Year of Publication

2014

College

Martin School of Public Policy and Administration

Degree Name

Master of Public Administration

Executive Summary

In the modern world of healthcare, the role of the pharmacy intern is growing as hospitals look to decrease cost and increase care. The University of Kentucky Pharmacy Intern Program (UKPIP) employs pharmacy interns as pharmacist extenders to help complete the clinical task of medication reconciliation (med recs). The purpose of this study was to quantify the value of completing this task and determine whether it is cost effective to have interns or pharmacists in this role.

The Institutional Review Board approved this study. UK’s electronic medical record database identified admission med recs completed by pharmacy interns and pharmacists in two different study periods. Each document was evaluated and a complexity scale was used to assign a value to each med rec utilizing a multiplication factor for those with higher numbers of home medications and those where additional research was required to obtain information, such as calling a pharmacy. Each complexity factor was multiplied by an hourly salary value for either an intern or a pharmacist to determine the cost of that med rec.

Since the initiation of the pharmacy intern program, the number of daily med recs completed by pharmacists has significantly decreased and the number of med recs completed overall has significantly increased. Interns are completing med recs on more complex patients and are more likely to document their sources of information than pharmacists, a potential quality indicator. These results are skewed by the institution of a policy to complete a med rec within 24 hours of admission between the time of the control and study groups. By comparing admission data, it was determined that the daily admissions were not significantly different between groups. Therefore, extrapolating the med recs that pharmacists would have potentially completed in the control group, with the same policy in place, leads to a cost savings of about 62% of funds previously allocated to med recs.

At this time, the UKPIP is cost effective for the hospital. Interns have decreased the burden of work on pharmacists in a cost effective manner and there are indications that interns are completing quality work with value. Expanding the clinical role to similar tasks may be an appropriate next step for pharmacy interns.

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