions that were continuously measuring cpKPIs. The most commonly delivered cpKPI processes of care were development of a pharmaceutical care plan (59% of patients), resolution of drug therapy problems (37% of patients), and participation in interprofessional patient care rounds (36% of patients). The least commonly delivered cpKPI care services were patient medication education during the hospital stay (7% of patients), medication reconciliation at discharge (15% of patients), and patient medication education at discharge (17% of patients). Conclusions: The first national registry for capturing clinical pharmacy health quality indicators was established and used to characterize real-world cpKPI-related patient care delivery. The findings from this registry could facilitate hospital-level cpKPI benchmarking and could support national sharing of best practices to advance pharmacy practice and improve patient outcomes.