scholarly journals Advancing ambulatory pharmacy practice through a crisis: Objectives and strategies used in an ambulatory care action team’s response to the COVID-19 pandemic

2021 ◽  
Author(s):  
Tina Do ◽  
Steph Luon ◽  
Kimberly Boothe ◽  
Martha Stutsky ◽  
Marie Renauer
Keyword(s):  
Ambulatory Care ◽  
Clinical Pharmacy ◽  
Pharmacy Practice ◽  
Pharmacy Services ◽  
Care Providers ◽  
Self Administration ◽  
Communication Infrastructure ◽  
Incident Command ◽  
Medication Therapy ◽  
Action Team

Abstract Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose The objectives and strategies used by an ambulatory care pharmacy team operating within a large health system’s pharmacy incident command structure during the initial response to the coronavirus disease 2019 (COVID-19) pandemic are discussed. Summary In a time of crisis, a pharmacy “ambulatory action team” was formed to provide ambulatory clinical pharmacy expertise and meet an immediate and ongoing need to limit nonemergent care during the COVID-19 pandemic. By building a strong communication infrastructure and partnership with ambulatory care providers, clinic medical and operational leaderships, clinical laboratory staff, and infusion centers, the team was able to swiftly execute solutions and respond to new issues and requests. Ambulatory care pharmacy practice continued to advance through provision of services to vulnerable patient populations with chronic conditions that were anticipated to experience gaps in care management during the COVID-19 pandemic. These efforts resulted in expansion of pharmacists’ involvement in collaborative drug therapy management, support of patients’ transition from in-clinic injection to home self-administration, provision of medication assistance support, and management of 1,300 patients via protocol-based warfarin management. Additionally, ambulatory pharmacy services in 15 primary care, anticoagulation, and specialty clinic sites were transitioned to telehealth. The ambulatory action team also implemented several strategies to manage medication therapy associated with COVID-19–related shortages and implemented electronic decision support to guide prescribing of hydroxychloroquine and azithromycin. Conclusion Building a strong communication infrastructure and a pharmacy ambulatory action team were essential to respond to a crisis and continue ambulatory clinical pharmacy services expansion.

scholarly journals Advancing ambulatory pharmacy practice through a crisis: Objectives and strategies used in an ambulatory care action team’s response to the COVID-19 pandemic

2021 ◽  
Author(s):  
Tina Do ◽  
Steph Luon ◽  
Kimberly Boothe ◽  
Martha Stutsky ◽  
Marie Renauer
Keyword(s):  
Ambulatory Care ◽  
Clinical Pharmacy ◽  
Pharmacy Practice ◽  
Pharmacy Services ◽  
Care Providers ◽  
Self Administration ◽  
Communication Infrastructure ◽  
Incident Command ◽  
Medication Therapy ◽  
Action Team

Abstract Purpose The objectives and strategies used by an ambulatory care pharmacy team operating within a large health system’s pharmacy incident command structure during the initial response to the coronavirus disease 2019 (COVID-19) pandemic are discussed. Summary In a time of crisis, a pharmacy “ambulatory action team” was formed to provide ambulatory clinical pharmacy expertise and meet an immediate and ongoing need to limit nonemergent care during the COVID-19 pandemic. By building a strong communication infrastructure and partnership with ambulatory care providers, clinic medical and operational leaderships, clinical laboratory staff, and infusion centers, the team was able to swiftly execute solutions and respond to new issues and requests. Ambulatory care pharmacy practice continued to advance through provision of services to vulnerable patient populations with chronic conditions that were anticipated to experience gaps in care management during the COVID-19 pandemic. These efforts resulted in expansion of pharmacists’ involvement in collaborative drug therapy management, support of patients’ transition from in-clinic injection to home self-administration, provision of medication assistance support, and management of 1,300 patients via protocol-based warfarin management. Additionally, ambulatory pharmacy services in 15 primary care, anticoagulation, and specialty clinic sites were transitioned to telehealth. The ambulatory action team also implemented several strategies to manage medication therapy associated with COVID-19–related shortages and implemented electronic decision support to guide prescribing of hydroxychloroquine and azithromycin. Conclusion Building a strong communication infrastructure and a pharmacy ambulatory action team were essential to respond to a crisis and continue ambulatory clinical pharmacy services expansion.

scholarly journals Establishing a New Ambulatory Care Practice Site as a Pharmacy Practice Faculty

Pharmacy ◽  
2018 ◽  
Vol 6 (4) ◽  
pp. 111 ◽  
Author(s):  
Vasudha Gupta ◽  
Evan Williams
Keyword(s):  
Ambulatory Care ◽  
Clinical Pharmacy ◽  
Clinical Skills ◽  
Pharmacy Practice ◽  
Care Practice ◽  
Pharmacy Services ◽  
Clinical Faculty ◽  
Clinical Pharmacy Services ◽  
Clear Vision ◽  
Pharmacist Services

There is an imminent need to identify and develop new ambulatory care practice sites with the increase in the number of colleges of pharmacy across the nation. This manuscript provides recommendations to help clinical faculty determine whether a potential pharmacy practice site will be able to provide adequate resources and support to establish a successful practice. This may be challenging to pharmacy practice faculty in settings where clinical pharmacy services have never been utilized. Topics include the pre-work needed prior to approaching a new practice site, assessing the need for physical requirements, meeting key personnel, marketing clinical skills and services, implementing, and evaluating practice site. Preparation includes having a clear vision of the pharmacist services, ensuring that stakeholders have an understanding of the pharmacy services inquiring the site support and resources for the pharmacist, and regularly communicating.

