Schoenrock Danielle L, Hartkopf Katherine, Boeckelman Carrie
University of Wisconsin Hospital and Clinics, Madison, WI.
Am J Health Syst Pharm. 2016 Dec 1;73(23 Supplement 6):S155-S160. doi: 10.2146/ajhp160185.
The development and implementation of a centralized, pharmacist-run population health program were pursued within a health system to increase patient exposure to comprehensive medication reviews (CMRs) and improve visit processes.
Program implementation included choosing appropriate pilot pharmacy locations, developing a feasible staffing model, standardizing the workflow, and creating a patient referral process. The impact on patient exposure, specific interventions, and the sustainability of the program were evaluated over a seven-month period. A total of 96 CMRs were scheduled during the data collection period. Attendance at scheduled CMRs was 54% (52 visits); there were 25 cancellations (26%) and 19 no-shows (20%). Since program implementation, there has been more than a twofold increase (2.08) in the number of CMRs completed within the health system. On average, all aspects of each patient visit took 1.78 hours to complete. Pharmacists spent 28% of scheduled time on CMR tasks and 72% of time on telephone calls and technical tasks to maintain appointments.
A pharmacist-run CMR program helped to elevate the role of the community pharmacist in a health system and to improve patient exposure to CMRs. Sustaining a centralized CMR program requires support from other members of the health-system team so that pharmacists can spend more time providing patient care and less time on the technical tasks involved.
在一个卫生系统内开展并实施由药剂师负责的集中式人群健康项目，以增加患者接受全面药物评估（CMR）的机会并改善就诊流程。
项目实施包括选择合适的试点药房地点、制定可行的人员配备模式、规范工作流程以及创建患者转诊流程。在七个月的时间里评估了该项目对患者接受率、具体干预措施以及项目可持续性的影响。在数据收集期间共安排了96次CMR。预定CMR的出勤率为54%（52次就诊）；有25次取消预约（26%）和19次未就诊（20%）。自项目实施以来，卫生系统内完成的CMR数量增加了两倍多（2.08倍）。每次患者就诊的所有环节平均需要1.78小时完成。药剂师将预定时间的28%用于CMR任务，72%的时间用于电话沟通和维护预约的技术任务。
由药剂师负责的CMR项目有助于提升社区药剂师在卫生系统中的作用，并增加患者接受CMR的机会。维持集中式CMR项目需要卫生系统团队其他成员的支持，以便药剂师能够有更多时间提供患者护理，而减少在相关技术任务上花费的时间。
