Pharmacy Benefits Management, Department of Veterans Affairs, Washington, DC.
Advanced Heart Failure/Cardiac Transplantation Clinic, Salisbury VA Healthcare System (HCS), Salisbury, NC.
Am J Health Syst Pharm. 2019 Aug 1;76(16):1248-1253. doi: 10.1093/ajhp/zxz126.
Results of a study to determine the proportion of anticoagulation clinic workload that could be performed by clinical pharmacy technicians (CPTs) and the potential impact on operational efficiency of pharmacist-managed anticoagulation clinics (ACCs) are reported.
In a quality improvement project involving 11 Veterans Affairs (VA) medical centers, investigators conducted a 3-day time study in pharmacist-managed ACCs followed by scoring of task appropriateness for CPTs via the RAND/UCLA appropriateness method by the VA Anticoagulation Subject Matter Expert (SME) Workgroup. The primary outcome was the percentage of tasks deemed appropriate for a CPT to perform.
The Anticoagulation SME Workgroup determined that a wide variety of mainly administrative ACC tasks could be completed by a CPT. At the 11 VA ACCs, an average of 53.4% (range, 39.9-76.1%) of tasks being performed by pharmacists were deemed appropriate for CPTs. The average percentage of total clinic time associated with performing tasks appropriate for a CPT equated to an estimated 1,111 hours per year. Shifting that portion of the annual work hours to a CPT could potentially result in cost avoidance of $55,302.
At the ACCs evaluated, a significant proportion of tasks (53.4% on average) may be appropriate to assign to CPTs to improve the operational efficiency of these clinics. This finding supports development of business plans for the addition of CPTs in ACCs along with elements to inform crafting of an effective template for ACC structure, including clearly defined CPT roles.
本研究旨在确定临床药师技术人员（CPTs）可完成的抗凝治疗门诊工作量的比例，以及药师管理的抗凝治疗门诊（ACCs）的运营效率的潜在影响。
在涉及 11 个退伍军人事务（VA）医疗中心的质量改进项目中，研究人员在药师管理的 ACC 中进行了为期 3 天的时间研究，随后由 VA 抗凝主题专家（SME）工作组通过 RAND/UCLA 适宜性方法对任务的适宜性进行 CPT 评分。主要结果是认为 CPT 可执行的任务比例。
抗凝 SME 工作组确定，CPT 可以完成各种各样的主要是行政 ACC 任务。在 11 个 VA ACC 中，药师执行的任务中，有 53.4%（范围为 39.9%-76.1%）被认为适合 CPT 完成。与执行适合 CPT 的任务相关的平均总诊所时间百分比相当于每年约 1,111 小时。将该部分年度工作时间转移给 CPT，可能会避免 55,302 美元的成本。
在评估的 ACC 中，相当一部分任务（平均 53.4%）可能适合分配给 CPT，以提高这些诊所的运营效率。这一发现支持在 ACC 中增加 CPT 的业务计划的制定，并为 ACC 结构的模板制定提供要素，包括明确的 CPT 角色。
