Practice model challenge

Woods, T. Mark

doi:10.2146/ajhp090244

Cited by 12 publications

(10 citation statements)

References 2 publications

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“…31 Three models were defined: a drug-distributioncentered model defined by a lack of pharmacist accountability for patient outcomes or leadership responsibility for the medication use process, a clinical pharmacist-centered model defined by pharmacists who "accept little or no responsibility for issues related to the medication-use or delivery systems," and a patient-centered integrated model in which pharmacists accept responsibility for all aspects of the medication use process. 32 The definition of the clinical pharmacist-centered model, subsequently referred to as the clinical specialist-centered model, was not well-received by a number of specialists because it appeared to serve as a foil for the integrated model by impugning the motives of specialists providing patient care. [33][34][35] The clinical specialist vs integrated model terminology was used by some of the speakers at the 2010 Pharmacy Practice Model Initiative Summit, 36 but by the next cycle of the ASHP survey of pharmacy practice in hospital settings conducted in 2011, there was no mention of the three practice models in the report.…”

Section: Specialization and Patient Care Practice Modelsmentioning

confidence: 99%

A brief history of pharmacy specialization in the United States

Erstad

Webb

2020

J Am Coll Clin Pharm

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The origins of pharmacy specialization has its beginning in the efforts of Harvey A. K. Whitney, Sr. through his leadership in establishing progressive hospital pharmacy services and hospital‐focused programs and policies within the nation's professional pharmacy organizations. Later, Donald Francke spoke of specialization in the hospital pharmacy setting as a natural outgrowth of practice activities that required more time and specialized expertise. A broader national discussion and eventual codification of specialty recognition and attendant certification within pharmacy began in 1971 with a policy statement approved by the APhA House of Delegates that led to the creation of a Task Force on Specialties in Pharmacy followed by the creation of the Board of Pharmaceutical Specialties (BPS). Given that specialization in any health profession is primarily a function of the reality of ever‐increasing scientific and technological developments, debate regarding the need, types, and value of specialization in pharmacy seem destined to be driven not by intra‐ or inter‐professional debates within pharmacy, but by the needs, expectations, and values of patients and health care systems.

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Section: Specialization and Patient Care Practice Modelsmentioning

confidence: 99%

A brief history of pharmacy specialization in the United States

Erstad

Webb

2020

J Am Coll Clin Pharm

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“…The practice model employed in the acute care setting must be based on a forward‐looking set of guiding principles, values, and philosophies for the provision of clinical pharmacy services and strive to achieve positive patient care outcomes (Table ). The ideal practice model should use clinical pharmacists to provide safe, effective, efficient, accountable, and evidence‐based pharmaceutical care to optimize therapeutic outcomes …”

Section: Guiding Principles Values and Philosophiesmentioning

confidence: 99%

“…The ideal practice model should use clinical pharmacists to provide safe, effective, efficient, accountable, and evidence-based pharmaceutical care to optimize therapeutic outcomes. 8 The provision of health care in the acute care setting is becoming increasingly complex, interprofessional, * and team-based. Clinical pharmacists are essential members of these teams.…”

