Table 2.

Clinical Pharmacy Resource Prediction Tools

Development	Limitations
pCATCH: uses 5 key components to identify areas of highest requirement for pharmacists
• Developed at the University of North Carolina Medical Center to determine the number of CPSs by various medical services62 • The task force reached a consensus on 5 key components upon which to base CPS allocation. • After applying this methodology to each medical service, the service receives a score from 1 to 5, with 5 indicating the highest need for a CPS, at which time pharmacists were reallocated.	• While a broad staffing model for a large academic medical center with an associated school of pharmacy, it is not specific to a critical care population. • Not linked to patient outcomes • Bases patient acuity on DRG • Limited external validity due to its design oriented toward a single academic medical center • Not specific to CCPs
PIS: resource‐based relative value intensity grouping system that utilizes pharmaceutical resource consumption data to allocate pharmacy personnel
• Calculated by multiplying the number of patients with a specific DRG by a specific PIW, giving insight into pharmacy cost and patient acuity • PIW is calculated by comparing the median pharmacy cost for a given DRG with the median pharmacy cost for all DRGs to determine the “intensity” of pharmacy resource use in relation to other diagnoses. • Gives insight into medication expense at an institution and potentially patient acuity at that site63	• Assumes patient acuity is correlated with DRG, which has been shown to not always hold true64,65 • Has only been used to predict expenditure on resources and has not been shown to improve patient outcomes or determine optimal pharmacist-to-patient ratio • Not specific to CCPs
MRCI: measure of patient-level MRC through 3 key components: dosage form, dosage frequency, and additional medication directions66
• Developed from the MCI from 134 chronic obstructive pulmonary disorder patient regimens by using an expert panel of 5 researchers scoring 6 regimens to demonstrate construct- and content-related validity • Two researchers scored the same 6 regimens to determine interrater and test-retest reliability	• Is a patient-oriented outpatient tool intended to screen for community pharmacist clinical services (vs those in the ICU) • Not intended to be related to patient acuity or patient outcomes67

Abbreviations: CCP, critical care pharmacist; CPS, clinical pharmacy specialist; DRG, diagnosis-related group; ICU, intensive care unit; MCI, medication complexity index; MRCI, medication regimen complexity index; pCATCH, census, patient acuity, teaching services, medication cost, and use of high-priority medications; PIS, pharmacy intensity score; PIW, pharmacy intensity weight.