Female nurse using tablet at the hospital
Health26 mei, 2022

Three steps for launching pharmacy standards that reduce variation in care

As pharmacists become increasingly critical members of hospital care teams their influence on clinical outcomes is growing exponentially.The pharmacy profession is adapting to rapidly developing therapies for a range of diseases, some of which have had limited treatment options for decades. As a result, the role pharmacists play in complex care processes is changing. Keeping up with the fast-changing world of patient care, today’s practitioners have to navigate concerns around infection control, immunology, cell regulation, and the human genome. By standardizing clinical practices, pharmacy leaders can expand their responsibilities, helping to improve outcomes and reduce costs.

How can your team make meaningful progress toward standardized care processes? Here are three key steps can help you get started on the path to improvement.

1. Evaluate the current landscape of pharmacy standards

Assess where your organization stands today. What potential projects would have the highest impact? What are your organizational goals? Understanding your key priorities can help you pick the initiatives that are most likely to yield successful, sustainable outcomes. 

For example, the United States’ opioid crisis has been raging for decades, costing 100,000 lives annually. Pharmacists are in a unique position to help an organization  an opioid stewardship program.

When founding a new clinical standardization project, pharmacy leaders should work in three stages:

Establish what your organization is already doing 

Your hospital or healthcare system is likely already engaged in some initiatives that align with the goals of a proposed program. For the opioid stewardship example, these could include: 

  • Appropriate opioid prescribing: Use clinical decision support tools that provide risk alerts in real time.
  • Proper opioid disposal: Use drop boxes for patient disposal of unused opioids.
  • Diversion prevention: Software, hardware, and education initiatives that help deter and prevent employee drug diversion.
  • Managing harmful opioids: Develop programs that encourage prescription of opioid antagonists for high-risk patients.

Look for colleagues who are already doing work in your chosen clinical area. Make sure to consider a range of departments, including behavioral health, the emergency department, and orthopedics. 

Assess current pharmacy standards, policies, and procedures

It’s likely that there are already guidelines in place that you can build from. For example, an organization might refer to the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain.

While the pharmacist may only have control over prescription and duration of opioid treatment, they can collaborate with other clinicians to monitor policies for following up with patients and safely discontinuing medications.

Conduct a needs assessment

A gap analysis, or needs assessment, will help you evaluate the distance between your organization’s current ways of working and your goals for better standardized processes. A strong needs assessment can be used to inform future discussions and priorities. 

The success of this type of project often snowballs into future projects: A successful first project that improves patient outcomes can help inspire leadership and clinicians to engage with more challenging initiatives in the future.

2. Obtain buy-in from clinical leaders  

Meaningful progress toward standardized clinical processes requires all staff to participate. Determining whether your organization is focused on maintaining accreditation, how it regards quality improvement and whether a project aligns with the overall organizational mission will be key initiatives.

Once a hospital or healthcare system is aligned, look for champions or action leaders among staff. These are the people who understand your vision and are willing to work with an individual or team responsible for the program. They will be critical in building support from both leadership and the clinicians who are responsible for day-to-day execution. According to the CDC, these champions are the ones that drive change and help you push through indifference, stagnation, and any pushback you may face. 

3. Start small, then maximize impact

Standardizing pharmacy practices, documentation and reporting is undeniably a high-level goal. Aim for maximum benefit by starting in an area that’s accessible and minimally disruptive. 

As pharmacists are becoming more involved in patient care, pharmacy technicians may serve as support personnel, improving efficiency and cost-effectiveness, as reported by the American College of Clinical Pharmacy (ACCP). Incorporating these staff members into the patient care process frees clinical pharmacists to focus on evaluating patient needs and developing patient-centered care plans. Pharmacy technicians and support personnel who are integrated into care processes can also assist with tasks like facilitating transitions of care, organizing and stocking patient education materials, and administering immunizations. 

Integrating pharmacists into the patient care continuum has also been proven to decrease medication waste in the ICU, which translates to significant cost savings. The ACCP recommends several best practices to engage personnel beyond their traditional job functions:

  • Identify the appropriate staff members.
  • Establish adequate training and certification.
  • Include personnel in the right areas of the care process.
  • Incorporate them into the ancillary processes that support clinical pharmacy services.
  • Conduct research on outcomes and share the results with participants. Compliance review as recommended by the International Pharmacy Federation (IPF) could also be helpful.

Regardless of your initiative, carefully establishing and tracking metrics that measure your success will help expand improvements across the organization. 

To learn more about the value of standardizing clinical processes and how documentation supports positive and sustainable results, download our white paper. 

Rich Dion PharmD
Pharmacy Clinical Program Manager

Dr. Richard Dion has 15 years of experience in the practice areas of medication use safety, pharmacy informatics and clinical decision support in varied settings.

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