Making a case for a patient-centered integrated pharmacy practice model

Abstract

T he two most recent American Society of Health-System Pharmacists (ASHP) national surveys 1,2 of pharmacy practice in hospital settings defined practice models as "how pharmacy department resources are used to provide patient care services. This includes how pharmacists practice and what services are provided in the care of patients, the role of pharmacy technicians in supporting patient care, and the use of automation and technology in the medication-use process." 2 For the profession to achieve consensus and consistency, it is critical to establish a clear taxonomy of terms to describe our practice models. The authors of the aforementioned ASHP surveys have proposed terminology to describe what are believed to be the three most commonly used pharmacy practice models. 1,2 These definitions are general, and we recognize that actual practice in most hospitals involves a blend of these models.Drug-distribution-centered model. Anderson 3 noted that "the traditional structure of most pharmacy departments is built around drug distribution, acquisition, and control." In this model, medication distribution and the processing of medication orders constitute the singular focus of the pharmacy department. There is little proactive involvement of pharmacists in medication selection or monitoring. In most cases, pharmacists are rel-64111 (twoods@saint-lukes.org).

Impact of the Pharmacy Practice Model Initiative on Clinical Pharmacy Specialist Practice

“…Among the many models, the patient‐centered integrated practice (PCIP) model is described as a proactive, comprehensive, flexible, adaptable, and efficient approach to achieve efficient patient‐focused care. This model maximizes the strengths of specialists and extends their impact by organizing the pharmacy team . This team assumes many clinical and operational responsibilities and is accountable for all aspects of pharmacy services from patient admission to discharge, resulting in less fragmented care.…”

Redesign of the Pharmacy Practice Model at a Tertiary Care Teaching Hospital

“…At the Royal Jubilee Hospital, development and implementation of formal roles for clinical pharmacy assistants and technicians will be required to further support the clinical pharmacists on the wards in practising to their full scope. Because it is no longer sufficient for pharmacists to be involved in care on weekdays only, 12 further expansion efforts should focus on the provision of high-quality clinical pharmacy services 7 days per week.…”

“…11 More specifically, a patient-centred, integrated pharmacy practice model would allow nearly all pharmacists to have both distributive and clinical responsibilities. 12,13 In addition, such a change would allow clinical pharmacists to seamlessly integrate into the interdisciplinary team and thereby improve patient care.…”

Stewardship of the pharmacy enterprise

“…Shane's 8 piece, "Critical Requirements for HealthSystem Pharmacy Practice Models That Achieve Optimal Use of Medicines," referred to the pharmacy enterprise three times in describing the characteristics of optimal models. The expression was also used in the article "Making a Case for a Patient-Centered Integrated Pharmacy Practice Model," by Woods et al, 9 and in the 2013 article "Highlights of the Cleveland Clinic Pharmacy Practice Model Summit." 10 Pharmacy enterprise is now a commonly used term.…”