I NTERDISCIPLINARY PATIENT CARE PHCL 472 Nouf M Aloudah Clinical Pharmacy lecture King Saud University

INTERDISCIPLINARY PATIENT CAREPHCL 472

Nouf M Aloudah

Clinical Pharmacy lecture

King Saud University

Today Quiz!

INTERDISCIPLINARY TEAM/ PATIENT CARE

INTERDISCIPLINARY PATIENT CARE

Introduction Why some pharmacists have been more

successful than others in moving to a new practice model?

Key difference is that they didn’t get it alone, they established solid relationships with other health care professionals who care for the same patients they do and developed clear lines of communication with other practitioners


Introduction Pharmaceutical care can’t be practiced in

vacuum! It is cooperative partnership between the

pharmacist, other healthcare professionals, and the patient

Workable patient care program established after taking time to uncover issues important to local provides and talked with them about targeted solutions

Others picked patient care program that was popular with other pharmacists but failed to discuss their choices with local provides (e prescription?, automation?)


Introduction IPC helps you to launch programs that meets

the needs of the pharmacist, physician and the patient


IPC: A Team Approach Direct and ongoing relationship between the

pharmacist and one or more health care providers who work together to improve the health of a particular patient

IPC requires to thoroughly understand each other’s unique knowledge and skills and to recognize the limits of one’s own discipline in solving a patient’s health problems


IPC: A Team Approach IPC is not “collaborative practice

agreement” or “practicing under protocol” Others involved cooperation but IPC is

broader in its scope of responsibilities Collaborative practice involved a written,

negotiated agreement in which both physician and pharmacist describe their responsibilities

IPC involves a true give and take relationship in which you use independent judgment and tailor your care to the overall needs of the patient


Collaborative practice protocol


IPC: A Team Approach IPC and “comprehensive case

management” Physician maintain overall responsibility for

the patient but the pharmacist is responsible for patient education, medication adherence, and many aspects of patient monitoring


IPC: A Team Approach Collaborative practice agreement and

practicing under control both interdisciplinary ?!

YES but both approaches restrict pharmacist’s activities to narrowly specified service


The Case Of IPC The need is urgent ! 100,000 people die in American hospitals

annually from preventable medical errors (a leading cause of mortality in the united state)

$17-29 billion is the total cost of preventable medical errors

Patient safety with the upcoming innovative expensive new drugs, increase in the number of prescription generated and dispensed

Progressively aging population, extended life expectancy and increase in the number and duration of chronic health conditions


The Case Of IPC Examples of formally sanctioned IPC

arrangements to address specific health problems Nutrition support Diabetes Pain management


The Case Of IPC Department of Veteran’s Affairs (VA) in which

pharmacist and physician establish care plans together and interdisciplinary patient rounds


The Case Of IPC Other health care systems also have

ambulatory clinics in which pharmacists are directly involved with patient management, positive results that have been documented from pharmacists’ efforts are an increase in office appointment compliance rates, increase medication adherence rates, increase patient satisfaction, decrease demand for physician to spend time on routine problems, improved continuity of care, decreased rates of adverse drug events, decreased demands for emergency departments or hospital care and improved cost to benefit rations for the institution


The Case Of IPC A study: pharmacist scheduled appointments

every 6-8 weeks to educate and monitor patients with hypertension, diabetes, asthma, and elevated cholesterol and they communicated with physician on patients’ progress

These patients mean total health care costs declined by $293 per person compared with patients who received standard care


The Case Of IPC Program developed in an independent pharmacy

in rural eastern Iowa, pharmacist received special training, followed written protocols, and sent documentation to physician with whom they collaborated to immunize patients at high risk for influenza Patients had to be 60 years or old Received Rx for chronic cardiovascular, respiratory, or

metabolic conditions From October 15 to December 6 1996,

pharmacists administered 343 doses of vaccine No adverse events were reported Go and read other studies !


June Felice Johnson’s experience with IPCSo nice go and read it, it will help to get depth

understanding of what we are talking about


Basic Ingredients For IPC What knowledge, skills, and attitude must be

in place to be broadly applied within a pharmaceutical care practice?


Basic Ingredients For IPC First: genuinely care about your

patients! You must get to know them and understand

their unique background The better you are at this the more accepting

patients will be about your involvement and the more likely that your interventions will be individually tailored rather than “one size fits all” !

Do you know my patient?!?!


Basic Ingredients For IPC Second: you must have solid grounding

and depth of knowledge in content disciplines that pertain to detecting and solving drug therapy problems

Services provided from drug interaction soft wares and pocket size therapeutic reference your services will not be needed!

Your knowledge and willingness to keep learning will solidify your value to the team and make your input indispensible


Basic Ingredients For IPC Third: teamwork requires a high level of

interpersonal skills Listen actively, negotiate, act with

assertiveness, communicate clearly in writing, and maintain cooperative outlook


Basic Ingredients For IPC Finally: you must be committed to

making certain changes and to sustaining them long enough for the practice to change as a whole

Don’t assume that others will automatically trust pharmacist, you must patiently and persistently spend significant time establishing and maintain relationships with other providers


Processes And Outcomes Establishing a patient focused practice takes

time But you are interested in knowing the

results? Collect information on the processes you

used to provide care No of intervention made Percent of recommendations accepted

After that monitor true patient outcomes


Processes And Outcomes Typical outcomes ECHO

Economics Direct, indirect, intangible costs

Clinical Medical results ex HG A1c

Humanistic Effects of the disease or treatment on the patient’s

functional status or quality of life


Benefits of IPCPatientsFewer adverse effects, improved quality of daily

life, more satisfaction with their carePhysiciandecrease workload, better pt adherence, more

clinic appointment kept, better monitoring and feedback on pts’ status between office visits

PharmacistsEnhance patient loyalty, develop a reference

network with other trusted providers, improve career satisfaction, contributing to cost effective outcome


Collaboration is important in today's complex health care environment

Develop the appropriate knowledge, skills and attitude

Plan carefully Select capable staff Maintain positive relationships Keep your mission to improve the lives

of the patient in your life!

Thanks

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I NTERDISCIPLINARY PATIENT CARE PHCL 472 Nouf M Aloudah Clinical Pharmacy lecture King Saud University