Establishing Clinical Pharmacy Services With Prescribing Privileges in a Federally Qualified Health Center Primary Care Clinic

2017 ◽  
Vol 31 (5) ◽  
pp. 434-440 ◽  
Author(s):  
Jeany K. Jun
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Clinical Pharmacy ◽  
Primary Care Clinic ◽  
Pharmacy Services ◽  
Care Clinic ◽  
Clinical Pharmacy Services ◽  
Clinical Pharmacists ◽  
Federally Qualified Health Center ◽  
Ambulatory Patients

Objectives: To describe the process and cost of establishing clinical pharmacy services with prescribing privileges in a federally qualified health center (FQHC) primary care clinic. Setting: The primary care clinic was located in a low-income area of Southern California and served patients with Medicaid and Medicare. The primary care clinic had preventive medicine and family medicine physicians, a family medicine residency program, behavioral health services, and a registered dietician. Practice Innovation: New clinical pharmacy services were established at this FQHC primary care clinic. The medication assistance program was a stepping stone to establish rapport with the physicians. Credentialing and privileging was implemented for clinical pharmacists. An open protocol collaborative practice agreement was developed to allow clinical pharmacists to manage ambulatory patients. Results: From August 2014 to June 2015, the clinical pharmacist interacted with 392 patients and spent 336 hours educating patients and providing disease state management. The pharmacist also provided consults to residents and providers. Diabetic patients made up 76% of all clinical pharmacy encounters. There were 86 face-to-face clinical pharmacy appointments with the pharmacist. The average time for clinical pharmacy appointments was 77 minutes. Conclusion: By describing ways to develop rapport with providers, how to credential and privilege pharmacists, and explain resources and costs of setting up a service, the hope is that more clinical pharmacists will be able to incorporate into independent or FQHC primary care clinics for improved management of ambulatory patients.

Ambulatory Care Pharmacy Services: Has the Agenda Changed?

2000 ◽  
Vol 34 (6) ◽  
pp. 772-787 ◽  
Author(s):  
Barry L Carter ◽  
Dennis K Helling
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Managed Care ◽  
Ambulatory Care ◽  
Clinical Pharmacy ◽  
Relevant Literature ◽  
Pharmacy Services ◽  
Clinical Pharmacy Services ◽  
Care Family ◽  
Veterans Affairs Medical Centers

OBJECTIVE: To provide an extensive review of ambulatory care clinical pharmacy services and evaluate the services and research data in the field. DATA SOURCES: MEDLINE was searched from January 1992 through July 1999. Search terms included pharmacy, clinical pharmacy, and pharmaceutical care, cross-referenced with ambulatory care, primary care, family medicine, and managed care. STUDY SELECTION: Relevant peer-reviewed studies and reports since our previous article in 1992 were selected and described. Literature prior to 1992 was briefly reviewed. DATA SYNTHESIS: The relevant literature was reviewed and some examples from the authors' institutions are provided. Much research has continued to be published documenting the value of clinical pharmacy services in ambulatory care, including in community pharmacy, anticoagulation services, family medicine, primary care clinics, Veterans Affairs Medical Centers, and managed care. However, these innovative services are underrepresented in the community at large. The vast majority of the public does not have access to these types of services. CONCLUSIONS: There will be continued and dramatic expansion of ambulatory care pharmacy services in the new decade beginning in the year 2000. It will be critical that standards of practice be very high. We believe there is a critical need for visible demonstration projects and large multicenter research projects that demonstrate the value of these services.

Influence of Environmental Design on Team Interactions Across Three Family Medicine Clinics: Perceptions of Communication, Efficiency, and Privacy

2019 ◽  
Vol 12 (4) ◽  
pp. 159-173 ◽  
Author(s):  
Zaher Karp ◽  
Sandra Kamnetz ◽  
Natalie Wietfeldt ◽  
Christine Sinsky ◽  
Todd Molfenter ◽  
...  
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Focus Groups ◽  
Primary Care Clinic ◽  
Environmental Design ◽  
Communication Styles ◽  
Interaction Patterns ◽  
Patient Contact ◽  
Care Clinic ◽  
Communication Efficiency

Objective: In this study, we explored how two different primary care clinic physical layouts (onstage/offstage and pod-based [PB] designs) influenced pre- and postvisit team experiences and perceptions. Background: Protocols encourage healthcare team communication before and after primary care visits to support better patient care. Physical clinic environments may influence these behaviors, but limited research has been performed. Method: We conducted observations, three interviews with clinic managers, and six focus groups with 21 providers and staff at three family medicine teaching clinics. Observational data were captured through field notes and spaghetti diagrams. Interviews and focus groups were recorded, transcribed, and analyzed using a grounded theory-based approach to understand how aspects of the clinic environment affected communication, efficiency, and privacy. Results: Variations in communication styles and trade-offs between patient contact and privacy emerged as differences. In the onstage/offstage design, colocated teams had increased verbal communication but perceived being isolated from other clinic teams. In contrast, teams in PB clinics communicated with other clinic teams but had more informal patient contact within care-team stations that imposed privacy risk. Conclusions: Primary care clinic design appears to alter provider–team and patient–provider communication and flow. Organizations should consider aligning environmental design with desired interaction patterns when building new primary care clinics.

