1364 Are In-patient Hospital Pharmacy Work System Characteristics Associated with Work and Work-Life Outcomes?: A National Study

S. Nadi; B. Bakken; C. Gaither; D. Kreling; D. Mott; J. Schommer; V. Arya; William Doucette

doi:10.1016/j.japh.2025.102820

Objectives The aims of this study were to explore the association of work system characteristics and pharmacists’ perceptions of patient medication safety and work-life outcomes among pharmacists practicing in in-patient hospital settings. Patient care and medication safety are improved in hospitals when pharmacists perform patient-centered clinical roles. However, pharmacists in hospital settings have more negative perceptions of their workplace compared to those in other settings, which is attributed mainly to their working conditions. In a hospital setting, up to 70% of pharmacists report experiencing moderate to high levels of burnout, raising the alarm that this may adversely impact patient safety. The association between hospital work system characteristics and pharmacists' evaluations of patient medication safety and their work life is not well understood. Previous studies often lack a comprehensive framework for systematically analyzing this relationship. Methods A descriptive, cross-sectional online survey design was used to collect data from a randomized sample of 93,990 licensed pharmacists in the US. The conceptual framework of the Systems Engineering Initiative for Patient Safety 2.0 served as a foundation for domains of the survey content. Survey items were developed from four focus groups of practicing pharmacists and adopted from earlier pharmacist workforce studies. This study examined work-life outcomes, work system characteristics, and demographic variables from the pool of survey items. Work system characteristics included the number of work activities that extend beyond what pharmacists were originally hired to do (Many activities), the adequacy of the number of pharmacists to meet patient care needs (Adequate pharmacists), the level of autonomy in how pharmacists accomplish their work (High autonomy), the engagement in many work activities that prevent pharmacists from fully utilizing their skills (Skill underutilization), the performance of many work activities that exceed their skill set (Skill set exceeded), and the organization’s poor performance in addressing the actual causes of employee burnout (Poor well-being support). A total of 4,947 usable responses were received. Multivariate linear regression models were estimated to test for significant associations. Results A sub-sample of 913 respondents who self-reported actively practicing in in-patient hospital settings was selected for analysis. Most respondents were females (69.5%), were age 25 to 34 years (25.8%), were working in medium-sized (200-500 beds) hospitals (32.6%), and were working as a centralized pharmacist (60.3%). Regarding work system characteristics, over 65% of pharmacists reported a high level of performing many activities. More than 75% reported that their organization lacks adequate well-being support, and over 50% reported insufficient pharmacist staffing. Although nearly 80% of respondents reported having high autonomy, over 80% reported that their tasks exceeded their skill set, and approximately 45% reported skill underutilization. Regression model results showed that patient medication safety was significantly negatively associated with having to perform many activities and poor well-being support, but positively associated with adequate pharmacist staffing and high levels of autonomy. Professional fulfillment was positively associated with adequate pharmacist staffing and high autonomy, but was negatively associated with skill underutilization, tasks exceeding the skill set, and poor well-being support. Work exhaustion was positively associated with skill underutilization, tasks exceeding the skill set, and poor well-being support. Job turnover intention was positively associated with skill underutilization and tasks exceeding the skill set, but negatively associated with adequate pharmacist staffing. Conclusions/Implications The results highlight the importance of organizational improvements within pharmacy work environments, to assure better work-life outcomes and better satisfy patient care demands. Subsequent research could investigate approaches employed by in-patient hospital pharmacies that successfully maintain patient medication safety standards and a healthy pharmacist workforce and disseminate, implement and evaluate their impact in other settings.

1364 Are In-patient Hospital Pharmacy Work System Characteristics Associated with Work and Work-Life Outcomes?: A National Study

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