A Model for Inpatient Clinical Pharmacy Practice and Reimbursement

1986 ◽  
Vol 20 (12) ◽  
pp. 989-992 ◽  
Author(s):  
Richard A. Hutchinson ◽  
David P. Vogel ◽  
Kenneth W. Witte
Keyword(s):  
Health Care ◽  
Clinical Pharmacy ◽  
Pharmacy Practice ◽  
Pharmacy Services ◽  
Clinical Role ◽  
Clinical Pharmacy Services ◽  
The Past ◽  
Health Care Reimbursement

The development and expansion of clinical pharmacy over the past 15 years have resulted in several debates. One debate that was very lively in the late 1970s concerned proper reimbursement for clinical pharmacy services. Although this debate is less heated now, its importance is even more significant with today's major changes in health care reimbursement. This article reviews the key reasons for the original debate and discusses how recent changes have increased and added direction to the debate. A model is presented that the authors believe represents the key to the increasing acceptance of the pharmacist's clinical role.

scholarly journals Hospital-Based Clinical Pharmacy Services to Improve Ambulatory Management of Chronic Obstructive Pulmonary Disease

2016 ◽  
Vol 33 (1) ◽  
pp. 8-14 ◽  
Author(s):  
Amber Lanae Smith ◽  
Valerie Palmer ◽  
Nada Farhat ◽  
James S. Kalus ◽  
Krishna Thavarajah ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Ambulatory Care ◽  
Pulmonary Disease ◽  
Clinical Pharmacy ◽  
Chronic Obstructive ◽  
Pharmacy Services ◽  
Obstructive Pulmonary Disease ◽  
Clinical Pharmacy Services ◽  
Significant Difference ◽  
The Impact

Background: No systematic evaluations of a comprehensive clinical pharmacy process measures currently exist to determine an optimal ambulatory care collaboration model for chronic obstructive pulmonary disease (COPD) patients. Objective: Describe the impact of a pharmacist-provided clinical COPD bundle on the management of COPD in a hospital-based ambulatory care clinic. Methods: This retrospective cohort analysis evaluated patients with COPD managed in an outpatient pulmonary clinic. The primary objective of this study was to assess the completion of 4 metrics known to improve the management of COPD: (1) medication therapy management, (2) quality measures including smoking cessation and vaccines, (3) patient adherence, and (4) patient education. The secondary objective was to evaluate the impact of the clinical COPD bundle on clinical and economic outcomes at 30 and 90 days post–initial visit. Results: A total of 138 patients were included in the study; 70 patients served as controls and 68 patients received the COPD bundle from the clinical pharmacist. No patients from the control group had all 4 metrics completed as documented, compared to 66 of the COPD bundle group ( P < .0001). Additionally, a statistically significant difference was found in all 4 metrics when evaluated individually. Clinical pharmacy services reduced the number of phone call consults at 90 days ( P = .04) but did not have a statistically significant impact on any additional pre-identified clinical outcomes. Conclusion: A pharmacist-driven clinical COPD bundle was associated with significant increases in the completion and documentation of 4 metrics known to improve the outpatient management of COPD.

Integrating Pharmaceutical Care into an HIV Clinic

1997 ◽  
Vol 10 (1) ◽  
pp. 52-67
Author(s):  
Kimberly Olson
Keyword(s):  
Ambulatory Care ◽  
Protease Inhibitors ◽  
Patient Information ◽  
Clinical Pharmacy ◽  
Pharmacy Services ◽  
Barriers To Success ◽  
New Class ◽  
Information Materials ◽  
Hiv Drugs ◽  
Physician Support

The purpose of this article is to describe the integration of clinical pharmacy services into an already exist ing HIV clinic. Ambulatory care pharmacy services were the only discipline not represented in the hospi tal based HIV clinic. With the move toward ambulatory care, the introduction of the new class of HIV drugs called the protease inhibitors, and the strong physician support of inpatient pharmacy services, the tim ing for pharmacy integration into the clinic was optimal. This article describes our goals for the clinic, the need for justification of pharmacy services through documentation, and the preparation steps made which established permanent pharmacy services in the HIV clinic. Daily procedures, interventions, statis tics of the pharmacy service, and barriers to success are also described. Patient information materials and examples of the documentation forms used by the clinic pharmacists are provided. This article is meant to aid other pharmacists who wish to integrate pharmacy services into an ambulatory HIV clinic setting.

scholarly journals Analysis on Clinical pharmacy services provided by pharmacists for promoting elderly patients care

