William Middendorf Alex, Hunt Aaron, Vanden Hull Alexa, Van Gilder Deidra, Miller Erin, Pinto Sharrel
South Dakota State University College of Pharmacy and Allied Health Professions.
Utah State University College of Education and Human Services.
Innov Pharm. 2024 Aug 21;15(3). doi: 10.24926/iip.v15i3.5772. eCollection 2024.
Community pharmacists are often the most accessible member of the healthcare team to many patients and can play a key role in managing their chronic conditions, such as diabetes or heart disease, through enhanced pharmacy services. Despite their accessibility, pharmacy services are often underutilized due, in part, to a lack of adequate reimbursement models that comprehensively encapsulate all elements of those pharmacy services. While routine documentation of services does collect certain qualitative data, they do not always indicate the nuance of the full scope of services with resulting robust impact and value of those services for the patient and healthcare system. To develop and pilot an online reporting tool for pharmacist documentation of high impact patient intervention "stories" that includes the nuances of care provision processes in outpatient pharmacy settings that promote positive outcomes. An online Patient Stories Reporting Tool (PRST) was developed to allow outpatient pharmacists to document details on distinct direct patient care encounters, or "stories", that they felt showcased their value. Documentation through PSRT included limited quantitative data and qualitative data with a focus on a free response narrative for the "story". In a pilot, the PSRT was distributed to 18 pharmacists across 16 practice sites from one partnering pharmacy organization. Qualitative data, the focus of the included analysis, was collected, assessed by project team members, and organized by intervention types. Forty-seven stories involving 17 pharmacists across 13 practice sites from August 2021 to March 2023 were reported. Three types of key intervention stories were identified including General Patient Education (7 stories), Medication Optimization (20 stories), and Cost Reduction (20 stories). Given the nature and scope of this initial pilot, one story for each of the three most prevalent intervention types was identified as exemplifying the types of stories the tool can collect and are subsequently discussed in detail. The three selected stories help to characterize the services pharmacists provide, the critical components of pharmacist-patient interactions, and the value of sharing these stories utilizing tools such as the PSRT. Through these stories, the PSRT also begins to record the nuances of pharmacist interventions and the impact they can make in a patient's healthcare journey. Potential applications of the tool are multivarious including supporting improvements in the perception of pharmacists' roles on the healthcare team and justifying expansion of reimbursement models.
社区药剂师通常是许多患者最容易接触到的医疗团队成员,通过加强药学服务,他们可以在管理患者的慢性病(如糖尿病或心脏病)方面发挥关键作用。尽管药剂师容易接触,但药学服务的利用率往往较低,部分原因是缺乏全面涵盖这些药学服务所有要素的适当报销模式。虽然服务的常规记录确实收集了某些定性数据,但它们并不总是能体现服务全貌的细微差别,以及这些服务对患者和医疗系统所产生的强大影响和价值。为了开发并试点一个在线报告工具,用于药剂师记录具有高影响力的患者干预“案例”,该工具要涵盖门诊药房环境中促进积极结果的护理提供过程的细微差别。开发了一个在线患者案例报告工具(PRST),以允许门诊药剂师记录他们认为能展示其价值的不同直接患者护理接触或“案例”的详细信息。通过PSRT进行的记录包括有限的定量数据和定性数据,重点是“案例”的自由回应叙述。在一次试点中,PSRT被分发给来自一个合作药房组织的16个执业地点的18名药剂师。定性数据是纳入分析的重点,由项目团队成员收集、评估,并按干预类型进行整理。报告了2021年8月至2023年3月期间来自13个执业地点的17名药剂师的47个案例。确定了三种关键干预案例类型,包括一般患者教育(7个案例)、药物优化(20个案例)和成本降低(20个案例)。鉴于这个初始试点的性质和范围,为三种最普遍的干预类型各确定了一个案例,作为该工具可以收集的案例类型的示例,并随后进行详细讨论。所选的这三个案例有助于描述药剂师提供的服务、药剂师与患者互动的关键组成部分,以及利用PSRT等工具分享这些案例的价值。通过这些案例,PSRT也开始记录药剂师干预的细微差别以及它们在患者医疗过程中所能产生的影响。该工具的潜在应用多种多样,包括支持改善对药剂师在医疗团队中角色的认知,以及为报销模式的扩展提供依据。