Department of Pharmacy, Nationwide Children's Hospital, Columbus, OH.
Cedarville University School of Pharmacy, Cedarville, OH.
Am J Health Syst Pharm. 2020 Mar 5;77(6):466-473. doi: 10.1093/ajhp/zxz340.
In a rapidly changing healthcare landscape, pharmacy leaders must be agile and innovative to ensure that patients receive the highest-quality care. Here we describe the benefits of using a structured approach to pediatric pharmacy practice advancement guided by strategic planning and quality improvement principles.
Although there are many profound differences between pediatric and adult pharmacy management practices, many similarities also exist. Small- and large-scale change is most commonly guided by quality improvement methodology at Nationwide Children's Hospital. Using this framework, the pharmacy practice model at Nationwide Children's Hospital was reenvisioned to facilitate best patient outcomes and advance the role of pharmacists in the care of pediatric patients. Through these efforts, the percentage of inpatient hospital services with a pharmacist embedded into the care team increased from 67% to 90%, the number of pharmacists providing direct inpatient care increased from 27 to 50, and the number of ambulatory clinical pharmacists more than tripled, from 3 to 10. Enhanced clinical pharmacy services were developed to provide consistent care on weekends and holidays while striving to reach zero patient harm. Involvement of pharmacists and pharmacy technicians, alignment with the health system's mission, and internal development of pharmacists through focused training programs were vital to successful practice advancement.
Significant practice model advancement in a pediatric healthcare system is achieved by using the organization's common language for change, involving frontline staff in creating the vision, and leadership steadfastly committing to realize the vision.
在快速变化的医疗保健环境中,药剂科领导者必须具备敏捷性和创新性,以确保患者获得最高质量的护理。在这里,我们描述了使用结构化方法推进儿科药学实践的好处,该方法由战略规划和质量改进原则指导。
尽管儿科和成人药学管理实践之间存在许多明显的差异,但也存在许多相似之处。小范围和大范围的变化通常由全国儿童医院的质量改进方法指导。使用这个框架,全国儿童医院的药房实践模式被重新构想,以促进最佳患者结果并推进药剂师在儿科患者护理中的作用。通过这些努力,有药剂师嵌入护理团队的住院患者服务比例从 67%增加到 90%,提供直接住院护理的药剂师人数从 27 人增加到 50 人,而门诊临床药剂师的人数增加了两倍多,从 3 人增加到 10 人。增强了临床药学服务,以在周末和节假日提供一致的护理,同时努力实现零患者伤害。药剂师和药剂技术员的参与、与医疗系统使命的一致性以及通过集中培训计划对药剂师进行内部发展对于成功推进实践至关重要。
通过使用组织的变革通用语言、让一线员工参与创建愿景以及领导层坚定地致力于实现愿景,在儿科医疗保健系统中实现了显著的实践模式进步。