Multidisciplinary perspectives on roles of hospital pharmacists in tertiary settings: a qualitative study

Abstract

In today’s complex healthcare landscape, exacerbated by resource constraints at various levels, optimization of health professionals’ roles is becoming increasingly paramount. Interprofessional collaboration, underpinned by role recognition and teamwork, leads to improved patient and organizational outcomes. Hospital pharmacists play a pivotal role in multidisciplinary teams, and it is imperative to understand multidisciplinary viewpoints on hospital pharmacists’ roles to guide role prioritization and organizational efficiency. However, no study extensively investigated multidisciplinary views on values of diverse pharmacist roles in tertiary settings. This study aims to address this gap by examining non-pharmacist health professionals’ views on hospital pharmacists’ roles, recognizing their specialized niches as a crucial step towards optimizing their roles and services in Australia and internationally. Multiple focus group discussions and interviews were held via a virtual conferencing platform. Study participants were recruited using the study investigators’ professional networks who were non-pharmacist health professionals with experience working with pharmacists in hospital settings. Data were collected from transcripts of the focus group recordings, which were later summarized using descriptive statistics and thematic analysis. Overarching themes were categorized and mapped against work system models to conceptualize organizational implications of multidisciplinary feedback, linking them to patient and organizational outcomes. Twenty-seven health professionals participated across focus groups and interviews, with the majority of professions being doctors and nurses. Three major themes were identified as follows: (i) overarching perceptions regarding hospital pharmacists; (ii) professional niches of hospital pharmacists; and (iii) future opportunities to optimize hospital pharmacy services. Valued professional niches included patient and health professional educators, transition-of-care facilitators, and quality use of medicines analysts. The study highlights critical insights into hospital pharmacists’ roles in Australia, identifying their niche expertise as vital to healthcare efficiency and success. Based on multidisciplinary feedback, the study advocates for strategic role optimization and targeted research for enhanced clinical, economic, and organizational outcomes.

Introduction

Today’s healthcare landscape—complex, dynamic, and resource intensive—requires individual role optimization and cohesive collaboration among health professionals. Successful interdisciplinary collaboration thrives on coordinated decision-making, anchored by mutual respect, understanding, and appreciation of each other’s roles [1, 2]. Studies have consistently highlighted the advantages of clear role definition in enhancing patient outcomes and resource utilization [1, 3–5].

Specifically, a well-coordinated effort between doctors, nurses, and pharmacists can prevent medication errors, optimize therapeutic regimens, and ensure holistic patient care [6, 7]. Hospital pharmacists are vital contributors to healthcare systems, working with doctors, nurses, and allied health professionals in diverse settings—from inpatient bedsides to emergency departments and outpatient clinics [8]. Role optimization of hospital pharmacists can enhance operational efficiency, enabling pharmacy leaders to utilize pharmacists’ skills and allocate resources effectively in daily operations [9, 10]. Understanding the perceived value of hospital pharmacist roles is required for resource prioritization, seamless integration, and ultimately, to promote better patient outcomes. However, there is little evidence of non-pharmacist health professional perceptions of hospital pharmacist roles outside of individual clinical units, especially in Australia.

To describe the links between multidisciplinary viewpoints of hospital pharmacists’ roles and role optimization, work system frameworks such as the Systems Engineering Initiative for Patient Safety (SEIPS) [11] and Clinical, Economical, and Organizational (CLEO) models [12] can be used. The SEIPS model illustrates that optimal patient and organizational outcomes are achieved through a balance between the tasks, tools, environments, and organization, while CLEO offers an outcome scale specific to pharmacists’ tasks.

This study aims to explore the perceptions of hospital pharmacist roles and services held by non-pharmacist health professionals using focus groups and semi-structured interviews. Highlighting the specialized professional niches of hospital pharmacists would offer an important step for optimizing their roles and services not only in Australia but also on a global scale.

