The Optimizing Care Model: Final findings of a novel community pharmacy practice model to enhance patient care delivery using technician product verification.

BACKGROUND: The community pharmacy represents a convenient health care access point for patients and is increasingly used to deliver direct patient care services; however, several barriers exist that hinder widespread patient service implementation and scalability. Such barriers include scope of practice restrictions, a dearth of sustainable payment models, lack of pharmacist capacity given other responsibilities, and workflow models developed for dispensing medications rather than clinical care. In an effort to overcome the lack of pharmacist time and capacity, further task delegation to pharmacy technicians has been suggested. OBJECTIVES: The primary objective of this study was to present the final outcomes of the Optimizing Care Model's impact. The model's impact on pharmacist patient care, workday composition, and rates of product selection errors not identified during final product verification are reported. METHODS: The Optimizing Care Model is an innovative approach to community pharmacy practice aiming to foster a new patient-centered care delivery model that expands clinical service delivery and fosters collaboration across health care settings through task delegation, primarily through technician product verification (TPV). To investigate the impact of its sustained implementation, a quasi-experimental, 1-group pretest-posttest design was used. Outcomes assessed included medication errors, clinical activities, and workday composition. RESULTS: Six chain and 3 independent pharmacies completed the final, continuation phase of the study. Overall pharmacist time spent delivering patient care services increased significantly upon implementation of the Optimizing Care Model (21% vs. 43%; P < 0.05), whereas pharmacist time spent performing dispensing-related activities decreased significantly (67% vs. 37%; P < 0.05). Total undetected error rates were significantly less in the Optimizing Care Model phase compared with the traditional model (0.05% vs. 0.01%; P < 0.001). CONCLUSION: This study presented the final results of a 2-year assessment of the Optimizing Care Model. Results reaffirmed initial published findings that the model and its use of TPV increase the array and frequency of direct patient care services rendered while resulting in lower undetected error rates. Final project results of the Optimizing Care Model demonstrate increased clinical service delivery versus the traditional model, while also improving patient safety with lower rates of undetected dispensing errors within the Optimizing Care Model. The Optimizing Care Model continues to show promise as a future practice model for community pharmacies.

The Optimizing Care Model: A novel community pharmacy approach to enhance patient care delivery by leveraging the technician workforce through technician product verification.

OBJECTIVES: To explore initial outcomes of the Optimizing Care Model's impact on patient care through technician product verification after the first 3 months of implementation, including the model's impact on pharmacist workday composition, rates of patient care services delivered, and rates of product selection errors not identified during final product verification. SETTING: Fourteen chain and independent community pharmacies licensed and located in Tennessee. INNOVATION: The Optimizing Care Model is an innovative approach to community pharmacy practice aiming to foster a new patient-centered care delivery model that expands clinical service delivery through task delegation to pharmacist extenders. EVALUATION: A quasiexperimental 1-group pretest-posttest design was used. Study sites self-reported data from 3 months before and 3 months after implementation of the intervention. RESULTS: Overall pharmacist time spent delivering patient care services increased significantly on implementation of the Optimizing Care Model (25% vs. 43%; P < 0.001), and time spent performing dispensing-related activities decreased significantly (63% vs. 37%; P = 0.02). There was a total increase in quantity of clinical services delivered to patients from baseline, but data from initial study outcomes did not reach statistical significance. At least 1 new clinical service provided under a collaborative practice agreement had been implemented by all 14 sites (100%) as of Spring 2018. Total undetected error rates were significantly less in the Optimizing Care Model phase compared to the traditional model (0.063% vs. 0.085%; P < 0.001). CONCLUSION: Initial results of the Optimizing Care Model demonstrate improved patient care through increased clinical service delivery versus the traditional model. Undetected error detection rates were low in both models, but lower in the Optimizing Care Model. The Optimizing Care Model may represent a novel approach to improving care for patients while creating efficiencies through a staff delegation model, providing pharmacists the opportunity to further evolve their practice and advance clinical care for patients.