Goals and Objectives for Pharmacy Practice in Hospitals and Related Healthcare Settings
Goal 1: Increase the extent to which pharmacists help individual hospital inpatients achieve the best use of medications.
Objective 1.1 In 100% of hospitals and related healthcare settings, pharmacists will ensure that medication reconciliation2 occurs during transitions across the continuum of care (admission, transfer and discharge).
Objective 1.2 The medication therapy of 100% of hospital inpatients with complex and high-risk medication regimens3 will be monitored4 by a pharmacist.
Objective 1.3 In 90% of hospitals, pharmacists manage medication therapy5 for inpatients with complex and high-risk medication regimens3 in collaboration with other members of the healthcare team.
Objective 1.4 75% of hospital inpatients discharged with complex and high-risk medication regimens3 will receive medication counselling6 managed by a pharmacist.
Objective 1.5 50% of recently hospitalized patients or their caregivers (family members for example) will recall speaking with a pharmacist while in the hospital.
Goal 2: Increase the extent to which pharmacists help individual non-hospitalized patients achieve the best use of medications.
Objective 2.1 In 70% of ambulatory and specialized care clinics providing clinic care, pharmacists will manage medication therapy5 for clinic patients with complex and high-risk medication regimens3, in collaboration with other members of the healthcare team.
Objective 2.2 In 95% of ambulatory and specialized care clinics, pharmacists will counsel6 clinic patients with complex and high-risk medication regimens.
Objective 2.3 In 85% of home care services, pharmacists will manage medication therapy5 for patients with complex and high-risk medication regimens3, in collaboration with other members of the healthcare team.
Objective 2.4 In 65% of long-term care facilities, pharmacists will manage medication therapy5 for patients with complex and high-risk medication regimens3, in collaboration with other members of the healthcare team.
Goal 3: Increase the extent to which hospital and related healthcare setting pharmacists actively apply evidence-based methods to the improvement of medication therapy.
Objective 3.1 In 100% of hospitals and related healthcare settings, pharmacists will be actively involved in providing care to individual patients that is based on evidence7, such as the use of quality drug information resources, published clinical studies or guidelines, and expert consensus advice.
Objective 3.2 In 100% of hospitals and related healthcare settings, pharmacists will be actively involved in the development and implementation of evidence-based7 drug therapy protocols and/or order sets.
Objective 3.3 90% of hospital pharmacies will participate in ensuring that patients hospitalized for an acute myocardial infarction will receive angiotensin-converting enzyme inhibitors or angiotensin receptor blockers at discharge.
Objective 3.4 90% of hospital pharmacies will participate in ensuring that patients hospitalized for congestive heart failure will receive angiotensin-converting enzyme inhibitors or angiotensin receptor blockers at discharge.
Objective 3.5 90% of hospital pharmacies will participate in ensuring that patients hospitalized for an acute myocardial infarction will receive beta-blockers at discharge.
Objective 3.6 90% of hospital pharmacies will participate in ensuring that patients hospitalized for an acute myocardial infarction will receive aspirin at discharge.
Objective 3.7 90% of hospital pharmacies will participate in ensuring that patients hospitalized for an acute myocardial infarction will receive lipid-lowering therapy at discharge.
Objective 3.8 In 90% of hospitals and related healthcare settings providing clinic care, pharmacists will participate in ensuring that non-hospitalized patients who are receiving medications to decrease blood glucose levels will be assessed at least annually with a HbA1c test.
Objective 3.9 In 70% of hospitals and related healthcare settings, pharmacists will be actively involved in medication- and vaccination-related infection control programs.
Goal 4: Increase the extent to which pharmacy departments in hospitals and related healthcare settings have a significant role in improving the safety of medication use.
Objective 4.1 90% of hospitals and related healthcare settings will have an organizational program, with appropriate pharmacy involvement, to achieve significant annual, documented improvement in the safety of all steps in medication use.
Objective 4.2 80% of pharmacies in hospitals and related healthcare settings will conduct an annual assessment of the processes used for compounding sterile medications, consistent with established standards and best practices.
Objective 4.3 80% of hospitals have at least 95% of routine medication orders9 reviewed for appropriateness by a pharmacist before administration of the first dos
Objective 4.4 100 % of medication orders in a hospital’s emergency department will be reviewed by hospital pharmacists within 24 hours.
Objective 4.5 90% of hospital pharmacies will participate in ensuring that patients receiving antibiotics as prophylaxis for surgical infections will have their prophylactic antibiotic therapy discontinued within 24 hours after the surgery end time.
Objective 4.6 85% of pharmacy technicians in hospitals and related healthcare settings will be certified by a clearly identifiable and recognized training program.
