Implementation and Evaluation of a Clinical Surveillance System at a Large Quaternary Care Academic Medical Center



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Implementation of pharmacy clinical surveillance systems (CSS) has enhanced clinical decision-making and improved pharmacists’ daily workflow. In September 2021, a CSS tool was implemented at a large, quaternary care academic medical center. Prior to CSS (TheraDoc®, Hospira, Lake Forest, IL) implementation, a robust rule-based CSS alert tool necessary for identifying potential interventions was not available at the institution. Previously, clinical pharmacists were tasked with identifying clinical data via use of the Epic© RxScorecard tool, a process which contributed to inconsistent capture of interventions. The objective of this single-center pre-post study was to evaluate the impact of an alert-based CSS tool on cost avoidance, documentation of pharmacy clinical interventions, and to compare pharmacists’ satisfaction with the profile review workflow before and after CSS implementation. Pharmacists’ satisfaction with the profile review workflow pre- and post-CSS implementation was assessed using an eight-question survey with response options ranging from 1 indicating “strongly disagree” to 5 indicating “strongly agree”. The department of pharmacy decreased its clinical interventions from 17,570 pre-CSS implementation period to 16,451 in the post-CSS implementation period; this represents a 6% decrease in the total number of interventions across the study period. Overall, implementation of the CSS tool improved decentralized pharmacists satisfaction with the profile review workflow. The estimated cost avoidance after CSS implementation was $3,001,003, down from $3,419,024 before implementation, representing a 12% decrease in cost avoidance. The value of decentralized pharmacists utilizing the CSS software is improved standardization for carrying out the patient profile review workflow.



Clinical decision support system, Costs, Interventions, Clinical surveillance systems