Methods

Recruitment and inclusion criteria

Non-pharmacist health professionals were invited to participate via email and staffroom advertisements through the investigators’ professional networks. Purposive sampling was employed to recruit participants with varied degrees of experience from a range of disciplines, regions, and clinical specialties. Potential participants expressed interest via an online form (REDCap ver. 13.1.27, Vanderbilt University). Demographics were collected via this form and were screened to determine participants’ eligibility. Eligible participants were encouraged to refer their colleagues if interested in participating in the study. Recruitment continued until the main themes were repeated (i.e. data saturation).

Health professionals registered with the Australian Health Practitioner Regulation Agency or another relevant governing body were eligible to participate if they were currently employed within a South Australian public hospital and had experience working with hospital pharmacist(s) within the preceding 12 months.

Data collection

Data were collected mainly via focus groups. Where participants could not attend a scheduled focus group, supplementary semi-structured interviews were offered. A discussion guide was used to explore multidisciplinary perceptions of hospital pharmacist roles, most/least valuable roles, and future suggestions (see Supplementary Data). Focus groups were conducted online via Zoom (ver. 5.9.1, USA) and lasted for ∼45–60 minutes (15–20 minutes for interviews). The virtual format facilitated participation by professionals from several different hospitals, eliminating travel time [13]. One facilitator led a discussion and at least one note-taker took field notes. Focus groups/interviews were recorded (audio and visual) within the Zoom platform.

Data analysis and reporting

Participant demographics were summarized using descriptive statistics via SPSS Statistics (ver. 28.0.1.1, IBM). Audio-visual recordings were transcribed verbatim, reviewed for transcription accuracy, deidentified, and imported into NVivo (R1.6.1, QSR International) for thematic analysis using a reflexive approach [14].

The transcripts were independently analysed by three investigators (K.M.K.L., J.J. and I.K.), who derived codes and themes inductively, creating a definition of each code/theme generated. Coding investigators compared their codes and themes and undertook the process of regrouping and redefining until they reached a consensus on a final list of themes and their definitions.

The list of themes was verified by another investigator (A.P.) who was not involved in the data collection process to minimize potential bias. The themes were categorized into thematic domains, and relevant participant quotations were presented. Where specific pharmacist tasks or roles were articulated by participants, codes were synthesized into statements describing the ‘professional niches’ hospital pharmacists were perceived to fill within the healthcare team. In this study, ‘professional niche’ refers to a specialized area or role where a health professional focuses their expertise, skills, and practice to meet a specific need within multidisciplinary teams or healthcare delivery.

To describe the organizational implications of multidisciplinary perceptions, themes were mapped against the SEIPS model which includes three components: the system, processes, and outcomes [11]. Within the outcomes, component themes were further mapped to the CLEO models [12] (Table 1).

Table 1.

The summary of work system components adopted from the SEIPS [11] and the CLEO models [12], used in theme mapping.

Major components	Subcomponents	Elements/scope
Work system/structural features	Person	Individuals or groups with distinct traits, e.g. physical, cognitive, and psychosocial
	Organization	Teamwork, coordination, collaboration and communication, organizational culture, work schedules, social relationships, supervisory and management style, performance evaluation, rewards, and incentives
	Task	Variety of tasks, job content, challenge and utilization of skills, autonomy, job control and participation, job demands (e.g. workload, time pressure, cognitive load, need for attention)
	Technology/tool	Various information technologies, electronic health records, computerized provider order entry and barcoding, medical administration, medical devices, human factors characteristics of technologies and tools (e.g. usability)
	Environment	Layout, noise, lighting, temperature, humidity and air quality, workstation design
Processes	Care processes	Information flow, maintenance, quality assurance
Outcomesa	Clinical (i.e. patients)	Vital, major, moderate, minor, null, harmful
	Employee and organizational	Favourable vs. unfavourable, e.g. job satisfaction, job stress and burnout, employee safety and health, turnover, profitability
	Economic	Cost increase vs. decrease

^aThe ‘outcomes’ components and elements were adopted from the CLEO model [12].

