Sorensen Todd D, Pestka Deborah, Sorge Lindsay A, Wallace Margaret L, Schommer Jon
Department of Pharmaceutical Care and Health Systems, College of Pharmacy, University of Minnesota, Minneapolis, MN.
Social and Administrative Pharmacy, College of Pharmacy, University of Minnesota, Minneapolis, MN.
Am J Health Syst Pharm. 2016 Mar 1;73(5):307-14. doi: 10.2146/ajhp150212.
The initiation, establishment, and sustainability of medication management programs in six Minnesota health systems are described.
Six Minnesota health systems with well-established medication management programs were invited to participate in this study: Essentia Health, Fairview Health Services, HealthPartners, Hennepin County Medical Center, Mayo Clinic, and Park Nicollet Health Services. Qualitative methods were employed by conducting group interviews with key staff from each institution who were influential in the development of medication management services within their organization. Kotter's theory of eight steps for leading organizational change served as the framework for the question guide. The interviews were audio recorded, transcribed, and analyzed for recurring and emergent themes.
A total of 13 distinct themes were associated with the successful integration of medication management services across the six healthcare systems. Identified themes clustered within three stages of Kotter's model for leading organizational change: creating a climate for change, engaging and enabling the whole organization, and implementing and sustaining change. The 13 themes included (1) external influences, (2) pharmacists as an untapped resource, (3) principles and professionalism, (4) organizational culture, (5) momentum champions, (6) collaborative relationships, (7) service promotion, (8) team-based care, (9) implementation strategies, (10) overcoming challenges, (11) supportive care model process, (12) measuring and reporting results, and (13) sustainability strategies.
A qualitative survey of six health systems that successfully implemented medication management services in ambulatory care clinics revealed that a supportive culture and team-based collaborative care are among the themes identified as necessary for service sustainability.
描述明尼苏达州六个医疗系统中药物管理项目的启动、建立和可持续性。
邀请明尼苏达州六个拥有成熟药物管理项目的医疗系统参与本研究：伊森蒂亚医疗集团（Essentia Health）、费尔维尤健康服务公司（Fairview Health Services）、健康伙伴公司（HealthPartners）、亨内平县医疗中心（Hennepin County Medical Center）、梅奥诊所（Mayo Clinic）和公园尼科莱特健康服务公司（Park Nicollet Health Services）。采用定性方法，对每个机构中在其组织内药物管理服务发展方面有影响力的关键工作人员进行小组访谈。科特的组织变革八步理论作为问题指南的框架。访谈进行了录音、转录，并分析了反复出现和新出现的主题。
共有13个不同的主题与六个医疗系统成功整合药物管理服务相关。确定的主题集中在科特组织变革领导模型的三个阶段：营造变革氛围、使整个组织参与并赋能、实施和维持变革。这13个主题包括：（1）外部影响；（2）药剂师作为未开发资源；（3）原则与专业精神；（4）组织文化；（5）动力推动者；（6）合作关系；（7）服务推广；（8）团队式护理；（9）实施策略；（10）克服挑战；（11）支持性护理模式流程；（12）衡量和报告结果；（13）可持续性策略。
对六个在门诊诊所成功实施药物管理服务的医疗系统进行的定性调查显示，支持性文化和团队式合作护理是被确定为服务可持续性所必需的主题。
