The validation of the Royal Stoke Pharmacy Workforce Calculator – a mixed methods study

Abstract

Background
The Royal Stoke Pharmacy Workforce Calculator (RSPWC) was developed to meet a local need of identifying clinical pharmacy staffing levels, not described nationally. This study demonstrates the validity and transferability of the RSPWC and its application to other settings.

Methods
A two-round Delphi consensus study was conducted to confirm the activity standard (tasks, times and frequencies) for clinical pharmacy services. An operator evaluation was undertaken to demonstrate the reliability of the tool by multiple operators and a series of qualitative interviews explored the utility of the tool in different settings. These research strands ran concurrently from April 2016 to December 2016.

Results
Participants from 21 sites across the UK were recruited, including district general hospitals (nine), teaching hospitals (eleven) and one mental health trust. A wide range of staffing levels, across all staff groups, was reported. Consensus was achieved for 68% of components of the algorithm that drives the RSPWC. For a further 21% of components, ‘nationally-representative’ figures were identified from the data. Eleven percent of the components, those relating to elements dependent on individual patient responses to medicines, failed to achieve agreement. A pragmatic approach was taken in the derivation, from study data, of these activity frequencies for typical patient groups. Content validity of the tool was demonstrated. The ‘operator evaluation’ demonstrated reliability in its use by different operators. The application of this tool to a variety of settings was identified through the qualitative data.

Discussion
The results of the study demonstrate the validity, transferability and utility of the RSPWC. They capture, for the first time, a consensus on the required service components for the delivery of pharmaceutical care, across multiple hospital sites nationally in the UK. Through this study a clinical pharmacy workforce calculator for acute hospital settings has been developed and validated.