J Am Pharm Assoc (2003). 2019 Nov-Dec;59(6):880-885. doi: 10.1016/j.japh.2019.07.009. Epub 2019 Aug 29.
To explore initial outcomes of the Optimizing Care Model's impact on patient care through technician product verification after the first 3 months of implementation, including the model's impact on pharmacist workday composition, rates of patient care services delivered, and rates of product selection errors not identified during final product verification.
Fourteen chain and independent community pharmacies licensed and located in Tennessee.
The Optimizing Care Model is an innovative approach to community pharmacy practice aiming to foster a new patient-centered care delivery model that expands clinical service delivery through task delegation to pharmacist extenders.
A quasiexperimental 1-group pretest-posttest design was used. Study sites self-reported data from 3 months before and 3 months after implementation of the intervention.
Overall pharmacist time spent delivering patient care services increased significantly on implementation of the Optimizing Care Model (25% vs. 43%; P < 0.001), and time spent performing dispensing-related activities decreased significantly (63% vs. 37%; P = 0.02). There was a total increase in quantity of clinical services delivered to patients from baseline, but data from initial study outcomes did not reach statistical significance. At least 1 new clinical service provided under a collaborative practice agreement had been implemented by all 14 sites (100%) as of Spring 2018. Total undetected error rates were significantly less in the Optimizing Care Model phase compared to the traditional model (0.063% vs. 0.085%; P < 0.001).
Initial results of the Optimizing Care Model demonstrate improved patient care through increased clinical service delivery versus the traditional model. Undetected error detection rates were low in both models, but lower in the Optimizing Care Model. The Optimizing Care Model may represent a novel approach to improving care for patients while creating efficiencies through a staff delegation model, providing pharmacists the opportunity to further evolve their practice and advance clinical care for patients.
在实施后的头 3 个月内,通过技术人员产品验证,探索优化护理模式对患者护理的初步结果,包括该模式对药剂师工作日构成、提供的患者护理服务率以及最终产品验证过程中未发现的产品选择错误率的影响。
田纳西州的 14 家连锁和独立社区药房。
优化护理模式是一种创新的社区药房实践方法,旨在通过任务委托给药剂师扩展人员来培养新的以患者为中心的护理提供模式。
采用准实验 1 组前后测试设计。研究地点在干预实施前后 3 个月内自我报告数据。
实施优化护理模式后,药剂师提供患者护理服务的总时间显著增加(25%对 43%;P < 0.001),而与配药相关的活动时间显著减少(63%对 37%;P = 0.02)。与基线相比,患者接受的临床服务数量总体增加,但初始研究结果的数据未达到统计学意义。截至 2018 年春季,所有 14 个地点都实施了至少一项新的根据合作实践协议提供的临床服务(100%)。与传统模式相比,优化护理模式阶段的总未检测错误率明显较低(0.063%对 0.085%;P < 0.001)。
优化护理模式的初步结果表明,与传统模式相比,通过增加临床服务提供来改善患者护理。两种模式的未检测错误检测率都较低,但优化护理模式的检测率较低。优化护理模式可能代表一种通过人员委托模型提高患者护理效率的新方法,为药剂师提供了进一步发展实践和为患者提供临床护理的机会。