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Balancing collaborative and independent practice roles in clinical pharmacy: a qualitative research study.
McCullough, Megan B; Solomon, Jeffrey L; Petrakis, Beth Ann; Park, Angela M; Ourth, Heather; Morreale, Anthony P; Rose, Adam J.
Afiliação
  • McCullough MB; Center for Healthcare Organization and Implementation Research (CHOIR), ENRM VAMC, Bedford, MA, USA Megan.McCullough@va.gov.
  • Solomon JL; Center for Healthcare Organization and Implementation Research (CHOIR), ENRM VAMC, Bedford, MA, USA.
  • Petrakis BA; Center for Healthcare Organization and Implementation Research (CHOIR), ENRM VAMC, Bedford, MA, USA.
  • Park AM; VA New England Healthcare System, ENRM VAMC, Bedford, MA, USA.
  • Ourth H; Clinical Pharmacy Practice Program and Outcomes Assessment, VA Pharmacy Benefits Management Services VACO, Ackworth, IA, USA.
  • Morreale AP; Clinical Pharmacy Services and Healthcare Services Research, VA Pharmacy Benefits Management Services VACO, San Diego, CA, USA.
  • Rose AJ; Center for Healthcare Organization and Implementation Research (CHOIR), ENRM VAMC, Bedford, MA, USA Boston University School of Medicine, Boston, MA, USA.
Ann Pharmacother ; 49(2): 189-95, 2015 Feb.
Article em En | MEDLINE | ID: mdl-25429093
BACKGROUND: Clinical pharmacists (CPs) with a scope of practice operate as direct care providers and health care team members. Research often focuses on one role or the other; little is understood about the dynamic relationship between roles in practice settings. OBJECTIVE: To identify the challenges CPs face in balancing dual roles as direct care providers and health care team members and the implications for CP effectiveness and quality of care. METHODS: Pharmacists were interviewed with a primary purpose of informing an implementation effort. Besides the implementation, there were emergent themes regarding the challenges posed for CPs in negotiating dual roles. This study is, therefore, a secondary analysis of semistructured interviews and direct observation of 48 CPs, addressing this phenomenon. Interview data were entered into NVivo 10 and systematically analyzed using an emergent thematic coding strategy. RESULTS: Pharmacists describe role ambiguity, where they perform as direct providers or team members simultaneously or in quick succession. They note the existence of a "transaction cost," where switching causes loss of momentum or disruption of work flow. Additionally, pharmacists feel that fellow providers lack an understanding of what they do and that CP contributions are not evaluated accurately by other health professionals. CONCLUSION: It is a challenge for CPs to balance the distinct roles of serving as collaborators and primary providers. Frequent role switching is not conducive to optimal work efficiency or patient care. Our findings suggest concrete steps that medical centers can take to improve both CP worklife and quality of patient care.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Equipe de Assistência ao Paciente / Serviço de Farmácia Hospitalar / Comportamento Cooperativo Tipo de estudo: Prognostic_studies / Qualitative_research Limite: Humans Idioma: En Revista: Ann Pharmacother Assunto da revista: FARMACOLOGIA / TERAPIA POR MEDICAMENTOS Ano de publicação: 2015 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Equipe de Assistência ao Paciente / Serviço de Farmácia Hospitalar / Comportamento Cooperativo Tipo de estudo: Prognostic_studies / Qualitative_research Limite: Humans Idioma: En Revista: Ann Pharmacother Assunto da revista: FARMACOLOGIA / TERAPIA POR MEDICAMENTOS Ano de publicação: 2015 Tipo de documento: Article País de afiliação: Estados Unidos