Primary care pharmacy technicians: Effect on pharmacist workload and patient access to clinical pharmacy services

2020 ◽  
Vol 77 (Supplement_4) ◽  
pp. S93-S99
Author(s):  
Dmitry Walker ◽  
Katherine J Hartkopf ◽  
David R Hager
Keyword(s):  
Primary Care ◽  
Clinical Pharmacy ◽  
Relative Increase ◽  
Relative Reduction ◽  
Pharmacy Services ◽  
Patient Access ◽  
Pharmacy Technician ◽  
Work Sampling ◽  
Clinical Pharmacy Services ◽  
Pharmacy Technicians

Abstract Purpose Improve patient access to clinical pharmacy services and decrease pharmacist technical task workload in primary care (PC) clinics. Summary Due to concerns with the amount of technical tasks performed by University of Wisconsin Health PC clinical pharmacists negatively impacting their capacity to care for patients and perform clinical tasks, the pharmacy department piloted a new PC pharmacy technician role that involved completion of technical tasks previously performed by PC pharmacists. PC pharmacist daily technical and clinical activities were identified through shadowing and quantified by a 4-week period of work sampling. A PC pharmacist workgroup determined the technical tasks that would be appropriate for a pharmacy technician to complete and developed the technician workflows. A PC pharmacy technician was implemented during a 3-week pilot, when pharmacist daily technical and clinical activities were quantified through work sampling. Following implementation, a 52.7% (P < 0.001) relative reduction and a 10.2% (P < 0.001) relative increase in pharmacist technical and clinical activities, respectively, were identified. Additionally, a 10% relative increase from the previous 3-month average was observed in the PC pharmacist rolling patient panel size during the pilot period, correlating with an increase of patient access to pharmacist clinical services. Conclusion Up to 17% of PC pharmacist daily activities are technical tasks. Leveraging pharmacy technicians to support pharmacists with completion of these tasks increases patient access to clinical pharmacy services but requires additional staff resources.

scholarly journals COVID-19 preparedness: Clinical pharmacy services remote staffing in a quaternary, level I trauma and comprehensive stroke center

2020 ◽  
Vol 77 (15) ◽  
pp. 1250-1256
Author(s):  
Sara Kjerengtroen ◽  
Samuel M Wilde ◽  
Gabriel V Fontaine ◽  
Kevin M Forbush ◽  
Charles M Van Gorder ◽  
...  
Keyword(s):  
Clinical Pharmacy ◽  
Medical Center ◽  
Remote Access ◽  
World Health ◽  
Pharmacy Services ◽  
Optimal Care ◽  
Clinical Pharmacy Services ◽  
Clinical Pharmacists ◽  
The World ◽  
Health Organization

Abstract Purpose The rapid spread of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has strained the resources of healthcare systems around the world. In accordance with recommendations from the World Health Organization, Centers for Disease Control and Prevention, and US Department of Defense, Intermountain Medical Center (IMED) in Murray, UT, has developed a plan to provide remote clinical pharmacy services to protect the health of pharmacy caregivers while maintaining appropriate clinical pharmacy coverage to optimally care for patients. Summary The utilization of telemedicine technology permits clinical pharmacists to readily communicate with nurses, physicians, other caregivers, and patients. We have identified strategies to allow clinical pharmacists to continue to participate in daily rounds, provide consultations under collaborative practice agreements, verify medication orders, collect medication histories, provide antimicrobial stewardship, and deliver medication education to patients from off-site locations. The pharmacy department at IMED proactively tested telemedicine technologies, defined the roles of clinical pharmacists, and identified communication strategies prior to a rapid rise in COVID-19 cases in the state of Utah. Conclusion The proactive measures described can help ensure that pharmacy caregivers have appropriate remote access and are capable of confidently using the resources. These steps allow for optimal care of hospitalized patients and promote social distancing, which may have the added benefit of decreasing the spread of SARS-CoV-2 among patients and caregivers.

Effect of clinical pharmacists on drug prescribing in a primary-care clinic

1987 ◽  
Vol 44 (3) ◽  
pp. 525-529 ◽  
Author(s):  
Andy Stergachis ◽  
Mary Fors ◽  
Edward H. Wagner ◽  
D. Dewayne Sims ◽  
Peter Penna
Keyword(s):  
Primary Care ◽  
Primary Care Clinic ◽  
Drug Prescribing ◽  
Care Clinic ◽  
Clinical Pharmacists

scholarly journals The ties that bind – Learning groups in family medicine residency

2021 ◽  
Vol 6 (1) ◽  
pp. 125-127
Author(s):  
Chooi Peng Ong ◽  
Cindy Shiqi Zhu ◽  
Desmond SL Ong ◽  
Ying Pin Toh
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Health System ◽  
Faculty Member ◽  
Primary Care Clinic ◽  
Care Clinic ◽  
Learning Groups ◽  
Family Medicine Residency ◽  
National University ◽  
Specific Competency

Family medicine training encompasses the need to develop a diverse skillset and the ability to practice in different settings. During three years of training, family medicine residents from National University Health System (NUHS) rapidly transit through many hospital rotations with varying specialty-specific competency requirements. Throughout this period, each resident is rostered to run a half-day primary care clinic on the same day each week and is assigned a dedicated faculty member to supervise him during the session. Each faculty member is assigned up to four to six residents for the half-day sessions every week. There is a need to contextualise what is learnt in hospital to primary care, and to effectively integrate knowledge across disciplines. We describe here a tool that the NUHS family medicine residency has used to bring together faculty and residents of varying seniorities and locations for discussion, reflection, and growth.

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