开发、试用和评估定性记录工具,供药剂师分享具有重大影响的患者干预故事。

Innovations in pharmacy Pub Date : 2024-08-21 eCollection Date: 2024-01-01 DOI:10.24926/iip.v15i3.5772
Alex William Middendorf, Aaron Hunt, Alexa Vanden Hull, Deidra Van Gilder, Erin Miller, Sharrel Pinto
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引用次数: 0

摘要

背景:对于许多患者来说,社区药剂师往往是医疗团队中最容易接触到的成员,他们可以通过加强药学服务,在管理患者的慢性病(如糖尿病或心脏病)方面发挥关键作用。尽管药学服务很容易获得,但其利用率往往不高,部分原因是缺乏全面囊括这些药学服务所有要素的适当补偿模式。虽然常规服务记录确实收集了某些定性数据,但它们并不总能说明全部服务范围的细微差别,以及这些服务对患者和医疗保健系统的强大影响和价值。目标:开发并试用一种在线报告工具,用于药剂师记录对患者有重大影响的干预 "故事",其中包括门诊药房提供护理服务过程中的细微差别,以促进积极的治疗效果。方法:我们开发了一个在线 "患者故事报告工具"(Patient Stories Reporting Tool,PRST),让门诊药剂师记录他们认为能体现其价值的、与众不同的直接患者护理接触的细节,或称 "故事"。通过 PSRT 记录的内容包括有限的定量数据和定性数据,重点是 "故事 "的自由回答叙述。在一次试点中,PSRT 分发给了一家合作药学机构 16 个实践基地的 18 名药剂师。定性数据是分析的重点,由项目组成员收集、评估,并按干预类型进行整理。结果:从 2021 年 8 月到 2023 年 3 月,报告了涉及 13 个实践基地 17 名药剂师的 47 个故事。确定了三种类型的关键干预措施,包括普通患者教育(7 例)、用药优化(20 例)和降低成本(20 例)。考虑到这一初步试点的性质和范围,三种最普遍的干预类型各确定了一个故事,作为该工具可以收集的故事类型的范例,随后将对其进行详细讨论。结论:所选的三个故事有助于描述药剂师提供的服务、药剂师与患者互动的关键要素,以及利用 PSRT 等工具分享这些故事的价值。通过这些故事,PSRT 也开始记录药剂师干预的细微差别,以及他们在患者医疗过程中可能产生的影响。该工具的潜在应用是多方面的,包括支持改善人们对药剂师在医疗团队中作用的认识,以及为扩大报销模式提供依据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Development, Pilot, and Evaluation of a Qualitative Documentation Tool for Pharmacists to Share High Impact Patient Intervention Stories.

Background: Community pharmacists are often the most accessible member of the healthcare team to many patients and can play a key role in managing their chronic conditions, such as diabetes or heart disease, through enhanced pharmacy services. Despite their accessibility, pharmacy services are often underutilized due, in part, to a lack of adequate reimbursement models that comprehensively encapsulate all elements of those pharmacy services. While routine documentation of services does collect certain qualitative data, they do not always indicate the nuance of the full scope of services with resulting robust impact and value of those services for the patient and healthcare system. Objective: To develop and pilot an online reporting tool for pharmacist documentation of high impact patient intervention "stories" that includes the nuances of care provision processes in outpatient pharmacy settings that promote positive outcomes. Methods: An online Patient Stories Reporting Tool (PRST) was developed to allow outpatient pharmacists to document details on distinct direct patient care encounters, or "stories", that they felt showcased their value. Documentation through PSRT included limited quantitative data and qualitative data with a focus on a free response narrative for the "story". In a pilot, the PSRT was distributed to 18 pharmacists across 16 practice sites from one partnering pharmacy organization. Qualitative data, the focus of the included analysis, was collected, assessed by project team members, and organized by intervention types. Results: Forty-seven stories involving 17 pharmacists across 13 practice sites from August 2021 to March 2023 were reported. Three types of key intervention stories were identified including General Patient Education (7 stories), Medication Optimization (20 stories), and Cost Reduction (20 stories). Given the nature and scope of this initial pilot, one story for each of the three most prevalent intervention types was identified as exemplifying the types of stories the tool can collect and are subsequently discussed in detail. Conclusions: The three selected stories help to characterize the services pharmacists provide, the critical components of pharmacist-patient interactions, and the value of sharing these stories utilizing tools such as the PSRT. Through these stories, the PSRT also begins to record the nuances of pharmacist interventions and the impact they can make in a patient's healthcare journey. Potential applications of the tool are multivarious including supporting improvements in the perception of pharmacists' roles on the healthcare team and justifying expansion of reimbursement models.

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