Objective 4.7 75% of pharmacies in hospitals utilize a unit-dose system10 for drug distribution for 90% or more of their total beds.
Objective 4.8 100% of new pharmacists entering hospital and related healthcare setting practice will have completed a Canadian Hospital Pharmacy Residency Board-accredited residency.
Goal 5: Increase the extent to which hospitals and related healthcare settings apply technology effectively to improve the safety of medication use.
Objective 5.1 75% of hospitals will use machine-readable coding to verify medications before dispensing.
Objective 5.2 75% of hospitals will use machine-readable coding to verify all medications before administration to a patient.
Objective 5.3 For routine medication prescribing for inpatients, 75% of hospitals will use computerized prescriber order entry systems that include clinical decision support.
Objective 5.4 100% of hospital pharmacists will use computerized pharmacy order entry systems that include clinical decision support11.
Objective 5.5 In 75% of hospitals and related healthcare settings, pharmacists will use medication-relevant portions of patients’ electronic medical records for managing patients’ medication therapy5.
Objective 5.6 In 75% of hospitals and related healthcare settings, pharmacists will be able to electronically access pertinent patient information and communicate across settings of care (e.g. hospitals, clinics, home care operations, and chronic care operations) to ensure continuity of pharmaceutical care for patients with complex and high-risk medication regimens3.
Goal 6: Increase the extent to which pharmacy departments in hospitals and related healthcare settings engage in public health initiatives on behalf of their communities.
Objective 6.1 60% of pharmacies in hospitals and related healthcare settings will have specific ongoing initiatives that target community health12.
Objective 6.2 85% of hospital pharmacies will participate in ensuring that high risk patients in hospitals and related healthcare settings receive vaccinations for influenza and pneumococcus.
Objective 6.3 80% of hospital pharmacies will participate in ensuring that hospitalized patients who smoke receive smoking-cessation counselling.
Objective 6.4 90% of pharmacy departments in hospitals and related healthcare settings will have formal up-to-date emergency preparedness programs integrated with their hospitals and related healthcare settings’ and their communities’ emergency preparedness and response programs.
Summary of Revisions
Following consultation with the American Society of Health-Systems Pharmacists over revisions made to ASHP 2015 at the five year mark, CSHP Council approved revisions to CSHP 2015 in May 2008. These changes are summarized below.
Original Objective 1.1: Pharmacists will be involved in managing the acquisition, upon admission, of medication histories for 75% of hospital inpatients with complex and high-risk medication regimens.
Revised Objective 1.1: In 100% of hospitals and related healthcare settings, pharmacists will ensure that medication reconciliation occurs during transitions across the continuum of care (admission, transfer and discharge).
Original Objective 1.3: In 90% of hospitals, pharmacists will have organizational authority to manage medication therapy in collaboration with other members of the healthcare team.
Revised Objective 1.3: In 90% of hospitals, pharmacists manage medication therapy for inpatients with complex and high-risk medication regimens in collaboration with other members of the healthcare team.
Original Objective 2.3: In 85% of home care services, pharmacists will have organizational authority to manage medication therapy in collaboration with other members of the healthcare team.
Revised Objective 2.3: In 85% of home care services, pharmacists will manage medication therapy for patients with complex and high-risk medication regimens, in collaboration with other members of the healthcare team.
Original Objective 2.4: In 65% of long-term care facilities, pharmacists will have organizational authority to manage medication therapy in collaboration with other members of the healthcare team.
Revised Objective 2.4: In 65% of long-term care facilities, pharmacists will manage medication therapy for patients with complex and high-risk medication regimens in collaboration with other members of the healthcare team.
Original Objective 3.1: For 100% of hospital and related healthcare setting patients, pharmacists will be actively involved in ensuring that they receive evidence-based medication therapy.
Revised Objective 3.1: In 100% of hospitals and related healthcare settings, pharmacists will be actively involved in providing care to individual patients that is based on evidence, such as the use of quality drug information resources, published clinical studies or guidelines, and expert consensus advice.
Original Objective 3.2: In 100% of hospitals and related healthcare settings, pharmacists will be actively involved in the development and implementation of all evidence-based therapeutic protocols involving medication use.
Revised Objective 3.2: In 100% of hospitals and related healthcare settings, pharmacists will be actively involved in the development and implementation of evidence-based drug therapy protocols and/or order sets.
NEW Objective 3.9: In 70% of hospitals and related healthcare settings, pharmacists will be actively involved in medication- and vaccination-related infection control programs.
