Health care is experiencing increasing pressure to implement evidence-based interventions that improve quality, control costs, and maximize value. Unfortunately, many clinical services and interventions to optimize medication use do not consistently produce the intended humanistic, clinical, and economic outcomes. The lack of conclusive results is believed to stem from the widely recognized research-to-practice gap. The field of implementation science seeks to discover and apply strategies designed to accelerate successful integration of interventions into routine practice. This primer provides an overview of implementation science principles for pharmacists and other health care providers interested in accelerating practice transformation to improve health care delivery and, ultimately, patient care.
OBJECTIVE Philosophy of practice is the foundation of any patient care practice because it provides a set of professional values and beliefs that guide actions and decisions in practice. Study objectives were to understand how pharmacists providing comprehensive medication management (CMM) describe their philosophy of practice and compare how participants' philosophies align with predefined tenets of a CMM philosophy of practice. METHODS An instrument with closed and open-ended items was developed and administered online to the lead pharmacist at 36 clinics participating in a large CMM study. Participants were asked to describe their philosophy of practice, rate how well their current practice activities align with five predefined CMM philosophy of practice tenets, and provide examples of how they carry out each tenet and how they could improve. Responses were coded, and descriptive analysis was used to calculate participants' practice alignment with the five philosophy of practice tenets. RESULTS Thirty pharmacists completed the instrument. Twelve codes emerged that participants used to describe their philosophy of practice. These codes were mapped to five predefined tenets of a philosophy of practice. Only 3 (10%) participants included all five tenets in their philosophy of practice, 8 (26.7%) included four, 8 (26.7%) included three, 6 (20%) included two, and 5 (16.7%) included one tenet. Overall, participants rated their alignment with the five tenets highly. "Embracing a patient-centered approach" received the highest mean score of 9.17/10; "Meeting a societal need" had the lowest mean score of 8.37/10. CONCLUSION Participants described their philosophy of practice with significant variability. CMM requires a single and consistently applied philosophy of practice to guide practice and the role of the practitioner. We propose five core tenets that resulted from this assessment to be embraced by pharmacists providing CMM and included in their philosophy of practice. KEY WORDS comprehensive medication management, philosophy of practice, clinical pharmacy services.
Accrediting bodies for Doctor of Pharmacy (Pharm.D.) and postgraduate residency training programs recognize the importance of research and scholarship training. However, specific guidance on how research and scholarship fundamentals should be delivered to trainees has not been provided. As a result, competing priorities often create barriers for trainees to develop research and scholarship skills and limit the trainees' ability to conduct and participate in high‐quality, meaningful research experiences. The purpose of this “how‐to” guide is to assist pharmacy school faculty and pharmacy residency program directors with strategies to overcome programmatic, trainee, and project barriers to providing a high‐quality training experience in research and scholarship. Programmatic topics addressed include institutional support and program oversight, expertise and number of research mentors, incentives for mentor engagement, and competing priorities that diminish time for research activities. Trainee topics include lack of trainee interest in the assigned project, trainee departure prior to project completion, lack of knowledge of the publication process, and time constraints to work on the project. Project topics addressed include time needed to initiate a project, training on methodology relevant to a project, selection of projects that lack rigor, depth, or feasibility, and resource constraints to disseminate project results. A summary of specific recommended actions is provided to effectively overcome these common barriers encountered in research and scholarship training programs.
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