Most research team members are pharmacists. J.J., I.K., and D.R. are employed in the South Australian public health sector, where all the participants also work. M.E.J., a postdoctoral medical researcher, was the primary focus group facilitator. The reporting follows the Consolidated Criteria for Reporting Qualitative Research Checklist [15].

Results

Between January and February 2023, 27 health professionals participated in online discussions: 19 across five focus groups and 8 in individual interviews. Participants included doctors (n = 9), nurses (n = 9), and allied health professionals/midwives (n = 9). The latter group comprised a podiatrist (n = 1), occupational therapist (n = 1), dietician (n = 1), social worker (n = 1), speech pathologists (n = 3), and midwives (n = 2). The length of participants’ experience in hospital settings ranged from 6 months to 34 years, with a mean of 15.1 years. Over half of participants reported interacting with a pharmacist at least daily (n = 14), with a third (n = 9) interacting with a pharmacist three or more times daily. Participant demographics are summarized in Table 2.

Table 2.

Summary of participants’ professional backgrounds and experience interacting with hospital pharmacists (n = 27).

Participant demographics	n (%)
Duration of practice in the hospital setting
<1 year	2 (7.4)
1–5 years	2 (7.4)
5–10 years	5 (18.5)
10+ years	18 (66.7)
Clinical specialty/primary work settinga
Geriatrics	4 (14.8)
Stroke/neurology	4 (14.8)
Mental health	4 (14.8)
General medicine	3 (11.1)
Renal	2 (7.4)
Community outreach	2 (7.4)
Gastrointestinal	2 (7.4)
Maternity	2 (7.4)
Othersb	4 (14.8)
Average frequency of interactions with a hospital pharmacistc
Once a week or less	4 (14.8)
Several times a week	8 (29.6)
1–2 times a day	5 (18.5)
3–4 times a day	4 (14.8)
>5 times a day	5 (18.5)

^aClinical units as defined by participants’ self-report.

^bOthers included surgical units, paediatric units, haematology/oncology units, and unspecified units (not presented individually as n = 1).

^cNot reported for n = 1 participant.

Three thematic domains emerged from focus group discussions and interviews. Themes were categorized according to the work system components (see Supplementary Data).

Domain 1: overarching perceptions regarding hospital pharmacists

Participants from all professional backgrounds perceived pharmacists to be valuable ‘core’ members of the multidisciplinary team, citing either exemplary experiences with individual pharmacists or pharmacy services in general.

I find [hospital pharmacists] as a health professional, they are incredibly valuable, because they are so approachable, and they’re so thorough. (P25, nurse, neurology)

The most valuable thing [about hospital pharmacist roles], I think, is just having somebody there who wants to help, knows how to help, and is really good at it. (P23, nurse, community outreach)

Core team. The nurse, pharmacist, doctor…they are absolutely at the centre, and then everything else is built around that. (P18, nurse, mental health)

Hospital pharmacists were seen as pivotal in optimizing clinical decisions, leading to improved outcomes and enhanced patient experiences/satisfaction. Participants emphasized the pharmacists’ impact in shortening patients’ hospital stays and enhancing patient safety by preventing medication errors and related harms.

I think they can advise home teams and treating doctors on the best course of action from the get-go […] so I think they reduce the length of stay. (P23, nurse, community outreach)

There’s significant medication safety enhancement with the presence of a hospital pharmacist. (P11, doctor, general medicine)

Getting the pharmacists in quickly…helps us with patient care and their experience of the hospital. That provides less stress to them, less stress for the nurses.. all of that, so it can make the hospital stay a lot smoother for the patients. (P15, nurse, surgical)

Broadly, doctors demonstrated a wider familiarity with hospital pharmacist roles than other healthcare professionals, many of whom appeared primarily acquainted with those roles directly related to their practice. One midwife and a podiatrist commented on ‘limited exposure’ to pharmacists in their multidisciplinary activities, resulting in a lack of knowledge of pharmacist roles.

Domain 2: professional niches of hospital pharmacists

Themes under this domain were conceptualized as professional niches, as presented in Table 3. Specific tasks cited as most valuable to the team and to patient care included:

Table 3.

