Abstract and Introduction
Objective: To describe the use of personal digital assistants (PDAs) in documenting pharmacists' clinical interventions.
Setting: Evans Army Community Hospital (EACH), a 78-bed military treatment facility, in Colorado Springs.
Participants: Pharmacists on staff at EACH.
Practice Description: All pharmacists at EACH used PDAs with the pilot software to record interventions for 1 month. The program underwent final design changes and then became the sole source for recording pharmacist interventions. The results of this project are being evaluated every 3 months for the first year and yearly thereafter.
Practice Innovation: Visual CE (Syware Inc. Cambridge, Mass.) software was selected to develop fields for the documentation tool. This software is simple and easy to use, and users can retrieve reports of interventions from both inpatient and outpatient sections. The software needed to be designed so that data entry would only take a few minutes and ad hoc reports could be produced easily.
Main Outcome Measures: Number of pharmacist interventions reported, time spent in clinical interventions, and outcome of clinical intervention.
Results: Implementing a PDA-based system for documenting pharmacist interventions across ambulatory, inpatient, and clinical services dramatically increased reporting during the first 6 months after implementation (August 2004-February 2005). After initial fielding, clinical pharmacists in advanced practice settings (such as disease management clinic, anticoagulation clinic) recognized a need to tailor the program to their specific activities, which resulted in a spin-off program unique to their practice roles.
Conclusion: A PDA-based system for documenting clinical interventions at a military treatment facility increased reporting of interventions across all pharmacy points of service. Pharmacy leadership used these data to document the impact of pharmacist interventions on safety and quality of pharmaceutical care provided.
Programs that use personal digital assistants (PDAs) for documenting pharmacist interventions are well described in the literature. PDA-based intervention programs are broad in scope and serve to improve intervention documentation and analysis and in assessing the value of pharmacists' cognitive services. In addition, some institutions use medical information tracked through PDA-based programs for physician profiling and reprivileging purposes.4 Overall, the results of these initiatives (and resultant analyses) show that PDA-based programs are both more effective and more efficient than legacy programs (paper documentation) in compiling, tracking, and analyzing intervention data.
In this report we describe the implementation of a PDA-based intervention program at an Army community hospital. The program was originally designed to simply improve the collection and reporting of intervention data. Since its implementation, however, PDA use has expanded to include documenting the value of pharmacist interventions in improving the quality and safety of the medication use system, compliance with approved clinical practice guidelines and related prescribing policies (physician profiling), and medication errors and adverse drug events. In addition, a spinoff program for clinical pharmacists practicing in a disease management clinic was initiated.