Print This Article | 
Share this Page |
Creating a Vision for the Health-System Pharmacy's Practice ModelBy Stephen J. Allen, MS, FASHP Executive Vice President and CEO ASHP Foundation  Defining a Model for Change The model that defines how pharmacists practice and the value they bring to organizations is changing. The changes are driven by higher educational standards, maturing technology, and recognition of the inherent value of a team approach to healthcare. Pharmacists are no longer seen as just dispensers of medication. Now they are viewed as professionals that lead and define safe and effective medication use. The American Society of Health-System Pharmacists (ASHP), in conjunction with the ASHP Research and Education Foundation, established the Pharmacy Practice Model Initiative to create consensus and support for a patient-focused hospital and health-system pharmacy practice model. In 2007, ASHP outlined a long-range vision for pharmacy that includes the role of multidisciplinary teams, technology, the importance of residency training, and the expanded use of pharmacy technicians. In order for a future practice model to be effective, it must reflect the experience and expertise of a broad cross-section of the profession. Creating this template for change is long overdue. In a recent survey, half of pharmacy director respondents indicated that they were planning reductions in how much direct involvement pharmacists had in routine dispensing. As these changes occur, pharmacists are seeking guidance on best practices. How can they carry out process change that will enhance safety and efficiency? One thing is certain — making effective use of technology and pharmacy talent and expertise is essential. In the years to come, hospitals and health systems will be challenged by a flood of aging baby boomers that are well informed and expect high standards of care. At the same time, care is becoming more complex, elevating risks for patients and presenting caregivers with more challenging drug therapy management and medical care issues. The Pharmacy Practice Model Initiative focuses on key elements of medication-use policy, including product selection, how drugs are distributed to patients and oversight of drug use. This progression from the dispensing role toward a leadership role in patient care is encouraged not just by the profession, but by hospital and health system executives. Increasingly they recognize that pharmacists are an underutilized resource. Maturing Technology The days when pharmacists were secluded in their departments is ending. Healthcare information technology is increasing their capacity to organize information and automate manual processes. The 2008 ASHP annual survey of hospital and health system pharmacists reveals just how much things have changed for the profession. Over a five-year period:  Deployment of bar code-assisted medication administration increased from just 2% to 25%. The use of smart infusion pumps for medication dispensing doubled. The usefulness of technology is improving. For example, automated dispensing cabinets help ensure that a pharmacist has reviewed medication orders prior to the drug being accessed by nurses. As a result, the medication policy role of the pharmacist is expanding. In many organizations we're seeing enhanced roles for the pharmacist within multidisciplinary teams. And it is on these teams that the pharmacist leadership role is vital. When organizations employ technology that affects the medication use process, pharmacists will find themselves around the table with health system executives, physicians, nurses and a host of other caregivers and specialists. The pharmacist must be savvy, knowledgeable and prepared to participate and lead in the selection, implementation and ongoing content management of clinical information systems hospital-wide. Tailoring Practice to Reality Each pharmacy must create flexible templates that support the optimal use and deployment of resources — including pharmacists and technicians, and advanced technology and automation. One size will clearly not fit all professionals or hospitals. As a former director of pharmacy, I've practiced in pediatric specialty hospitals, a large teaching hospital and a community hospital. In each institution, the pharmacist practice models didn't necessarily match up. Some hospitals focus pharmacist activities on drug distribution exclusively. Others have taken a more progressive approach with a clinically-centered model that places the pharmacist in high-risk medication management areas such as critical care units and oncology. Some organizations have managed to effectively integrate the two approaches. That is the challenge before us now. How do we achieve that optimal balance? How do we help professionals in the drug-distribution-centered model to move to a more integrated form of practice? The Road Ahead A successful transition will require individuals who are able to meet the challenge of handling day-to-day patient care medication management responsibilities while formulating and driving change. Pharmacists can't drive change alone. The Pharmacy Practice Model Initiative will define the vision and offer specific goals and objectives needed to create real change. It is imperative that pharmacists become direct patient care providers rather than just dispensers of drugs. Effective deployment of technology and technicians will enable pharmacists to exert a greatly expanded influence on quality, safety and cost effectiveness. Pharmacists must directly contribute to achieving quality patient medication outcomes that are in line with evidence-based medication. Stephen J. Allen is the Executive Vice President and Chief Executive Officer of the American Society of Health-System Pharmacists (ASHP) Research and Education Foundation. He has more than 25 years of clinical, administrative and teaching experience. Allen served as Director of Pharmacy Services at Georgetown University Hospital and as Director of Pharmacy, Nutrition, and Central Supply at the Children's National Medical Center. He earned his Bachelor's degree in pharmacy from the University of Rhode Island and a Master's degree in hospital pharmacy from the University of Maryland. McKesson Corporation is a Leadership Sponsor of the ASHP Pharmacy Practice Model Initiative.
 |
|
|
||||||||||||||||||||||||||||||||||||||||
       |
||
  
|
||