Professional niches of hospital pharmacists as described by the study participants.

Hospital pharmacists’ professional nichea	Narrative description of professional niche	Example descriptive quotes
Patient advocate and educator	Hospital pharmacists provide comprehensive education when medicines are started or changed in the inpatient setting, at hospital discharge, and in outpatient settings. They provide advice on adherence strategies and create consumer-friendly educational materials. Hospital pharmacists advocate for patient-centred treatment plans and collaborate with patients, healthcare teams, and relevant healthcare programmes to facilitate cost-effective medication access.	Make sure the patient or the care provider or a guardian, as it might, be well educated in, I guess, what they need to take, the dosage and access as well, and when to review (P20, speech pathologist, paediatric). I guess, for me the pharmacists really make sure that, like if we’re preparing a patient for discharge that organises a lot more like independence if they start to practice managing their own medications. So that’s a role that we sort of try and utilise and support the patient with (P14, occupational therapist, neurology). They [pharmacists] also provide a very comprehensive handout, some medication lists for the patient, so that they’re aware of what they meant to be taking, at what time, what is the main indication, side effects, etc (P2, doctor, mental health). I’d say [a hospital pharmacist is] a patient advocate, linkage with community and other specialties, and an educator. Support person for them [patients] as well (P1, nurse, renal). Obviously, PBS [Pharmaceutical Benefits Scheme], some are cheaper in the hospital, so the pharmacists often help us get the best value for our patients and support for that (P1, nurse, renal). The fortune of being able to have the pharmacists help with IPUs [Individual Patient Use application] to get access to medications that may not be obtainable through affordability, or through the prescribing guidelines for off-label medications (P25, nurse, neurology).
Health professional advisor	Hospital pharmacists offer expert advice on specialized medicine–related topics, providing tailored drug information and clinical recommendations in response to patient-level queries.	They’re [hospital pharmacists] real source of knowledge for us, and we [doctors] have a really good working relationship with our pharmacists, and they tell us they advise us about interactions with medications that we obviously don’t know (P9, doctor, haematology). [The hospital pharmacist] has a look at any issues with crushing, not being able to crush or not crush medications for our patients (P17, nurse, neurology). They can give information on infusions … how to give you infusions, protocols, you know, all those kinds of information (P23, nurse, community outreach). Also just getting information about pregnancy and breastfeeding. So getting.. again access to that information through the phones. This gives me more confidence (P25, nurse, neurology).
Health professional educator	Hospital pharmacists deliver informal education embedded in practice and formal education in structured sessions and recognized training programmes. They function as preceptors and mentors to students, interns, and peers less experienced in medicines management.	They’re [hospital pharmacists] very helpful for educating not only the patient but the nursing staff, as well as medical staff and other staff involved in the patients care about how they should be taking it, how formulations might interact, and how that patient might actually experience the formulation (P3, doctor, gastroenterology). When they [hospital pharmacists] come on the round they can do so many functions they can educate. They can be a resource for information […] Maybe the involvement in research and teaching as well, and training the junior pharmacists (P10, doctor, geriatrics). The [hospital] pharmacists attend some of our [podiatrist] endorsement meetings, which is great (P16, podiatrist, community outreach). With helping doctors and nurses to truly understand the medication that they’re prescribing and administering (P18, nurse, mental health).
Medication supply manager	Hospital pharmacists dispense prescriptions, supply of medicines to health services, and compound and manufacture pharmaceutical products. They are responsible for coordinating, medicine stock management and overseeing safe and appropriate medication storage. They facilitate timely access to and administration of medicines, which can also include preparation activities and may occur in emergency situations.	There’s dispensing, ensuring the supply of inpatient and outpatient and discharge medications and sharing timely supply and discharge medications (P12, doctor, mental health). [The hospital pharmacist] has a look at what drugs we keep in our drug room and maybe updates that sometimes things that we might be ordering a lot to go on our Imprest (‘ward stock’) (P17, nurse, neurology). There’s also a compound [sic] pharmacist, the one that makes up the chemo [chemotherapy] drugs and transplant type medications (P10, doctor, geriatrics). Checking the vaccination and the medication fridge. So, just being a resource and making sure that yeah, we [midwives] are storing and handling medicines appropriately (P24, midwife, maternity). [Hospital] pharmacists work very closely during resus [resuscitation] in the emergency department, assisting with preparation administration of drugs through the resuscitation process (P8, nurse, geriatrics).
