(1457) Evaluating Correlation of Critical Care Pharmacist-to-Patient Ratios and Pharmacist Productivity

Introduction: Numerous studies have described critical care pharmacist (CCP) workloads as defined by CCP-to-patient ratio. However, no studies have evaluated CCP-to-patient ratio and its correlation with pharmacist productivity using the metrics of interventions and cost avoidance. The purpose of this study is to evaluate the relationships between the CCP-to-patient ratio and the number of pharmacist interventions and associated cost avoidance.

Methods: This was a single-center, retrospective, observational study which is a sub-analysis of a single institution data from the Optimizing Pharmacist Team-Integration for ICU Patient Management (OPTIM) study with pharmacist intervention data. Adult patients admitted to 3 participating ICUs between September 5, 2023, to December 15, 2023 for greater than 24 hours were included. Patients transitioned to hospice in the first 24 hours were excluded. This study focused on examining the correlation between the CCP-to-patient ratio and both the number of pharmacist interventions and cost avoidance. Pearson correlation coefficients were calculated to examine these relationships. Subsequently, a generalized linear model with a Poisson distribution was utilized for multivariate analysis.

Results: There were 3635 pharmacist interventions and a total cost avoidance of $1,356,160.99. The median pharmacist-to-patient ratio was 1:21 and the median number of interventions per patient per pharmacist per day was 2. There was a negative correlation (r=-0.32, p-value < 0.0001) with the number of patients followed per pharmacist and number of interventions per patient per pharmacist per day. The multivariate analysis showed the number of interventions per patient per pharmacist per day decreased by 4% with each increase in the number of patients followed per pharmacist. Additionally, cost-avoidance per patient per pharmacist per day decreased by 3% with each increase in the number of patients followed per pharmacist.

Conclusions: Increased number of patients followed per pharmacist or increased pharmacist workload correlated with a decreased number of interventions per patient per pharmacist per day and total cost avoidance.