NEW Objective 4.8: 100% of new pharmacists entering hospital and related healthcare setting practice will have completed a Canadian Hospital Pharmacy Residency Board-accredited residency.
Objective 1.1 In 100% of hospitals and related healthcare settings, pharmacists will ensure that medication reconciliation2 occurs during transitions across the continuum of care (admission, transfer and discharge).
Objective 1.2 The medication therapy of 100% of hospital inpatients with complex and high-risk medication regimens3 will be monitored4 by a pharmacist.
Objective 1.3 In 90% of hospitals, pharmacists manage medication therapy5 for inpatients with complex and high-risk medication regimens3 in collaboration with other members of the healthcare team.
Objective 1.4 75% of hospital inpatients discharged with complex and high-risk medication regimens3 will receive medication counselling6 managed by a pharmacist.
Objective 1.5 50% of recently hospitalized patients or their caregivers (family members for example) will recall speaking with a pharmacist while in the hospital.
Goal 2: Increase the extent to which pharmacists help individual non-hospitalized patients achieve the best use of medications.
Objective 2.1 In 70% of ambulatory and specialized care clinics providing clinic care, pharmacists will manage medication therapy5 for clinic patients with complex and high-risk medication regimens3, in collaboration with other members of the healthcare team.
Objective 2.2 In 95% of ambulatory and specialized care clinics, pharmacists will counsel6 clinic patients with complex and high-risk medication regimens.
Objective 2.3 In 85% of home care services, pharmacists will manage medication therapy5 for patients with complex and high-risk medication regimens3, in collaboration with other members of the healthcare team.
Objective 2.4 In 65% of long-term care facilities, pharmacists will manage medication therapy5 for patients with complex and high-risk medication regimens3, in collaboration with other members of the healthcare team.
Goal 3: Increase the extent to which hospital and related healthcare setting pharmacists actively apply evidence-based methods to the improvement of medication therapy.
Objective 3.1 In 100% of hospitals and related healthcare settings, pharmacists will be actively involved in providing care to individual patients that is based on evidence7, such as the use of quality drug information resources, published clinical studies or guidelines, and expert consensus advice.
Objective 3.2 In 100% of hospitals and related healthcare settings, pharmacists will be actively involved in the development and implementation of evidence-based7 drug therapy protocols and/or order sets.
Objective 3.3 90% of hospital pharmacies will participate in ensuring that patients hospitalized for an acute myocardial infarction will receive angiotensin-converting enzyme inhibitors or angiotensin receptor blockers at discharge.
Objective 3.4 90% of hospital pharmacies will participate in ensuring that patients hospitalized for congestive heart failure will receive angiotensin-converting enzyme inhibitors or angiotensin receptor blockers at discharge.
Objective 3.5 90% of hospital pharmacies will participate in ensuring that patients hospitalized for an acute myocardial infarction will receive beta-blockers at discharge.
Objective 3.6 90% of hospital pharmacies will participate in ensuring that patients hospitalized for an acute myocardial infarction will receive aspirin at discharge.
Objective 3.7 90% of hospital pharmacies will participate in ensuring that patients hospitalized for an acute myocardial infarction will receive lipid-lowering therapy at discharge.
Objective 3.8 In 90% of hospitals and related healthcare settings providing clinic care, pharmacists will participate in ensuring that non-hospitalized patients who are receiving medications to decrease blood glucose levels will be assessed at least annually with a HbA1c test.
Objective 3.9 In 70% of hospitals and related healthcare settings, pharmacists will be actively involved in medication- and vaccination-related infection control programs.
Goal 4: Increase the extent to which pharmacy departments in hospitals and related healthcare settings have a significant role in improving the safety of medication use.
Objective 4.1 90% of hospitals and related healthcare settings will have an organizational program, with appropriate pharmacy involvement, to achieve significant annual, documented improvement in the safety of all steps in medication use.
Objective 4.2 80% of pharmacies in hospitals and related healthcare settings will conduct an annual assessment of the processes used for compounding sterile medications, consistent with established standards and best practices.
Objective 4.3 80% of hospitals have at least 95% of routine medication orders9 reviewed for appropriateness by a pharmacist before administration of the first dos
Objective 4.4 100 % of medication orders in a hospital’s emergency department will be reviewed by hospital pharmacists within 24 hours.
Objective 4.5 90% of hospital pharmacies will participate in ensuring that patients receiving antibiotics as prophylaxis for surgical infections will have their prophylactic antibiotic therapy discontinued within 24 hours after the surgery end time.
Objective 4.6 85% of pharmacy technicians in hospitals and related healthcare settings will be certified by a clearly identifiable and recognized training program.
