Pharmacist Clinical Services Performance Evaluation

Pharmacist Clinical Services Performance Evaluation

Purpose The Pharmacist Clinical Services Performance Evaluation is a tool for evaluating pharmacists who are coordinating, developing, and/or actively providing medication therapy management (MTM) and other clinical services. Background Providers may have several responsibilities, ranging from managerial and/or dispensing services to providing MTM and other clinical services. While all facets are important, this tool specifically addresses the provider s performance in the area of clinical service delivery. The evaluation is designed to be accentuated with additional qualitative and quantitative criteria as deemed appropriate. Some examples include the type of interventions made by the provider, the effectiveness of interventions made, and the number of services provided. The supervisor may also incorporate components of the form into an existing evaluation tool or use the form in its entirety. Instructions for use Carefully read through each clinical core competency. Depending on your practice, you may not need to evaluate the provider on each core competency. In the far left column, place an X next to the competencies that will be evaluated during the current evaluation period. Next, select the performance rating that best describes the practitioner s performance for the specific clinical core competency. Check the corresponding number in the righthand columns and fill in any necessary information if applicable; see the following example: To Be Evaluated X 1.6 Use appropriate technique(s) and clinical skills to administer medications, including immunizations Use appropriate technique(s) on a consistent basis Follows policies and procedures on a consistent basis Number of immunizations administered over 6 months: 500 Performance Rating 5 4 3 2 1 X After rating each competency, calculate the overall performance rating using the directions provided in Section IV. Please note the following when using this evaluation instrument: Additional competencies or further qualitative and quantitative expectations may be added to the evaluation that are specific to the provider s professional goals. Other evaluations, such as responses to patient satisfaction surveys or other similar instruments, may be used to supplement this evaluation instrument. Alternative formulas may be used in the overall scoring of the employee s performance to weight more significantly than other evaluation criteria those specific competencies deemed most critical by the employer to the job performance. 2

Employee Name: Employee Position/Title: Hire Date: Supervisor Name: Supervisor Position/Title: Evaluation Date: Evaluation Period: Clinical Practitioner s Professional Goals Date(s) of previous evaluation period: Professional goals established during previous evaluation period: 1. 2. 3. 4. 5. 3

Performance Rating 5 4 3 2 Performance Description Consistently Surpasses Expectations: Exceeds performance expectations on a consistent and uniform basis. Work is of an exceptional quality in all essential areas of responsibility and skills. All clinical goals are met. Makes an exceptional or unique contribution in achievement of clinical objectives. Frequently Exceeds Expectations: Always achieves performance expectations and frequently exceeds them. Work is of a high level of quality in all areas of responsibility and skills. The majority of clinical goals are met. Consistently Meets Expectations: Consistently meets performance expectations and periodically may exceed them. Work is of good quality in all significant areas of responsibility. Skill level may be moderate in certain areas. Critical clinical goals are met. Needs Improvement To Fully Achieve Expectations: Fails to meet expectations in one or more of the significant/essential position requirements. One or more critical clinical goals are not met. Improvement is needed. A plan to correct performance must be outlined and monitored and timelines established to improve performance. This rating calls for reevaluation to see if performance improves. 1 Fails To Achieve Expectations: Does not meet goals and objectives. Majority of critical clinical goals are not met. Improvement is needed in most aspects of position. Corrective performance plan must be outlined and monitored and timelines for improvement established. This rating warrants reevaluation to determine future employment status. 4

Section I : Clinical Core Competencies Patient Care (1.0) To Be Evaluated 1.1 Develop, enhance, and/or maintain programs/services based on community-specific patient needs Programs/services designed/developed: Performance Rating 5 4 3 2 1 1.2 Successfully implement new programs/services and/or improve existing programs/services Programs/services implemented/improved: 1.3 Establish collaborative pharmacist patient relationships Number of patients seen over [time period]: 1.4 Use effective skills to appropriately assess patients (e.g., physical assessment, medical history, overall health status, quality of life, cultural issues, educational level, language barriers, literacy level, current symptoms, laboratory results, and medication-related problems) 1.5 Design comprehensive, evidence-based medication or nonmedication health improvement, wellness, and/or disease prevention regimens and monitoring plans for patients 1.6 Use appropriate technique(s) and clinical skills to administer medications, including immunizations Uses appropriate technique(s) on a consistent basis Follows policies and procedures on a consistent basis Number of immunizations administered over [time period]: 1.7 Document patient care activities appropriately, according to organization s policies and procedures Number (and type) of patient interventions: 1.8 Record patient outcomes according to organization s policies and procedures 1.9 Use effective communications skills when providing patient education (e.g., patient education materials, verbal education, and training designed to enhance patient understanding and appropriate use of medications) 1.10 Communicate ongoing patient information to other health care professionals 1.11 Maintain disease and treatment knowledge via current literature and clinical practice guidelines Practice-based activities/training programs completed: 1.12 Additional criteria: Patient Care (1.0) Subtotal Supervisor comments: 5

