Prioritizing pharmaceutical activities: a simulation exercise.

Hospital pharmacy practice has undergone many changes over the past 3 decades. New technologies, such as automated repackaging, robotic unit-dose cart-fill systems, and automated dispensing cabinets, have improved the efficiency, effectiveness, and quality of drug distribution systems. In addition, new pharmacy practice models have been introduced in which pharmacists accept responsibility and accountability for managing drug therapy (e.g., pharmaceutical care, medication therapy management). There is an abundance of evidence regarding the benefits of many pharmacy services for the quality and effectiveness of health care, but the uptake of many evidence-based services has been slow and incomplete. As such, there is a relative paucity of literature about the decisionmaking processes that pharmacy managers and practitioners use to prioritize the pharmacy services that they provide. Given that available human and financial resources are limited, it is important for pharmacy managers and others in the profession to identify and understand the basis for their prioritization decisions. More specifically, they need to understand if the portfolio of services provided by a particular pharmacy department is evidence-based, preference-based, or a result of random opportunities that have arisen in the hospital. A simulation exercise was developed to examine how hospital pharmacy managers make prioritization decisions. The primary objective of the exercise was to examine the consistency of pharmacy managers’ prioritization decisions in a simulated environment with constraints on available resources. The secondary objective was to rank the factors influencing prioritization decisions and to compare individuals’ and teams’ rankings of these factors.