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影响的衡量标准:实体器官移植药学实践质量指标的建议。

The measure of impact: Proposal of quality metrics for solid organ transplant pharmacy practice.

机构信息

Department of Pharmacy, University of North Carolina Medical Center, Chapel Hill, North Carolina, USA.

Department of Transplant, Yale New Haven Hospital, New Haven, Connecticut, USA.

出版信息

Am J Transplant. 2024 Feb;24(2):164-176. doi: 10.1016/j.ajt.2023.10.027. Epub 2023 Nov 2.

Abstract

As healthcare continues its transition toward value-based care, it is increasingly important for transplant pharmacists to demonstrate their impact on patient care, health-related outcomes, and healthcare costs. Evidence-based quality and performance metrics are recognized as crucial tools for measuring the value of service. Yet, there is a lack of well-developed and agreed-upon specific metrics for many clinical pharmacy specialties, including solid organ transplantation. To address this need, a panel of transplant pharmacy specialists conducted a detailed literature review and engaged in several panel discussions to identify quality metrics to be considered for assessing the value of clinical pharmacy services provided to solid organ transplant recipients and living donors. The proposed metrics are based on the Donabedian model and are categorized to coincide with the typical phases of transplant care. The measures focus on key issues that arise in transplant recipients related to medication therapy, including adverse drug events, nonadherence, and clinical outcomes attributable to medication therapy management. This article proposes a comprehensive set of measures, any number of which transplant pharmacists can adopt and measure over time to objectively gauge the value of services they are providing to transplant recipients, the transplant center, and the overall healthcare system.

摘要

随着医疗保健向基于价值的护理持续转变,移植药剂师越来越需要展示他们对患者护理、健康相关结果和医疗成本的影响。循证质量和绩效指标被认为是衡量服务价值的重要工具。然而,许多临床药学专业,包括实体器官移植,缺乏完善和一致的特定指标。为了满足这一需求,一组移植药房专家进行了详细的文献回顾,并进行了多次小组讨论,以确定用于评估为实体器官移植受者和活体供者提供的临床药学服务价值的质量指标。拟议的指标基于 Donabedian 模型,并根据移植护理的典型阶段进行分类。这些措施侧重于与药物治疗相关的移植受者中出现的关键问题,包括药物不良事件、不依从和药物治疗管理可归因的临床结果。本文提出了一整套措施,移植药剂师可以随时采用其中的任何一项或多项措施,客观地衡量他们为移植受者、移植中心和整个医疗保健系统提供服务的价值。

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