Section: Guiding Principles Values and Philosophiesmentioning

confidence: 99%

Acute Care Clinical Pharmacy Practice: Unit‐ versus Service‐Based Models

et al. 2012

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This commentary from the 2010 Task Force on Acute Care Practice Model of the American College of Clinical Pharmacy was developed to compare and contrast the "unit-based" and "service-based" orientation of the clinical pharmacist within an acute care pharmacy practice model and to offer an informed opinion concerning which should be preferred. The clinical pharmacy practice model must facilitate patient-centered care and therefore must position the pharmacist to be an active member of the interprofessional team focused on providing high-quality pharmaceutical care to the patient. Although both models may have advantages and disadvantages, the most important distinction pertains to the patient care role of the clinical pharmacist. The unit-based pharmacist is often in a position of reacting to an established order or decision and frequently is focused on task-oriented clinical services. By definition, the service-based clinical pharmacist functions as a member of the interprofessional team. As a team member, the pharmacist proactively contributes to the decision-making process and the development of patient-centered care plans. The service-based orientation of the pharmacist is consistent with both the practice vision embraced by ACCP and its definition of clinical pharmacy. The task force strongly recommends that institutions pursue a service-based pharmacy practice model to optimally deploy their clinical pharmacists. Those who elect to adopt this recommendation will face challenges in overcoming several resource, technologic, regulatory, and accreditation barriers. However, such challenges must be confronted if clinical pharmacists are to contribute fully to achieving optimal patient outcomes. Key Words: clinical pharmacist, clinical pharmacy, practice model, pharmacotherapy. (Pharmacotherapy 2012;32(2):e35-e44)The 2010 Task Force on Acute Care Practice Model of the American College of Clinical Pharmacy was charged with preparing this commentary to critically compare and contrast the "unit-based" and "service-based" acute care practice models for the delivery of clinical pharmacy services and relate these practice models to the definition of clinical pharmacy and other relevant ACCP documents. The task force's charge reflected concern that the unitbased model, which has evolved in many acute care settings, places the clinical pharmacist in an intrinsically reactive position in the therapeutic decision-making process. Thus, rather than having the opportunity to participate proactively in the evaluation and selection A C C P C O M M E N T A R Y

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“…Departments of pharmacy nationwide have been shifting from predominantly product‐focused models to patient‐centered care practice models which have allowed pharmacists to become more fully integrated into the oversight and delivery of direct patient care . Determining how best to distribute pharmacists, technicians, and departmental resources, however, remains a significant challenge and a topic of much debate …”

Section: Introductionmentioning

confidence: 99%

Evaluation of a comprehensive, integrated, medical service‐based pharmacy practice model

Vest

Carrasquillo

Morbitzer

et al. 2018

J Am Coll Clin Pharm

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Purpose: Prior to 2008, the pharmacy practice model utilized by the University of North Carolina (UNC) Medical Center was a traditional central pharmacist and clinical specialist model. The department of pharmacy implemented a unique and innovative pharmacy practice model in 2008 organized around medical services. Through this medical service-based model, all patients are now covered by a pharmacist. The objectives of this study were to evaluate the sustainability of the improvements associated with the medical service-based pharmacy practice model at UNC Medical Center, which included pharmacist turnover, employee satisfaction and workforce engagement, resident and student involvement in patient care, and inpatient drug costs. Methods: This retrospective analysis focused on data spanning fiscal year (FY) 2004 to 2016. Internal data reporting sources were analyzed to evaluate the outcomes of this practice model. Results: In FY 2016, 67% of work groups were tier 1 (highest satisfaction tier) and 4% were tier 3 (lowest satisfaction tier) and inpatient pharmacist turnover rate was only 7% compared with a 17% hospital turnover rate. Prior to 2008, the average difference between actual and expected drug expenditures was $2.8 million per year, and post-implementation, the average difference improved to $3.3 million per year. In FY 2017, the department had 35 residents, representing a 169% increase in number of residency positions available compared with FY 2008. In FY 2016, 134 months of early immersion experiences were offered, 29 months of Introductory Pharmacy Practice Experiences (IPPEs), and 417 months of Advanced Pharmacy Practice Experiences (APPEs), which represents a 263% increase in IPPE months and a 369% increase in APPE months from FY 2008.Conclusion: This practice model, along with other factors, has had a continued sustained positive impact on employee engagement, inpatient drug costs, and patient care in our health system. In addition, this practice model is organized around pharmacist responsibilities that support continued growth of pharmacy learners. K E Y W O R D Sdrug costs, employee satisfaction, pharmacy administration, pharmacy service, practice models, turnover, workforce engagement

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Practice model challenge

Cited by 12 publications

References 2 publications

A brief history of pharmacy specialization in the United States

A brief history of pharmacy specialization in the United States

Acute Care Clinical Pharmacy Practice: Unit‐ versus Service‐Based Models

Evaluation of a comprehensive, integrated, medical service‐based pharmacy practice model

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