Table 3.

Purposes, Challenges, and Solutions of Implementing Clinical Pharmacy Key Performance Indicators (cpKPIs)

Rationale and Utility of cpKPIs	Barriers and Challenges	Authors’ Proposed Solutions
Front-line pharmacists
Provide reference summary of: Activities proven to improve outcomes Priority of patient care activities to optimize impact on outcomes Pharmacists’ role that can be promoted to other members of interdisciplinary team Performance expectations with the employer	Time required to document cpKPIs	Automate data collection where possible (e.g., self-populated patient name and medical record number) Enable pull-down data entry at point of care Incorporate into electronic health care system
	Complexity of indicator documentation	Simplify platform for documentation; e.g., check boxes Collect minimal amount of required information
	Cost	Use existing or least expensive hardware and software data platforms
	Daily tracking and reporting consistency	Make it a daily routine for all pharmacists Pharmacist-to-pharmacist accountability Live capture or end-of-day input
Practice leaders and pharmacy managers
Provide reference summary for: Justifying prioritization of scarce clinical pharmacy services Justifying expansion of clinical pharmacy services Explaining value and estimating return on investment in clinical pharmacy services Determining effectiveness and efficiency of clinical pharmacy services Setting benchmarks Performance management	Front-line staff ownership and uptake	Access and use cpKPI knowledge mobilization kit* Regularly present collected data to staff Engage front-line staff in change management and leadership processes
	Lack of accuracy and precision	Provide training during orientation and interim audits Facilitate understanding to resolve local apprehension
	Effective change management to implement and sustain cpKPIs with everyday practice	Change management strategies
	Trend analysis	Set benchmarks through comparison between clinical wards, hospitals, or health regions Be cautious in analyzing trends
Patient, taxpayers, external stakeholders
Provide reference summary of: Clinical pharmacists’ role Activities proven to improve patient outcomes Patient expectations Activities to ensure pharmacist accountability Appropriate use of resources to promote a more sustainable health care system	Comprehension and interpretation of cpKPI data	Correlate with and extrapolate to meaningful patient outcomes (e.g., hospital readmissions), with recognized limitations Explain the clinical significance of cpKPIs Tailor presentation according to the interest of audience Acknowledge limitations of reporting isolated indicators versus a dashboard of indicators Acknowledge differences in systems and human resources across heterogeneous sites

^*This kit is now available at www.cshp.ca/productsServices/cpKPI/index_e.asp