Researchers in China have constructed a dual-evaluation indicator system designed to assess the performance and work effectiveness of unit-based clinical pharmacists. The study, published in BMC Health Services Research, addresses the urgent need for scientific and operable evaluation tools as the country’s clinical pharmacy service model undergoes rapid transformation. This development is driven by the implementation of DRG/DIP payment reforms and national centralized procurement policies, which have accelerated the shift in how pharmacy services are delivered and valued. The primary aim of the research was to create a framework that distinguishes between process-oriented performance appraisal and outcome-oriented work effectiveness, thereby overcoming the limitations of existing systems that often overemphasize procedural compliance while neglecting actual patient outcomes.
The study utilized a mixed-methods approach combining the Delphi method and the Analytic Hierarchy Process (AHP) to develop and weight the evaluation indicators. A preliminary set of indicators was initially drafted based on a comprehensive literature review and policy analysis. To refine this set, the research team conducted two rounds of expert consultation using the Delphi method. This iterative process allowed for the screening and refinement of indicators based on expert consensus, ensuring that the final system reflects current professional standards and operational realities in Chinese clinical pharmacy settings.
The expert consultation process demonstrated high levels of engagement and consensus. In the first round of the Delphi survey, the response rate was 89.47%, with 17 out of 19 invited experts participating. The second round achieved a 100% response rate, with all 17 experts from the first round participating again. The authority coefficients of the experts ranged from 0.93 to 0.95, indicating a high level of expertise and reliability in the judgments provided. Statistical analysis using Kendall’s W coefficients confirmed that the consensus among experts was significant in both rounds, with values of 0.193 and 0.337 for the first set of indicators and 0.153 and 0.227 for the second set, all with P-values less than 0.05.
Following the Delphi process, the Analytic Hierarchy Process was employed to determine the relative weights of each indicator. The resulting performance appraisal system, which focuses on process-oriented metrics, includes five first-level indicators and 26 second-level indicators.
Within the performance appraisal system, specific second-level indicators also received significant weighting. This was followed by “Departmental and hospital training and lectures” with a weight of 0.0713, and “Medical dispute case analysis” with a weight of 0.0596.
The second component of the dual-evaluation system is the work effectiveness evaluation, which focuses on outcome-oriented metrics. This system comprises five first-level indicators and 19 second-level indicators. The most heavily weighted first-level indicator in this category is “Clinical services and medication safety,” with a weight of 0.2661.
Specific second-level indicators within the work effectiveness evaluation also showed high weights, reflecting their direct impact on patient care and organizational efficiency. “Pharmacy administration indicators” received a weight of 0.0812, while “Improvement rate of prescription and order review issues” was weighted at 0.0809. Additionally, “Valid complaints or disputes” was assigned a weight of 0.0782.
The study concludes that the constructed dual-evaluation system serves not only as an assessment tool but also as a developmental instrument for unit-based clinical pharmacists. By linking individual key performance indicators with team and organizational goals, the system provides a basis for demonstrating the value of clinical pharmacy services in enhancing patient safety and organizational sustainability. The integration of performance appraisal with competency development, employee motivation, and well-being suggests that the system can support the career growth of pharmacists while aligning their efforts with broader institutional objectives. However, the authors note that future multicentre empirical studies are required to further evaluate the real-world feasibility and performance thresholds of this system, indicating that while the framework is theoretically robust, its practical application across diverse healthcare settings requires further validation.
Subject of Research: Development of a performance appraisal and work effectiveness evaluation indicator system for unit-based clinical pharmacists in China
Article Title: Development of a performance appraisal and work effectiveness evaluation indicator system for unit-based clinical pharmacists in China: a study based on the Delphi method and the analytic hierarchy process
Article References: Wu, N., Huang, L., Huang, Y., & Liu, D. (2026). Development of a performance appraisal and work effectiveness evaluation indicator system for unit-based clinical pharmacists in China: a study based on the Delphi method and the analytic hierarchy process. BMC Health Services Research. https://doi.org/10.1186/s12913-026-16090-w
Image Credits: AI Generated
DOI: 10.1186/s12913-026-16090-w
Keywords: clinical pharmacy, performance appraisal, Delphi method, Analytic Hierarchy Process, health services research, China, medication safety, evaluation indicators, Development, performance, appraisal, work
News Source: Ophelia Keating. (November 8, 2026). China Develops Dual Evaluation System for Clinical Pharmacists. Scienmag.
