Advancement of clinical pharmacy practice through intervention capture

The American College of Clinical Pharmacy (ACCP) 2011 publication “Tenets for Developing Quality Measures for Ambulatory Clinical Pharmacy Services” describes comprehensive, accountable, feasible, scientifically sound, and usable quality metrics for ambulatory care (AC) practice. ACCP endorsed the definition of comprehensive medication management (CMM) in 2014 and has since advocated consistent implementation of CMM in patient‐centered, team‐based care. Given the decade of changes and advances in AC practice since the 2011 publication, the 2020 ACCP Publications Committee has developed the present white paper to update quality metrics and provide performance indicators with proposed guidance for CMM in AC practice.

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confidence: 99%

Current and future state of quality metrics and performance indicators in comprehensive medication management for ambulatory care pharmacy practice

Clements

Emmons

Anderson

et al. 2021

“…With the expansion of clinical pharmacy services in the VA, it has become crucial to understand the interventions being made by the CPS that contribute to their CMM services. The PBM CPPO developed an electronic intervention documentation template, the Pharmacists Achieve Results with Medications Documentation (PhARMD) Project, to capture interventions to demonstrate, describe, and define CPS provider services . This intervention capture tool allows the CPS to document select interventions made during patient care encounters that contribute to care and overall patient outcomes.…”

Section: Role Of Va Cps In Increasing Quality Of Carementioning

confidence: 99%

Optimizing the primary care clinical pharmacy specialist: Increasing patient access and quality of care within the Veterans Health Administration

McFarland

Nelson

Ourth

et al. 2019

Self Cite

Background Access to high‐quality care is a US Department of Veterans Affairs (VA) top priority. The VA utilized the principles of the Patient Centered Medical Home model to design the Patient‐Aligned Care Team (PACT) to deliver primary care to our nation's Veterans. The PACT model was introduced in the VA in 2009 and was implemented across the health care system in 2010. Objective This review will highlight how the VA clinical pharmacy specialist (CPS) have been integrated throughout the VA to provide clinical care services in the primary care setting. CPSs in PACTs provide comprehensive medication management (CMM) in between typical PACT provider visits to initiate, modify, or discontinue medications, as well as providing disease management in foundational and high‐volume areas such as anticoagulation, pain management, diabetes, hypertension, anemia, chronic obstructive pulmonary disease, heart failure, hepatitis C, and hyperlipidemia. Conclusions Within the VA, CPSs work autonomously but collaboratively under a global or practice area‐based scope of practice (SOP) with prescriptive authority. VA CPS serving as a provider in primary care increase access and quality of care to veterans through the provision of CMM. This model has the opportunity to be leveraged in other health care systems.

“…In the U.S. Department of Veterans Affairs (VA), the Pharmacists Achieve Results with Medications Documentation (PhARMD) Project developed a template to promote pharmacist documentation of direct patient care clinical interventions 9 . Throughout the VA system, including the authors' institution, the PhARMD template is embedded into the electronic health record (EHR), can be completed as part of patient encounter progress note documentation, and allows for tracking of disease and non‐disease state specific clinical interventions made by the pharmacist.…”

Section: Introductionmentioning

confidence: 99%

Prescribing and documentation by critical care clinical pharmacy specialists with around‐the‐clock staffing: A single‐center evaluation

Westmoreland

Franck

2021

IntroductionEvidence supports pharmacists as essential team members in the intensive care unit (ICU). Data are limited for pharmacist prescribing and documentation, ideal pharmacist staffing, and timing of clinical pharmacy activities in the ICU.ObjectiveThe purpose of this evaluation was to assess the frequency, timing, and most common areas of prescribing and documentation for critical care clinical pharmacy specialists (CPSs) in a single medical center with around‐the‐clock staffing.MethodsA Veterans Affairs (VA) medical center implemented a collaborative practice model in which CPSs provide direct ICU patient care around the clock. Direct patient care activities are provided for two ICUs with three multidisciplinary teams (medical, surgical, and cardiovascular), the nutrition support team, and emergency response teams. Documentation through an electronic health record progress note is required any time a CPS performs a patient encounter and uses prescriptive authority. A retrospective evaluation was performed to evaluate critical care CPS patient encounters and clinical interventions from October 1, 2016 through September 30, 2020.ResultsCumulatively, 78 622 CPS clinical interventions requiring prescriptive authority were made during 17 938 documented encounters. For clinical interventions, 40 897 (52.0%) were during daytime hours and 37 725 (48.0%) were after‐hours. Of the documented encounters, 10 461 (58.3%) were during daytime hours compared with 7477 (41.7%) after‐hours. Medication‐related prescribing interventions accounted for 57 400 (73.0%) of the interventions, while 6931 (8.8%) were nonpharmacologic and 14 291 (18.2%) were additional interventions. The most common disease states for prescribing interventions included Anticoagulation (13.8%), Infectious Diseases (13.1%), Cardiovascular (10.5%), Nutrition/Gastrointestinal (6.6%), Neuropsychiatric (5.3%), Endocrine (4.3%), Nephrology (3.5%), and Pulmonary (1%).ConclusionThis evaluation provides details of prescribing and documentation by critical care CPSs with an around‐the‐clock staffing model. This may be useful for ICU clinicians and administrators considering expanding critical care pharmacy services.