ASHP's new pharmacy practice model initiative anticipates future
Initiative launched in 2009
The American Society of Health-System Pharmacists (ASHP) of Bethesda, MD, has launched a pharmacy practice model initiative to open discussion about pharmacists' role in patient care in health care organizations.
"We're calling it an initiative on purpose," says David Chen, RPh, MBA, director of pharmacy practice section at ASHP.
"We see it as ongoing, a continuum of activities that will include stimulating people's thoughts about what the potential can be for pharmacists with editorials in our journal," Chen explains. "We intend to incorporate focused education, integrating education technology, and adapting to the external environment to continue to advance pharmacy practice."
An example of how important pharmacists are in the big health care picture can be found in the 470-page National Quality Forum's "Safe Practices for Better Healthcare — 2009 Update: A Consensus Report," Chen says.1
"Number 18 of its safe practices mentions pharmacists, which are the only profession called out in the report," he adds.
This suggests that it's becoming more widely recognized that pharmacists should have an active role in the administrative leadership team, he says.
"Pharmacists should provide leadership as an expert on an interdisciplinary team and formal leadership on an administrative team as they make decisions on safe medication practices," Chen says.
According to ASHP's literature on the new pharmacy practice model initiative, it will have these main goals:
1. Create a framework: Create a framework for a pharmacy practice model that ensures provision of safe, effective, efficient, accountable, and evidence-based care for all hospital/health system patients.
2. Determine services: Determine patient care-related services that should be consistently provided by departments of pharmacy in hospitals and health systems and increase demand for pharmacy services by patients/caregivers, health care professionals, health care executives, and payers.
3. Identify emerging technologies: Identify the available technologies to support implementation of the practice model, and identify emerging technologies that could impact the practice model.
4. Develop a template: Support the optimal utilization and deployment of hospital and health-system pharmacy resources through development of a template for a practice model that is operational, practical, and measurable.
5. Implement change: Identify specific actions pharmacy leaders and staff should take to implement practice model change including determination of the necessary staff (pharmacy leaders, pharmacists, and technicians), skills, and competencies required to implement this model.
Numerous studies have shown how adverse events and other safety indicators were improved by having pharmacists included in patient care teams and on patient rounds, Chen says.
Research shows that pharmacists' recommendations are accepted by physicians nearly all of the time, as well, Chen notes.
"When you look at the total cost of care and the quality of care and the goal of improving outcomes of patients, having that medication therapy expert as part of the team is an important ingredient in improving outcomes and avoiding adverse events," Chen says.
The ASHP initiative is designed to identify best practices incorporating pharmacists so health care organizations can adopt these models as their own, he adds.
ASHP also will be stressing the role of pharmacists in administrative level decision-making.
"At the administrative level, there are macro decisions on how to approach patient care and therapy management, as well as drug distribution and getting drugs from the pharmacy to bedside, and pharmacists are experts in that arena, as well," Chen says.
As health care organizations evolve, meeting the challenges of 21st century medicine, ASHP envisions that pharmacists will be needed less for direct distribution of medications, he says.
"Technology will take over a larger portion of what currently is a pharmacist's role and what pharmacy technicians do in moving medications as a product from the pharmacy to bedside," Chen says. "And pharmacists will continue to move into positions of providing information, giving direct patient care, and being part of decision-making in an interdisciplinary team."
Some of this change will occur as hospitals decentralize, which is only one possible model for the future, he says.
"That's one of the models for having pharmacists out on the unit providing direct care, side-by-side with an interdisciplinary team," Chen says. "To decide how pharmacists make that happen depends on the situation at a particular hospital."
The key is for ASHP and other industry leaders to give organizations information about pharmacy practice models.
"There's a journey in front of us," Chen says.
Reference
- Corrigan JM. Safe Practices for Better Healthcare — 2009 Update: A Consensus Report. Washington, DC: National Quality Forum; March 2009.
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