Practice Management (2.0) To Be Evaluated 2.1 Establish collaborative professional relationships with other health care professionals involved in the care of patients Performance Rating 5 4 3 2 1 2.2 Establish/maintain formal collaborative practice agreement(s) with other health care professionals (e.g., local physicians) 2.3 Design a business plan for a new program/service or an enhanced program/service 2.4 Contribute to the development and/or implementation of a marketing strategy to support current programs/services 2.5 Proactively pursue revenue-generating opportunities for pharmacist-provided patient care services (e.g., MTM, immunizations, health screenings) involving the entire organizational team 2.6 Meet defined revenue goals and ensure that budget targets are met with the practice site s growth plan 2.7 Adhere to and integrate legal, regulatory, safety, and relevant accreditation requirements into patient programs and/or services 2.8 Maintain patient confidentiality via an organized, secure documentation system 2.9 Assist in recruitment, interview, and selection of personnel (e.g., pharmacy staff, pharmacists, technicians, and residents) 2.10 Exhibit practice leadership in organizational and management activities 2.11 Maintain consistent communications with pharmacy management and staff 2.12 Convey a professional appearance, image, attitude, and behavior 2.13 Additional criteria: Subtotal Practice Management (2.0) 6 Supervisor comments:

Evaluation of Patient Care Programs/Projects (3.0) To Be Evaluated 3.1 Appropriately evaluate outcomes of programs/services and/or projects Evaluations conducted: Performance Rating 5 4 3 2 1 3.2 Appropriately conduct continuous quality improvement (CQI) activities on existing programs/services (e.g., analyze program(s)/service(s) for quality improvement) 3.3 Present and/or publish program outcomes Program outcomes presented and/or published: 3.4 Appropriately assess impact and sustainability of program/service 3.5 Additional criteria: Subtotal Evaluation of Patient Care Programs/Projects (3.0) Supervisor comments: 7

Mentorship/Precepting (4.0) To Be Evaluated 4.1 Serve as primary preceptor for introductory and/or advanced pharmacy practice experience (IPPE/APPE) student pharmacists for at least one school of pharmacy Number of student pharmacists precepted during evaluation period: Performance Rating 5 4 3 2 1 Satisfactory evaluations: Yes No 4.2 Precept pharmacy resident(s) Number of pharmacy resident(s) precepted: Satisfactory evaluations: Yes No 4.3 Serve as a role model for pharmacists, pharmacy technicians, and/or pharmacy staff within the site and/or organization 4.4 Additional criteria: Subtotal Mentorship/Precepting (4.0) 8 Supervisor comments:

Professional/Community Outreach (5.0) To Be Evaluated 5.1 Participate actively in the activities of local, state, and/or national professional organizations Performance Rating 5 4 3 2 1 5.2 Serve in a leadership role in local, state, and/or national professional organizations 5.3 Conduct presentations and/or educational programs for health care professionals Number of presentations/educational programs: Targeted audience(s): 5.4 Participate in the delivery of health fairs (e.g. screenings, education programs, immunizations, and other clinical services) Number of events: Subtotal Professional/Community Outreach (5.0) Supervisor comments: 9

Section II : Clinical Practioner s Professional Goals & Professional Development Date(s) of next evaluation period: A. Professional goals for next evaluation period: 10 1. 2. 3. 4. 5. B. Professional development objectives for next evaluation period: 1. 2. 3. 4. 5. Section III : Overall Employee Comments

Section IV : Calculation of Performance Rating Directions: Add subtotals in each core competency section. Next, divide this number by the total number of competencies used to evaluate the provider. The result of this calculation will provide you with an overall clinical performance rating score. The chart below provides performance definitions/descriptions for all possible scores. [(Total competency score) (total # of competencies evaluated) ] = Overall Clinical Performance Rating Performance Rating 4.6 to 5 3.6 to 4.5 2.9 to 3.5 1.8 to 2.8 Less than 1.7 Performance Description Consistently Surpasses Expectations: Exceeds performance expectations on a consistent and uniform basis. Work is of an exceptional quality in all essential areas of responsibility and skills. All clinical goals are met. Makes an exceptional or unique contribution in achievement of clinical objectives. Frequently Exceeds Expectations: Always achieves performance expectations and frequently exceeds them. Work is of a high level of quality in all areas of responsibility and skills. The majority of clinical goals are met. Consistently Meets Expectations: Consistently meets performance expectations and periodically may exceed them. Work is of good quality in all significant areas of responsibility. Skill level may be moderate in certain areas. Critical clinical goals are met. Needs Improvement To Fully Achieve Expectations: Fails to meet expectations in one or more of the significant/essential position requirements. One or more critical clinical goals are not met. Improvement is needed. A plan to correct performance must be outlined and monitored, and timelines established to improve performance. This rating calls for reevaluation to see if performance improves. Fails To Achieve Expectations: Does not meet goals and objectives. Majority of critical clinical goals are not met. Improvement is needed in most aspects of position. Corrective performance plan must be outlined and monitored and timelines for improvement established. This rating warrants reevaluation to determine future employment status. Employee Signature Date Supervisor Signature Date Section V : Employee Comments 09-448 11

The Pharmacist Clinical Services Performance Evaluation was developed by the APhA Academy of Pharmacy Practice and Management MTM Task Force, based in part on an evaluation tool originally developed by Kerr Drug, Inc. and modified with permission. 2009 American Pharmacists Association. All rights reserved.