Scope of Practice

How to make the pharmacist part of your practice’s team

Sara Berg, MS , News Editor

When patients require further guidance outside of the office, such as with medication management or directives, a team-based approach can help practices improve outcomes. However, some often missed key partners are pharmacists and pharmacy technicians.

Strategies such as embedding a clinical pharmacist within the practice and building a collaborative relationship with a community retail pharmacist can provide what is missing to get better results for patients.  That can include help with reconciling medications, implementing protocol-driven drug therapy changes and switching medications to improve safety or lower costs.

Physicians can learn more about the inclusion of pharmacists and pharmacy technicians within their practice through a new AMA STEPS Forward™ module. This free online module explains how to determine the pharmacy needs for a physician’s health care team and how to identify the right type of support for their practice.

The module  explores working with community pharmacists and pharmacy technicians based on the practice’s needs. The education module offers six steps for practices to integrate pharmacists into the health care team.

Identify the roles pharmacists or pharmacy technicians can play. The role of a pharmacist will depend greatly on patient population, needs of the health care team, financial considerations and state legal requirements. A pharmacist may perform pre-appointment medication reconciliation for complex patients or meet with individual patients to provide medication education, address barriers to adherence and answer questions. Together, physicians and pharmacists can create protocols to optimize drug therapy to achieve clinical outcomes.

Decide how they can benefit from including a pharmacist. A practice’s resources and needs will determine if there is room to add a pharmacist to their health care team. An alternative way to include a pharmacist would be by sharing their services with another practice. The availability of an embedded pharmacist for multiple practices can keep costs down while achieving the benefit of the professional’s skills. Practices that cannot embed a pharmacist can try to collaborate with community pharmacists who many patients know and trust.

Find a pharmacist or pharmacy technician match. Finding a pharmacist or pharmacy technician that shares a practice’s vision is important. Practices can download a toolkit available as part of the module to help identify a pharmacist that best meets their needs. The module helps in the decision process by sharing skills and qualities practices should look for when embedding a pharmacist.

Prepare and set expectations for the health care team and patients. Once a pharmacist has been chosen for a practice, it is important to designate a physician champion to explain the role pharmacists and pharmacy technicians will play in enhancing patient care. If a clinical pharmacist has been chosen, it is also important to explain to the team exactly what this means by “clearly defining roles and creating decision trees to lessen confusion and conflict,” according to the module. Being prepared for the inclusion of a pharmacist, clinical pharmacist or community pharmacist is important in maintaining a team-based approach.

Determine the resources the pharmacist needs and the impact on the physician’s workflow. It isn’t necessary to completely overhaul a practice when embedding a pharmacist. A practice will need to provide the pharmacist with a private space with a desk, phone and an exam room. Any room with privacy can potentially work for a pharmacist joining the practice. It is also important to provide access to a computer as well as common equipment to further aid the pharmacist in patient care.

Measure the impact of embedding a pharmacist. There are various ways practices can measure the impact of a pharmacist or pharmacy technician. Suggestions include clinical outcomes, impact on process metrics, monitoring or documenting medication changes, improvement in medication adherence, and decreases in medical and pharmacy costs.

The module may be completed for continuing medical education credit. The AMA’s STEPS Forward collection features six new practice-improvement modules bringing the total to 49. Several come thanks to a grant from, and in collaboration with, the Transforming Clinical Practices Initiative.

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