		They [hospital pharmacists] also help us organise things like the Sepsis Box, which has, like a group of antibiotics rarely available for us in a sepsis emergency (P26, midwife, maternity). ED [emergency department] pharmacists attend Level One traumas, P1 (‘Priority 1ʹ] patients [. to provide] resus [resuscitation] meds (P13, nurse, geriatrics).
Quality use of medicines analyst	Hospital pharmacists promote the quality use of medicines, focusing on proactively optimizing medication effectiveness and safety. To achieve this, they review drug orders and regimens, monitor drug use, check medication adherence, and initiate interventions, including deprescribing.	Checking with ScriptCheck (‘live prescription monitoring system of controlled drugs’) and making sure that you know certain medications that can be misused, or whatever is that we’re not compounded in that. That’s obviously as prescribers as we have a responsibility to do that as well, but having the pharmacists also check that (P2, doctor, mental health). The [hospital] pharmacist plays a really crucial role in helping us to deprescribe and to monitor these high-risk medications in the older population (P8, nurse, geriatrics). I echo everybody else’s sentiment in the role of pharmacists in patient safety. And I think, especially in cancer, where we’re dealing with chemotherapy and calculating doses according to body surface area. They are just absolutely vital (P9, Doctor, Haematology). A patient was on carbamazepine, and he was initiated in dual anti-platelets, and one of the antiplatelets was actually interacting with the carbamazepine. She flagged that interaction with that changed management completely for which drug we’d use in this patient (P6, Doctor, General Medicine). They [hospital pharmacists] pick up things that were missed like you might have said there’s a dose that you wanted to do, and you told the junior doctor to do it, and somehow you got lost in translation. They [hospital pharmacists] pick that error up (P10, Doctor, Geriatrics). So even different drugs, different timing, different doses, different days. That sort of stuff gets quite complicated. So you know, I think they are really critical part of just checking that things are prescribed properly done, not overdose, not under dose (P4, Dietician, Renal).
Transition-of-care facilitator	On admission, hospital pharmacists are responsible for obtaining a comprehensive medication history and performing medication reconciliation. They assist in planning inpatient discharges to ensure a smooth transition regarding medicines management between hospital and community settings, liaising with community pharmacies and residential care facilities to optimize continuity of care.	The most important things that they [hospital pharmacists] do is to provide that community-to-hospital liaison […] in terms of when the patient comes into hospital […] to help with maintaining and supporting adherence (P2, doctor, mental health). They [hospital pharmacists] help with efficient discharges in, you know all that pre-work and planning. I think the pharmacists can do a lot of that takes the pressure off the doctors, and the nurses having to organise all those you know ins and outs (P23, nurse, community outreach). [Hospital pharmacists are] helping discharge, planning whether they [patients] need a Webster pack [unit-dose packaging], or whether you know that they actually have a lot of difficulty [sic], you know, using that particular inhaler. So, a lot of the practical stuff that sometimes, like myself as a doctor don’t think about that (P3, doctor, gastroenterology). [Hospital pharmacists are] making sure that patients have the right scripts and medications that they need before they discharge home from hospital (P22, speech pathologist, general medicine). I’ve dealt with a hospital pharmacist for a long time. They [sic] are heavily involved throughout the admission of a patient […] in the various departments where they take usually a very thorough medication history (P6, doctor, general medicine).
Medicines governance and policy auditor	Hospital pharmacists contribute to medication governance and policymaking and lead quality assurance processes related to medicine use and pharmacy services.	They [hospital pharmacists] update and review current protocols or procedures around different medications […] developing protocols for drug infusions or oral medications that need to be monitored in a certain way (P25, nurse, neurology). They [hospital pharmacists] also contribute to our unit policies, and they do audits for us as part of their motivation to grow as healthcare professionals (P9, doctor, haematology). Often, they [hospital pharmacists] have to prepare the evidence and or pharmacist roles in like hospital committees, especially the drugs and therapeutics committee (P10, doctor, geriatrics).
Researcher	Hospital pharmacists engage in research to advance medicine and pharmacy-related knowledge, contributing to evidence-based practices and improved patient care.	[Hospital pharmacists] work from that evidence-based exploration and assessment […] [and have] got some research knowledge (P18, nurse, mental health).
Collaborative prescribers	In some settings, hospital pharmacists prescribe medications, either independently or within collaborative prescribing models.	They [hospital pharmacists] are beyond the safest prescribers I’ve ever come across (P18, nurse, mental health).

