A pilot study of process and outcome assessment in antibiotic therapy

A quality assurance survey of cefazolin therapy was conducted by pharmacists using process-related and outcome-related assessments. The purpose of this survey was to study the possibility of having pharmacists review and categorize the appropriateness and success of antibiotic therapy. During a three week period, 168 orders for cefazolin were identified and 67 prophylactic and medical therapies were selected and submitted for possible pharmacist review. Thirty-seven therapies were reviewed by staff pharmacists who scored each therapy for the acceptability of risk of adverse drug effect, the cost-effectiveness, and the overall appropriateness. An evaluation form was used, but explicit utilization criteria were not provided. The average scores (+/- SD) on a 10 centimeter visual analog scale were 9.1 (+/- 0.71), 8.7 (+/- 1.21), and 8.8. +/- 0.79) respectively. Twenty-six (70%) of these therapies were monitored to resolution, and 24 (65%) were successful in achieving the therapeutic goal. No adverse effects were noted. The average estimated times to complete the initial review and follow-up review were 10.1 (+/- 5.60) and 3.5 (+/- 2.29) minutes respectively, less than the 19.5 minutes estimated using the Canadian Hospital Pharmacy Workload Measurement System. This survey demonstrated that pharmacists can provide both process-related and outcome-related QA data.