Workload and cost-benefit of hospital pharmacy residents.

The workload performed by three hospital pharmacy residents during typical clinical rotations was quantified then subjected to cost-benefit analysis. Daily activities and interventions were recorded on standardized forms for a four-week period. The cost of a resident to provide direct patient care services was compared to that of a staff pharmacist. In addition, the balance of the residents' salary and partial salaries of any pharmacists spending time with the residents were included in the cost analysis. The interventions were analyzed for their impact on patient care and potential cost avoidance by an external review committee. Collectively, more than 660 hours were recorded. Fifty-two percent of hospital time was spent on education-related activities and 32 percent on the provision of clinical services. Thirty interventions were submitted to a review panel of three physicians. Of the 90 evaluations, 76 percent were considered to have a positive impact on patient care, 22 percent no effect, and two percent a potentially detrimental effect. In one case, reviewers thought that hospitalization could have been prolonged had the intervention not occurred. Cost-benefit analysis yielded a ratio of 1.4 to 1 in favour of the residents. While the major benefit of a residency program is the perceived long-term benefit to the profession and patients, this study suggests that even during their residency year, hospital pharmacy residents provide cost-beneficial clinical services.