^aProfessional niches are defined in this study as a specialized area or role where a health professional focuses their expertise, skills, and practice to meet a specific need or gap within the multidisciplinary team or healthcare delivery.

1. provision of education and advice for health professionals and patients;

2. facilitation of handover and provision of medicines at transition-of-care;

3. reconciling medication history and reviewing medication orders; and

4. proactive intervention regarding medication management during ward rounds.

Domain 3: future opportunities to optimize hospital pharmacy services

When asked about the less valuable roles of hospital pharmacists, participants consistently found it challenging to pinpoint specific areas. Instead, the conversation shifted towards operational aspects of hospital pharmacy services. Operational challenges were perceived to affect interprofessional collaboration and workflow efficiency, influencing participants’ views on the ability of hospital pharmacists to contribute to the healthcare team. The following themes emerged:

1. demand for greater pharmacy hours and/or staffing levels;

2. need for tailored scope aligned with clinical units;

3. preference for specialization of hospital pharmacists;

4. desire for increased pharmacist involvement in specific activities; and

5. delegation of tasks to pharmacy technicians and assistants.

Health professionals from various work settings reported a need for increased pharmacy staffing or operational hours. The need for extended hours of pharmacy was consistently raised by the study participants across all focus groups. The rationale included ‘unplanned and after-hours discharges and admissions […] for some specialised medications or things like methadone (P1, doctor)’, ‘because hospitals are 24-hour-based (P17, nurse)’ and ‘just a couple more hours’ could be beneficial.

You kind of missed a window for some patients who really need the pharmacist to educate them on discharge, and it is a barrier to discharge. (P3, doctor, gastroenterology)

When asked about the least valuable pharmacist roles, participants noted this is dependent on the needs of each clinical unit citing, ‘Because it’s [interaction with pharmacists] so individual. So, what might be valuable for one person might not be as valuable for the next one (P25, nurse).’ One midwife (P24) mentioned that bedside counselling by hospital pharmacists seemed to be a ‘double-up’, as most midwives are confident in providing patient education on common postpartum discharge medicines. A doctor observed that comprehensive pharmacist activities might be unnecessary in some units, implying that the scope of pharmacist roles should be adapted based on the needs of the clinical unit they service.

In day surgery […] it [patient’s medication] usually doesn’t change much, only a couple of medications to stop then to be recommenced […] dermatology probably..more in surgery it’s [pharmacy services are] probably less valuable. (P27, doctor, geriatric)

Participants emphasized the need for specialized pharmacist roles in areas like renal, geriatrics, and transplant units. Several participants commented on the frequent rotations of hospital pharmacists, expressing concerns about whether pharmacists had sufficient time for specialized training within their assigned unit.

Number of them [hospital pharmacists] will come when they first get rotated on a 12-month basis. They have either very little or no experience specifically working in mental health, and their familiarity of the medications are [sic] limited. (P2, doctor, mental health)

Need a specialist pharmacist at renal but [..] continuity of service and specialised training is needed. (P4, dietician, renal)

Although acknowledged to be occurring in some services, a desire for even greater pharmacist involvement in research and interprofessional education was expressed. The absence of pharmacists during ward rounds was identified, and expansion of ‘partnered charting at admission’ was suggested for increased medication safety.

