Longitudinal qualitative evaluation of pharmacist integration into the urgent care setting

Abstract

PurposeTo describe the most effective model for managing, educating, and training pharmacist advanced clinical practitioners (ACPs) in the urgent care center (UCC) setting, role evolution and how to measure their effectiveness.Participants and methodsEthical approval was obtained to perform a qualitative longitudinal cohort study in three sites, with three pharmacists in each trained as ACPs from 2016 to 2017. ACP role, location, management, mentorship, and supervision were locally determined. ACPs attended focus groups (FGs) at 1 and 3 months (sites 1–3), 6 and 12 months (site 1 only), and the UCC staff were interviewed once with a topic guide regarding training, integration, role, and impact. Verbatim transcriptions were analyzed thematically.ResultsEight ACP FGs and 24 stakeholder interviews produced major themes of communication, management, education and training, role, and outcomes. Effective education, training, and integration required communication of role to address concerns regarding salary differentials, supportive management structure, and multi-professional learning. ACPs reported that the model of workplace training, experiential learning, and university-based education was appropriate. Training was better located in the minor injuries and general practitioner areas. Recommended measures of effectiveness included patient satisfaction and workload transfer.ConclusionThe education and training model was appropriate. Communication and management require careful consideration to ensure effective integration and role development. Pharmacists were better located initially in the minor illness rather than major trauma areas. Quality of patient experience resulting from the new role was important in addition to reassurance that the role represented a positive contribution to workload.

Systematic review and narrative synthesis of pharmacist provided medicines optimisation services in care homes for older people to inform the development of a generic training or accreditation process

“…We have not considered this model of care or its impact on the training needs of pharmacists. Increasingly, pharmacists are undertaking clinical assessments and physical examinations and this knowledge may be necessary in this environment in the not‐too‐distant future.…”

The advanced clinical practice pharmacy role and its implementation to practice in England

“…Many of the papers discussed the facilitators, challenges and barriers towards implementing an ACP role. Three studies investigated the outcome of ACP (Seneviratne, Bradbury & Bourne, 2017;Bradley et al 2018;Wright et al 2018) implementation. In addition, The Nuffield Trust (2016) provided feedback from the secondary care case study that it was reporting on.…”

“…The paper cites the workforce shortages in nursing, however this is currently not a problem within the pharmacy profession (Wright, 2013). Although with some colleagues being 'sceptical of the new role' (Nuffield Trust, 2016: p.41), another barrier discussed was the increased cost of an ACP (Pharmacist) in comparison to other ACP professions (Wright et al, 2018).…”

“…Often a cause of confusion among patients and HCPs alike, many authors report that the historic ambiguity of ACP role and scope of practice is finally becoming clearer with the introduction of a national framework and definition (Pearce & Breen, 2018). There is a consistent opinion that the HEE framework is a much-needed approach to understand, recognise, and standardise ACP, which is often cited as a challenge when implementing such a role (Wright et al, 2018;Nelson et al, 2019). Considering past national healthcare policies highlighted the same issues as today, these developments may be the positive step towards the greater success of an ACP role.…”

“…Benefits of the role were consistent with the reasons for developing the role, which were the provision of flexible models of care where needed, across multi-professions and sectors of care. Several authors suggested ACPs were best suited within primary care roles or roles traditionally provided by primary care providers in secondary care, such as urgent care centres or a minor illness area (Barnes, Ashraf & Din, 2017;Hughes et al, 2017;Wright et al, 2018).…”