Jacobi Judith, Ray Shaunta', Danelich Ilya, Dodds Ashley Elizabeth, Eckel Stephen, Guharoy Roy, Militello Michael, O'Donnell Paul, Sam Teena, Crist Stephanie M, Smidt Danielle
Department of Pharmacy, IU Health Methodist Hospital, Indianapolis, Indiana.
Department of Clinical Pharmacy, University of Tennessee College of Pharmacy, Knoxville, Tennessee.
Pharmacotherapy. 2016 May;36(5):e40-9. doi: 10.1002/phar.1745. Epub 2016 Apr 27.
This paper describes the goals of the American Society of Health-System Pharmacists' Pharmacy Practice Model Initiative (PPMI) and its recommendations for health-system pharmacy practice transformation to meet future patient care needs and elevate the role of pharmacists as patient care providers. PPMI envisions a future in which pharmacists have greater responsibility for medication-related outcomes and technicians assume greater responsibility for product-related activities. Although the PPMI recommendations have elevated the level of practice in many settings, they also potentially affect existing clinical pharmacists, in general, and clinical pharmacy specialists, in particular. Moreover, although more consistent patient care can be achieved with an expanded team of pharmacist providers, the role of clinical pharmacy specialists must not be diminished, especially in the care of complex patients and populations. Specialist practitioners with advanced training and credentials must be available to model and train pharmacists in generalist positions, residents, and students. Indeed, specialist practitioners are often the innovators and practice leaders. Negotiation between hospitals and pharmacy schools is needed to ensure a continuing role for academic clinical pharmacists and their contributions as educators and researchers. Lessons can be applied from disciplines such as nursing and medicine, which have developed new models of care involving effective collaboration between generalists and specialists. Several different pharmacy practice models have been described to meet the PPMI goals, based on available personnel and local goals. Studies measuring the impact of these new practice models are needed.
本文介绍了美国卫生系统药师协会药学实践模式倡议(PPMI)的目标,及其对卫生系统药学实践转型的建议,以满足未来患者护理需求,并提升药师作为患者护理提供者的角色。PPMI设想了一个未来,即药师对与药物相关的结果承担更大责任,技术人员对与产品相关的活动承担更大责任。尽管PPMI的建议在许多情况下提高了实践水平,但它们也可能影响现有的临床药师,尤其是临床药学专家。此外,虽然扩大药师提供者团队可以实现更一致的患者护理,但临床药学专家的角色绝不能被削弱,尤其是在照顾复杂患者和人群方面。必须有经过高级培训并具备资质的专科从业者来为担任通科职位的药师、住院医师和学生树立榜样并进行培训。事实上,专科从业者往往是创新者和实践领导者。医院和药学院之间需要进行协商,以确保学术临床药师继续发挥作用,并确保他们作为教育工作者和研究人员做出贡献。可以借鉴护理和医学等学科的经验,这些学科已经开发出了涉及通科医生和专科医生有效协作的新护理模式。基于现有人员和当地目标,已经描述了几种不同的药学实践模式来实现PPMI的目标。需要开展研究来衡量这些新实践模式的影响。