Description of a team-based job improvement process within a large geographically dispersed primary care clinical pharmacy service.

OBJECTIVE

To describe the team-based job improvement process that Primary Care Clinical Pharmacy Services (CPS) used to enhance teamwork and improve job satisfaction during a 4-year period.

SETTING

Health maintenance organization in Colorado from 2005 through 2008.

PRACTICE DESCRIPTION

Kaiser Permanente Colorado is a group model, not-forprofit health maintenance organization that provides health services to approximately 490,000 members. Highly integrated clinical pharmacy services are offered at each of its 17 primary care medical offices in the Denver-Boulder metropolitan area.

PRACTICE INNOVATION

A written survey consisting of three open-ended questions specifically directed at perceived positive and negative job-related features within Primary Care CPS was administered to team members. Six areas of focus emerged that were addressed by Primary Care CPS members within small groups.

MAIN OUTCOME MEASURES

Pre- and postsurvey results from six identified focus areas were measured to address any impact of the team-based job improvement process.

RESULTS

Positive responses increased from baseline by 48% for communication, 42% for new employee orientation, 25% for teamwork, and 25% for Primary Care CPS meetings (P < 0.05; chi-square test). Positive responses related to clinical practice increased 22%; however, this did not reach statistical significance. Perceived satisfaction with the documentation system for tracking clinical interventions declined 11% from baseline.

CONCLUSION

Based on the initial successes with surveys and small-group discussions, Primary Care CPS continues to use this team-based job improvement process to resolve concerns or share best practices.