Defining Optimal Pharmacist-to-Patient Ratios for Comprehensive Direct Patient Care in Pediatric Settings: A Nationwide Survey in Canada

Background: The pharmacist staffing ratios required for comprehensive patient care are not well defined, particularly in pediatrics. Understanding optimal clinical pharmacist staffing ratios for pediatrics may help in advocating for appropriate staffing and optimizing patient outcomes. Objectives: The primary objective was to describe optimal pediatric clinical pharmacist staffing ratios in general pediatric, surgical, and hematology-oncology-bone marrow transplant (heme-onc-BMT) units in tertiary pediatric hospitals in Canada. The secondary objectives were to quantify how pediatric clinical pharmacists spend their time and to qualify their perspectives on current workload. Methods: Two electronic surveys were distributed. One survey, sent to leaders in tertiary pediatric health care centres, was designed to describe current staffing ratios. The second survey, sent to pediatric clinical pharmacists, aimed to estimate the frequency of and time spent on 13 comprehensive pharmaceutical care activities, as validated by a working group. The survey data were used to estimate pharmacist staffing ratios according to the World Health Organization workforce calculator. Results: Seven (50%) of the 14 sites responded to the management survey, and 33 clinical pharmacists responded to the clinical pharmacist survey. Optimal pharmacist-to-patient ratios (based on clinical pharmacist survey responses) were estimated to be 1:11 for general pediatric units, 1:14 for pediatric surgery units, and 1:6 for pediatric heme-onc-BMT units, with median lengths of stay of 4.9, 2.5, and 7 days, respectively. Conclusions: Further research is needed to validate these ratios in various pediatric clinical pharmacy settings.