There’s a significant absence of clinical research embedded into day-to-day work [of hospital pharmacists]. (P11, doctor, general medicine)

We [pharmacology department] used to go to these [interprofessional] meetings regularly on a weekly basis […] I think it’s a pity, yeah, that this thing is not happening anymore. (P6, doctor, general medicine)

It would be much more efficient for them [hospital pharmacists] to be there if they could have that [ward round] as part of their day, so that when discharges are organised or there’s concern about medications, it’s not having to ‘Oh, we’ll check with the pharmacists later’, it could be all done at the same time. (P3, doctor, gastroenterology)

A nurse practitioner with extensive experience in both hospital and community settings supported the routine integration of hospital pharmacists as part of the team rather than providing a service to the team and expanding the pharmacist’s contribution to prescribing.

Be identified as an intrinsic part of the care team […] It needs to be a really clear part of the clinical team and part of any service delivery design…Otherwise, pharmacists could contribute […] got to be involved in those prescribing decisions. (P18, nurse, mental health)

Some participants highlighted that the withdrawal of funding posed a significant challenge, leading to the discontinuation of clinical pharmacy services in their units, contrary to the desires of the multidisciplinary teams.

We wanted them [hospital pharmacists] to come with us to outpatient clinics, as well, but they’re not allowed to do that, I think, because of some of the service requirements and funding constraints. (P9, doctor, haematology)

Participants expressed a desire for hospital pharmacists to allocate less time to perceived ‘logistical’ tasks such as compounding, unit-dose packaging, prescription handovers, and the return of unused narcotics, allowing for a greater focus on direct patient care and collaboration with the multidisciplinary team. Several participants suggested that certain pharmacist tasks, such as medication history-taking, could be delegated or shared with other team members, e.g. pharmacy technicians. This sentiment found resonance among other participants, who also supported initiatives that would reduce time spent on technical tasks to allow pharmacists’ time to be redirected to cognitive clinical services.

Anything that takes a [hospital] pharmacist away from inclusion in clinical care […] counting the number of tablets in a bottle or faxing through an order. I’m sure it could be done by other people that can count or can use a fax machine, but we [multidisciplinary team] end up doing lots and lots of that which then reduces the impact that we can have on our consumers. (P18, nurse, mental health)

Themes mapped to SEIPS model

The SEIPS model mapping diagram (Fig. 1) illustrates ‘Person’ (i.e. hospital pharmacists) as the primary focus of the study in a hospital setting; relevance of health professionals’ views concerning each ‘System’ component; and the interplay (i.e. lines and arrows) between systems, processes, and outcomes. The majority of thematic domains were assigned to ‘Organization’ and ‘Tasks’ within the ‘System’ component, highlighting the essential role of the ‘Organization’ (i.e. pharmacy leaders and hospital decision-makers) in optimizing and prioritizing ‘Tasks’ (i.e. hospital pharmacist roles) to achieve successful ‘Clinical, Economical, and Organizational’ outcomes.

Figure 1.

Themes mapped to the work system and patient safety model, the SEIPS [11].

Notes: Refer to Supplementary Data for an overview of theme classifications and Table 1 for detailed descriptions of work system components. ‘Economic’ component was adopted from the CLEO model [12].

Discussion

Statement of principal findings

This study synthesizes perspectives from a wide variety of health professionals who perceive hospital pharmacists as essential multidisciplinary team members who fill several distinct and specialized professional niches. Hospital pharmacists were referred to as a source of expert advice, support, and education. Operational opportunities for improvement were noted, including a desire for greater staffing and increased pharmacy operating hours, greater specialization, and a need to tailor the pharmacists’ role to align with the clinical unit in which they practise. Suggestions for role optimization included a greater emphasis on dedicating pharmacist time to ward round participation, interprofessional education, and research while delegating administrative and technical duties to pharmacy technicians and assistants.

