A Survey of Hospital Pharmacy Leader Perspectives on Advocating for Clinical Pharmacy Services

BACKGROUND: Although numerous research studies have demonstrated the positive impact of clinical pharmacy services, these benefits do not translate into sustained practice changes without support from hospital pharmacy leaders. Factors influencing leadership decisions to expand pharmacy services remain unclear. This study aimed to identify barriers to implementing pharmacy practice model changes and gain insights into potential methods of overcoming these barriers from the hospital pharmacy leader perspective. METHODS: We conducted a cross-sectional survey of hospital pharmacy leaders distributed via email over 3 weeks between September and October 2025. The survey included questions about perceptions related to implementation of practice model changes, resources/evidence used to justify clinical positions, barriers to expanding clinical pharmacy services, and demographics of health care systems they represented. The survey included Likert scales and open-ended questions. The primary outcome was the types of evidence most compelling to justify clinical pharmacist positions. Secondary outcomes included resources currently in use for decision-making and perceived barriers. RESULTS: The survey was completed in full by 84 leaders and highlighted key factors influencing administrative decision-making regarding the expansion of clinical pharmacy services and revealed significant barriers to justifying clinical positions related to knowledge gaps. The types of evidence considered most compelling included data indicating pharmacist impact on budget and impact on patient outcomes, followed by data indicating impact on hospital workload. Resources currently used for decision-making were most frequently benchmarking, productivity, or workload metrics; physicians or other champions; and regulatory or accreditation requirements. CONCLUSION: This survey provided valuable insights into the perspectives of hospital pharmacy leaders on resources and evidence needed to support expanded pharmacy services and justify clinical pharmacist positions. These insights can inform future research by ensuring relevant clinical and administrative metrics are included in outcomes.