Strategies to facilitate the implementation of collaborative practice agreements in chain community pharmacies
Strategies to facilitate the implementation of collaborative practice agreements in chain community pharmacies
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DOI：
10.1016/j.japh.2016.02.014
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发表时间：
2016-05-01
影响因子：
2.1
通讯作者：
McGivney, Melissa Somma
中科院分区：
文献类型：
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作者：
Bacci, Jennifer L.;Coley, Kim C.;McGivney, Melissa Somma
目的：本研究的目的是描述(1)影响合作实践协议(CPA)实施和可扩展性的关键因素和(2)连锁社区药房组织已经使用的CPA实施策略。设计：采用工作系统方法进行定性分析。背景：从2014年8月到2015年3月，在纽约、俄亥俄州、宾夕法尼亚州或西弗吉尼亚州拥有至少一个药房地点的8家连锁社区药房组织。参与者：10名临床药剂师经理和9名执业社区药剂师。干预：对研究参与者进行半结构化访谈。主要观察指标：临床药剂师经理和社区药剂师对实施和推广CPAS的关键因素和战略的认知，工具和资源可以促进CPAS的实施。结果：在SEIPS模型的个人、组织、外部环境和任务域中，七个主题成为影响CPA实施和可扩展性的关键因素，包括需要与医生和其他卫生保健提供者建立关系，优化药剂师的教育和培训，解决患者的看法，确保一致的操作，发展可持续的商业模式，倡导许可的州和联邦立法，安排时间和工作量。具体战略的例子包括利用现有的医生关系，确定药房和区域一级的冠军，以及根据处方量和临床服务分配人员。结论：确定了一些关键因素，当解决这些因素时，可以促进患者护理服务和注册会计师的实施和可扩展性。连锁社区药店应该使用特定的策略来解决与其组织需求相匹配的每个关键因素。(C)2016年美国药剂师协会。爱思唯尔公司出版，版权所有。
Objectives: The objectives of this study were to describe (1) key factors affecting the implementation and scalability of collaborative practice agreements (CPAs) and (2) CPA implementation strategies that have been used by chain community pharmacy organizations.Design: Qualitative analysis using a work system approach.Setting: Eight chain community pharmacy organizations with at least one pharmacy location in New York, Ohio, Pennsylvania, or West Virginia from August 2014 to March 2015.Participants: Ten clinical pharmacist managers and 9 practicing community pharmacists.Intervention: Semistructured interviews with study participants. Interview transcripts were thematically analyzed using the Systems Engineering Initiative for Patient Safety (SEIPS) 2.0 model of work system and patient safety.Main outcome measures: Clinical pharmacist managers' and community pharmacists' perceptions of key factors and strategies for implementing and scaling CPAs, tools, and resources that could facilitate the implementation of CPAs.Results: Seven themes emerged as key factors for the implementation and scalability of CPAs within the person, organization, external environment, and task domains of the SEIPS model, which include the need for building relationships with physicians and other health care providers, optimizing pharmacists' education and training, addressing patient perceptions, ensuring consistent operations, developing a sustainable business model, advocating for permissive state and federal legislation, and structuring time and workload. Examples of specific strategies included using existing physician relationships, identifying pharmacy-and regional-level champions, and allocating staffing based on prescription volume and clinical services.Conclusion: A number of key factors were identified that, when addressed, can facilitate the implementation and scalability of patient care services and CPAs. Chain community pharmacies should use the specific strategies for addressing each key factor that match the needs of their organization. (C) 2016 American Pharmacists Association. Published by Elsevier Inc. All rights reserved.