Department of Health Policy and Management, University of North Carolina Gillings School of Global Public Health, Chapel Hill, USA.
Department of Health Policy and Management, University of North Carolina Gillings School of Global Public Health, Chapel Hill, USA.
Res Social Adm Pharm. 2019 Sep;15(9):1118-1125. doi: 10.1016/j.sapharm.2018.09.015. Epub 2018 Sep 27.
Limited evidence exists on how to integrate community pharmacists into team-based care models, as the inclusion of community pharmacy services into alternative payment models is relatively new. To be successful in team-based care models, community pharmacies need to successfully build relationship with diverse stakeholders including providers, care managers, and patients.
The aims of this study are to: (1) identify the role of network ties to support implementation of a community pharmacy enhanced services network, (2) describe how these network ties are formed and maintained, and (3) compare the role of network ties among high- and low-performing community pharmacies participating in an enhanced services network.
Using a semi-structured interview guide, we interviewed 40 community pharmacy representatives responsible for implementation of a community pharmacy enhanced services program. We analyzed for themes using social network theory to compare network ties among 24 high- and 16 low-performing community pharmacies.
The study found that high-performing pharmacies had a greater diversity of network ties (e.g., relationships with healthcare providers, care managers, and public health agencies). High-performing pharmacies were able to use those ties to support implementation of NC-CPESN. High- and low-performing pharmacies used similar strategies for establishing ties with patients, such as motivational interviewing and assigning staff members to be responsible for engaging high-risk patients. High-performing pharmacies used additional strategies such as assessing patient preferences to support patient engagement, increasing patient receptivity towards enhanced services.
Community pharmacies may vary in their ability to develop relationships with other healthcare providers, care management and public agencies, and patients. As enhanced services interventions that require care coordination are scaled up and spread, additional research is needed to test implementation strategies that support community pharmacies with developing and maintaining relationships across a diverse group of stakeholders (e.g., healthcare providers, care managers, public health agencies, patients).
将社区药剂师纳入基于团队的护理模式的相关证据有限，因为将社区药房服务纳入替代支付模式相对较新。要在基于团队的护理模式中取得成功，社区药房需要与包括提供者、护理经理和患者在内的各种利益相关者成功建立关系。
本研究的目的是：（1）确定网络联系在支持实施社区药房增强服务网络中的作用，（2）描述这些网络联系是如何形成和维持的，以及（3）比较参与增强服务网络的高绩效和低绩效社区药房之间网络联系的作用。
我们使用半结构化访谈指南采访了 40 名负责实施社区药房增强服务计划的社区药房代表。我们使用社会网络理论对主题进行了分析，以比较参与增强服务网络的 24 家高绩效和 16 家低绩效社区药房之间的网络联系。
研究发现，高绩效的药房具有更多样化的网络联系（例如，与医疗保健提供者、护理经理和公共卫生机构的关系）。高绩效的药房能够利用这些联系来支持 NC-CPESN 的实施。高绩效和低绩效的药房使用类似的策略与患者建立联系，例如动机访谈和分配员工负责接触高风险患者。高绩效的药房还使用了其他策略，例如评估患者偏好，以支持患者参与，提高患者对增强服务的接受度。
社区药房在与其他医疗保健提供者、护理管理和公共机构以及患者建立关系的能力上可能存在差异。随着需要协调护理的增强服务干预措施的扩大和推广，需要进行更多的研究来测试支持社区药房与各种利益相关者（例如医疗保健提供者、护理经理、公共卫生机构、患者）发展和维持关系的实施策略。
