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

Under the background of DRG/DIP payment reform and national centralised procurement, China’s clinical pharmacy service model is accelerating its transformation. The unit-based clinical pharmacist pilot program launched in 2024 urgently requires scientific and operable evaluation tools to overcome the limitations of existing systems that overemphasize process while neglecting outcomes. This study aimed to construct a dual-evaluation system (process-oriented performance appraisal and outcome-oriented work effectiveness) to support the scientific management and career development of unit-based clinical pharmacists. A preliminary indicator set was drafted based on literature review and policy analysis. Two rounds of expert consultation using the Delphi method were conducted to screen and refine the indicators. Subsequently, the Analytic Hierarchy Process (AHP) was employed to determine the weights of each indicator. The two rounds of expert consultation achieved response rates of 89.47% (17/19) and 100% (17/17), with expert authority coefficients from 0.93 to 0.95. Kendall’s W coefficients were significant (0.193 and 0.337; 0.153 and 0.227; P < 0.05). The final performance a​ppraisal​ system includes 5 first-level and 26 second-level indicators. “Pharmacy administration and quality control” held the highest weight (0.3499), while the top second-level indicators were “Teaching/supervision” (0.0851), “Departmental/hospital training/lectures” (0.0713), and “Medical dispute case analysis” (0.0596). The work effectiveness evaluation system comprises 5 first-level and 19 second-level indicators. “Clinical services and medication safety” was the most weighted first-level indicator (0.2661); the top second-level indicators were “Pharmacy administration indicators” (0.0812), “Improvement rate of prescription/order review issues” (0.0809), and “Valid complaints or disputes” (0.0782). This study constructed a process- and outcome-differentiated, operable dual-evaluation system for unit-based clinical pharmacists. It serves not only as an assessment tool but also as a developmental tool linking performance evaluation with competency development, employee motivation, and well-being. By connecting individual KPIs with team/organisational goals, it provides a basis for demonstrating the value of clinical pharmacy services in patient safety and organisational sustainability. Future multicentre empirical studies are required to further evaluate its real-world feasibility and performance thresholds.