Delgado Osmel, Kernan William P, Knoer Scott J
Osmel Delgado, Pharm. D., M.B.A., BCPS, FASHP, is Chief Operating Officer; and William P. Kernan, Pharm.D., BCPS, is Assistant Director of Pharmacy, Cleveland Clinic Florida, Weston, FL. Scott J. Knoer, Pharm.D., M.S., FASHP, is Chief Pharmacy Officer, Cleveland Clinic, Cleveland, OH.
Am J Health Syst Pharm. 2014 Nov 1;71(21):1871-6. doi: 10.2146/ajhp130624.
The implementation, benefits, and outcomes of a layered learner model (LLM) using pharmacy students as pharmacist extenders are described.
In 2011, Cleveland Clinic Florida (CCF) implemented a pharmacy practice model change with the goal of providing all inpatients quality pharmaceutical care while still providing key specialty clinical pharmacy services. An LLM was initiated in which pharmacists supervise pharmacy residents and students in a team format in which students are used as pharmacist extenders. CCF partnered with local and regional colleges of pharmacy to increase the number of advanced pharmacy practice experience student rotations at CCF. Students are given accountability for a specific number of patient beds based on their rotation. They are required to perform medication histories, education on drug indication and adverse effects, discharge counseling, targeted disease counseling, and profile review for drug-related problems for their patients. After the implementation of this model, improvements were observed in Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores (58% versus 70%, respectively), pharmacy interventions per patient per day (0.9 versus 1.4, respectively), and bedside medication delivery capture rate (48% versus 65%, respectively).
The implementation of an LLM and partnering with local colleges of pharmacy have improved pharmacy practice at CCF by allowing pharmacy students to work as pharmacist extenders in providing comprehensive pharmacy services to many patients who would not otherwise be reached. This approach has improved HCAHPS scores within the "communication of medication" domain, increased overall patient interventions, and allowed expansion of CCF's discharge prescription program.
描述一种将药学专业学生作为药剂师助手的分层学习模式（LLM）的实施情况、益处及成果。
2011年，佛罗里达克利夫兰诊所（CCF）实施了一项药学实践模式变革，目标是在为所有住院患者提供优质药学护理的同时，仍能提供关键的专科临床药学服务。启动了一种分层学习模式，药剂师以团队形式监督药学住院医师和学生，学生被用作药剂师助手。CCF与当地及地区药学院合作，增加在CCF进行高级药学实践经验学生轮转的人数。根据轮转情况，学生负责一定数量的病床。他们需要为患者进行用药史采集、药物适应症和不良反应教育、出院指导、针对性疾病指导以及药物相关问题的档案审查。该模式实施后，医院医疗服务提供者和系统消费者评估（HCAHPS）得分有所提高（分别从58%提升至70%），每位患者每天的药学干预次数增加（分别从0.9次增加至1.4次），床边给药采集率提高（分别从48%提升至65%）。
实施分层学习模式并与当地药学院合作，通过让药学专业学生作为药剂师助手为许多原本无法得到服务的患者提供全面药学服务，改善了CCF的药学实践。这种方法提高了“用药沟通”领域的HCAHPS得分，增加了总体患者干预次数，并扩大了CCF的出院处方项目。
