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    New patient-care opportunities begin with a "blueprint"

    The integration of pharmacists’ services with standard delivery of patient-care services doesn’t happen in a vacuum. And it doesn’t happen overnight. It takes time, commitment, vision, networking, development of a “value proposition,” and an implementation plan.

    Melissa McGivneyMelissa Somma McGivneySee also: Health-system pharmacists empower the team

    In addition, failure is not something to fear, because the pharmacist has learned something from the experience and can try again, said Melissa Somma McGivney, PharmD, FCCP, FAPhA, associate professor, Pharmacy and Therapeutics, and associate dean for Community Partnerships at the University of Pittsburgh School of Pharmacy.

    “Ever since I became a pharmacist, I have been exploring opportunities that build on our basic mission of taking care of people in the community,” said McGivney, during a presentation at the 2016 American Pharmacists Association (APhA) annual meeting in Baltimore.

    McGivney based her presentation on insights and conclusions derived from a 2014 APhA focus group that was composed of pharmacy leaders who had successfully implemented pharmacist-integrated care models.

    Their success stories, she said, “went beyond the traditional pharmacy practice models. They were sustainable through actual payment for care.”

    See also: Pharmacists' new role in team-based care

    The panel

    The 14 participants, who represented a variety of outpatient settings, convened at APhA offices in Washington, D.C., “to examine the common themes of success so we could organize the principles and make them accessible to other practices.” 

    The group’s facilitators were McGivney; Anne Burns, BS Pharm, vice president, Professional Affairs, APhA; Brian Wall, PharmD, senior manager, Governance, APhA; and Sarah Drombowski, PharmD, BCACP, from Lake Erie College of Osteopathic Medicine.

    “Our participating pharmacists were fascinating. The focus group collected their individual stories describing how their vision successfully implemented, replicated, and created a sustained pharmacist-integrated patient care model,” McGivney said.

    A “blueprint” for success

    Table 1

    The focus group reported its findings in the document “Nine blueprint elements for building a successful business case,” which offers structure and guidelines for pharmacists who want to move forward in their professional practice.

    The blueprint begins with “understanding your own practice model; what is the standard protocol patients are familiar with and expect from a pharmacist? How does your model work?” This creates a solid foundation from which to move forward.

    The standard practice model of dentists and doctors, for example, is the same no matter where a patient goes.

    “Teeth are always examined starting with the same tooth and working around the mouth, and a physician always begins a physical exam from head to toe,” McGivney said. “In pharmacy, people expect to have their prescription filled and to talk to the pharmacist about their medicines.”

    By advancing this practice, McGivney said, a pharmacist can move into doing more assessments.

    For example, “Was the patient recently discharged from the hospital, and is this medicine for follow-up care? Are there medicines being prescribed by a different doctor who is unaware the patient has been hospitalized, which may pose risk?”

    Patients’ lifestyles are also critical.

    “Are there reasons they may not take it [the medication]? Can they afford it? Does it taste bad? Can they use the device
    required? And do they have transportation for a refill?”

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