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 745-750
Author(s):  
Bushan Kumar GG ◽  
Jyothi Singamsetty ◽  
Rajasekhar K V ◽  
Sahitya Meda
Keyword(s):  
Patient Care ◽  
Adverse Drug Reactions ◽  
Clinical Pharmacy ◽  
Clinical Pharmacist ◽  
Pharmacy Services ◽  
Care Hospital ◽  
Drug Reactions ◽  
Clinical Pharmacy Services ◽  
Medication Therapy ◽  
Prescription Errors

Clinical pharmacy services are the services provided by the pharmacists to promote patient care, optimizes medication therapy, promote health and disease prevention. This prospective cross sectional study was conducted in tertiary care hospital over a period of 6 months. This collected data is checked for their appropriateness of any prescription related errors and DRPs were identified. Results obtained were assessed to determine the influence of Clinical pharmacist services. Majority of the prescriptions were with 5-9(62.5%) drugs. The majority of co-morbidities among 125 enrolled patients in age group of 60-70, 55 patients were with 3-4 co-morbidities. Among 125 prescriptions around 12 prescriptions were identified with 622 drug interactions. Among 125 patients 2 (0.277) adverse drug reactions were observed and according to Naranjo's probability assessment scale these adverse drug reactions were mild and 15(2.08%) dispensing errors, 10(1.386%) prescription errors where majority of prescription errors are due to missed written frequencies in the prescriptions. 5(0.693%) administration errors, 5 (0.693%)untreated indications were observed. Presence of clinical pharmacist in hospital settings can reduce drug related problems and they can assist other staff in improving patient care.

scholarly journals Baseline Knowledge and Education on Patient Safety in the Ambulatory Care Setting for 4th Year Pharmacy Students

2015 ◽  
Vol 6 (1) ◽  
Author(s):  
Jessica W. Skelley ◽  
Chase Carpenter ◽  
Trisha Elkins ◽  
Thomas W. Woolley ◽  
B. DeeAnn Dugan
Keyword(s):  
Ambulatory Care ◽  
Care Setting ◽  
Pharmacy Practice ◽  
Average Score ◽  
Training Manual ◽  
Multiple Choice Questions ◽  
Ambulatory Care Setting ◽  
Medication Therapy ◽  
Practice Experience ◽  
Baseline Knowledge

Objectives: To assess the baseline knowledge of fourth year student pharmacists on their ability to properly identify and categorize medication related problems (MRP) during their Advanced Pharmacy Practice Experience (APPE) in the ambulatory care setting, and to assess the efficacy of a written resource designed to educate and train users on identification and documentation of MRP's and used for this purpose with participating students on their ambulatory care APPE. Methods: A pretest consisting of ten multiple-choice questions was administered electronically to fourth year student pharmacists (N=18) at the start of their ambulatory care APPE. The test was designed to assess both the students' baseline knowledge regarding MRP's, and their ability to identify a wide variety of medication-related problems. Students then received a written copy of The Medication Therapy Intervention & Safety Documentation Program training manual and were asked to read it in its entirety in the first week of their APPE. Finally, students were given a posttest survey (identical to the pretest) to complete to assess if their knowledge had increased from baseline. Results: The average score for the 18 students taking the baseline knowledge pre-test was 63.33%, indicating limited baseline knowledge regarding the identification and classification of MRP's. In assessing the effectiveness of the written training document, the overall posttest results compared to pretest results did not indicate improvement in students' knowledge or ability to properly identify and classify medication related problems (MRP) after reviewing the training manual. The average scores declined from 63.33% on the pretest to 62.78% on the posttest, although this was not found to be statistically significant (p = 0.884). However, a statistically significant decline in students' knowledge occurred on one specific question, which tested their ability to classify MRP's (p = 0.029). Conclusions: Based on the results of the pre-test, students at our institution enter their APPE year with limited baseline knowledge of medication safety within the ambulatory care setting. Results from the posttest indicate potential ineffectiveness of a written document in providing effective education on MRP's to students in the experiential setting. Education may be made more effective with a hands-on, active learning approach that overcomes the limitations of other passive forms of learning.   Type: Student Project

Acute Care Pharmacy Practice: A Perspective for Pharmacy Students, Residents, and Other Health-Care Providers

2018 ◽  
Vol 33 (3) ◽  
pp. 350-355
Author(s):  
Rebecca L. Dunn ◽  
Jonathan C. Cho ◽  
Brittany L. Parmentier
Keyword(s):  
Health Care ◽  
Acute Care ◽  
Health Care Providers ◽  
Care Setting ◽  
Pharmacy Practice ◽  
Interdisciplinary Teams ◽  
Acute Care Setting ◽  
Care Providers ◽  
Patient Centered ◽  
Medication Therapy

Purpose: To describe the acute care setting with a specific focus on acute care pharmacy practices. Summary Acute care is the sector of health care where time-sensitive episodes of illness are managed. Acute care pharmacy practice includes both hospital and clinical pharmacists serving, in a variety of domains, as medication experts and authority on patient-centered medication therapy. Pharmacists serving in this area can have a beneficial impact on patient care and the health-care system. Conclusion: The demand for acute care services is likely to grow as the population continues to grow and age. Pharmacists are key members of interdisciplinary teams in the acute care setting.

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