Interpretation within the context of the wider literature

Overall, the extent of knowledge and viewpoints regarding roles of hospital pharmacists among non-pharmacist health professionals observed in this Australian cohort closely aligns with those reported in the literature. As illustrated in a recent systematic review, health professionals worldwide acknowledged the diverse roles of pharmacists within multidisciplinary teams, showing a preference for proactive clinical roles of hospital pharmacists over administrative tasks [16]. Clinical hospital pharmacist activities perceived to be valuable in the literature for optimal patient and organizational outcomes included prescribing advice, medication reviews, and medication reconciliation [17, 18]. Several studies pinpointed barriers to interprofessional collaboration such as insufficient professional exposure to hospital pharmacists [19–21]. A similar observation was made in the current study, in that some health professional groups reported limited understanding of pharmacists’ roles, impacting multidisciplinary rapport. To mitigate these barriers, introduction of policy frameworks for interprofessional collaboration and enhanced educational opportunities to raise awareness about pharmacist roles are proposed [22–26].

Strengths and limitations

The study exhibited several strengths that warrant recognition. It incorporated a wide range of health professionals practising in diverse clinical settings, including adult emergency, medical, surgical, mental health, paediatric, and maternity units. The dynamics of focus group discussions aided the participants with the stimulation of thinking and generation of detailed responses which might be overlooked with other research methodologies [27, 28].

In a unique approach to this study, participant perspectives were fused to describe specific niches that hospital pharmacists play within their multidisciplinary teams. This novel classification of pharmacist roles promotes a paradigm shift, extending conventional role descriptions centred around work settings to instead focus on what pharmacists bring to patient care and the unique functions they play within the team.

Incorporating health system models [11, 12] was valuable in interpreting the study findings. These models provided a structured framework for analysing multidisciplinary perspectives and their implications for hospital pharmacists as an organization.

It is also important to acknowledge this study’s inherent limitations. Participants were mainly from the South Australian metropolitan area, potentially limiting the findings’ transferability to rural settings or other regions. Certain health professionals like dentists and physiotherapists were not represented, presumably their roles involve fewer interactions with hospital pharmacists. Health professionals with positive experiences with pharmacists may have been more likely to volunteer to participate, which could have introduced bias.

Implications for policy, practice, and research

Organizational priority should be given to the pharmacist activities reported as most valuable. Administrative and technical tasks could be delegated to skilled pharmacy technicians. Decision-makers should consider the desire of other health professionals for specialized pharmacists and increased service hours in future planning. More targeted research is needed to formally determine which activities should be prioritized for funding in specific clinical settings.

Conclusion

This study explored the perceptions of multidisciplinary health professionals and identified the professional niches pharmacists are seen to fill in Australian hospital settings, highlighting their essential role in the multidisciplinary team and patient care. Roles of hospital pharmacists should be strategically allocated, with a focus on unique tasks that harness pharmacists’ clinical expertise. Future research and expert insights should direct resource distribution to shape practice standards for optimal healthcare outcomes.

Author contributions

Kyung Min Kirsten Lee (Conceptualization, Methodology, Formal analysis, Investigation, Data curation, Writing—original draft, Writing—review & editing, Visualization, Project administration), Jacinta Johnson (Conceptualization, Methodology, Formal Analysis, Investigation, Resources, Data curation, Writing—review & editing, Visualization, Supervision, Project administration), Ivanka Koeper (Conceptualization, Formal analysis, Writing—review & editing), Michaela Johnson (Investigation, Writing—review & editing). Amy Page (Methodology, Writing—review & editing, supervision), and Debra Rowett (Writing—review & editing, supervision).

Supplementary data

Supplementary data is available at IJQHC online.

Conflict of interest

J.J., I.K., and D.R. reports a relationship with SA Health that includes employment.

Funding

This study did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Data availability

The data underlying this article will be shared on reasonable request to the corresponding author.

Ethics approval

Ethics approval was granted by the Human Research Ethics Committees of both the University of South Australia (#204736) and the Central Adelaide Local Health Network, SA Health (#17124). All participants provided written informed consent prior to enrolment in the study.