Objective 4.7 75% of pharmacies in hospitals utilize a unit-dose system10 for drug distribution for 90% or more of their total beds.
Objective 4.8 100% of new pharmacists entering hospital and related healthcare setting practice will have completed a Canadian Hospital Pharmacy Residency Board-accredited residency.
Goal 5: Increase the extent to which hospitals and related healthcare settings apply technology effectively to improve the safety of medication use.
Objective 5.1 75% of hospitals will use machine-readable coding to verify medications before dispensing.
Objective 5.2 75% of hospitals will use machine-readable coding to verify all medications before administration to a patient.
Objective 5.3 For routine medication prescribing for inpatients, 75% of hospitals will use computerized prescriber order entry systems that include clinical decision support.
Objective 5.4 100% of hospital pharmacists will use computerized pharmacy order entry systems that include clinical decision support11.
Objective 5.5 In 75% of hospitals and related healthcare settings, pharmacists will use medication-relevant portions of patients’ electronic medical records for managing patients’ medication therapy5.
Objective 5.6 In 75% of hospitals and related healthcare settings, pharmacists will be able to electronically access pertinent patient information and communicate across settings of care (e.g. hospitals, clinics, home care operations, and chronic care operations) to ensure continuity of pharmaceutical care for patients with complex and high-risk medication regimens3.
Goal 6: Increase the extent to which pharmacy departments in hospitals and related healthcare settings engage in public health initiatives on behalf of their communities.
Objective 6.1 60% of pharmacies in hospitals and related healthcare settings will have specific ongoing initiatives that target community health12.
Objective 6.2 85% of hospital pharmacies will participate in ensuring that high risk patients in hospitals and related healthcare settings receive vaccinations for influenza and pneumococcus.
Objective 6.3 80% of hospital pharmacies will participate in ensuring that hospitalized patients who smoke receive smoking-cessation counselling.
Objective 6.4 90% of pharmacy departments in hospitals and related healthcare settings will have formal up-to-date emergency preparedness programs integrated with their hospitals and related healthcare settings’ and their communities’ emergency preparedness and response programs.
Summary of Revisions
Following consultation with the American Society of Health-Systems Pharmacists over revisions made to ASHP 2015 at the five year mark, CSHP Council approved revisions to CSHP 2015 in May 2008. These changes are summarized below.
Original Objective 1.1: Pharmacists will be involved in managing the acquisition, upon admission, of medication histories for 75% of hospital inpatients with complex and high-risk medication regimens.
Revised Objective 1.1: In 100% of hospitals and related healthcare settings, pharmacists will ensure that medication reconciliation occurs during transitions across the continuum of care (admission, transfer and discharge).
Original Objective 1.3: In 90% of hospitals, pharmacists will have organizational authority to manage medication therapy in collaboration with other members of the healthcare team.
Revised Objective 1.3: In 90% of hospitals, pharmacists manage medication therapy for inpatients with complex and high-risk medication regimens in collaboration with other members of the healthcare team.
Original Objective 2.3: In 85% of home care services, pharmacists will have organizational authority to manage medication therapy in collaboration with other members of the healthcare team.
Revised Objective 2.3: In 85% of home care services, pharmacists will manage medication therapy for patients with complex and high-risk medication regimens, in collaboration with other members of the healthcare team.
Original Objective 2.4: In 65% of long-term care facilities, pharmacists will have organizational authority to manage medication therapy in collaboration with other members of the healthcare team.
Revised Objective 2.4: In 65% of long-term care facilities, pharmacists will manage medication therapy for patients with complex and high-risk medication regimens in collaboration with other members of the healthcare team.
Original Objective 3.1: For 100% of hospital and related healthcare setting patients, pharmacists will be actively involved in ensuring that they receive evidence-based medication therapy.
Revised Objective 3.1: In 100% of hospitals and related healthcare settings, pharmacists will be actively involved in providing care to individual patients that is based on evidence, such as the use of quality drug information resources, published clinical studies or guidelines, and expert consensus advice.
Original Objective 3.2: In 100% of hospitals and related healthcare settings, pharmacists will be actively involved in the development and implementation of all evidence-based therapeutic protocols involving medication use.
Revised Objective 3.2: In 100% of hospitals and related healthcare settings, pharmacists will be actively involved in the development and implementation of evidence-based drug therapy protocols and/or order sets.
NEW Objective 3.9: In 70% of hospitals and related healthcare settings, pharmacists will be actively involved in medication- and vaccination-related infection control programs.
NEW Objective 4.8: 100% of new pharmacists entering hospital and related healthcare setting practice will have completed a Canadian Hospital Pharmacy Residency Board-accredited residency.
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