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Pharmaceutical Services, Delivery of Health Care, Systems Analysis, Total Quality Management, United States
Objectives: The primary objective was to expand upon results of a previously piloted patient perception survey with Healthcare Failure Mode and Effect Analysis (HFMEA), to identify areas within pharmacist-managed clinics needing improvement.
Methods: The survey was adapted for use in pharmacist-managed clinics. Patients completed the survey following regularly scheduled pharmacist appointments. Data were analyzed with a method adapted from HFMEA. Product scores could range from five to 25. A product of five indicates that pharmacists are doing a good job on the items that patients place the most value on, while a product score of 25 indicates that pharmacists are doing a poor job. A score greater than or equal to ten was used to identify areas for improvement.
Results: Seventy-one patients completed surveys. Thirteen components were assessed and no item achieved a mean product greater than or equal to ten. The survey item with the highest mean product pertained to discussion of potential medication side effects (mean: 7.06; interquartile range: 5-10). Analysis of each survey item found that all survey items had multiple individual responses that provided a product score of greater than or equal to ten. The survey items most frequently listed in the overall population as being most valued were “Told you the name of each of your medicines and what they are used for”, “Answered your questions fully,” and “Explained what your medicines do”.
Conclusions: Educational components provided during pharmacist-managed clinic appointments are aligned with patients’ needs and are successfully incorporating the components that patients value highly in a patient-healthcare provider interaction. The HFMEA model can be an important teaching tool to identify specific processes in need of improvement and to help enhance pharmacists’ self-efficacy, which may further improve patient care.
2. American Society of Health-Systems Pharmacists Council on Professional Affairs. Draft statement on pharmaceutical care. Am J Hosp Pharm. 1993;50(1):126-128.
3. Barnett CW, Nykamp D, Ellington AM. Patient-Guided Counseling in the Community Pharmacy Setting. J Am Pharm Assoc (Wash). 2000;40(6):765-772.
4. Svarstad BL, Bultman DC, Mount JK. Patient Counseling Procided in Community Pharmacies: Effects of State Regulation, Pharmacist Age, and Busyness. J Am Pharm Assoc (2003). 2004;44(1):22-29.
5. Nkansah NT, Brewer JM, Connors R, Shermock KM. Clinical outcomes of patients with diabetes mellitus receiving medication management by pharmacists in an urban private physician practice. Am J Health Syst Pharm. 2008;65(2):145-149. doi: 10.2146/ajhp070012
6. Jameson JP, Baty PJ. Pharmacist collaborative management of poorly controlled diabetes mellitus: a randomized controlled trial. Am J Manag Care. 2010;16(4):250-255.
7. Bex SD, Boldt AS, Needham SB, Bolf SM, Walston CM, Ramsey DC, Schmelz AN, Zillich AJ. Effectiveness of a hypertension care management program provided by clinical pharmacists for veterans. Pharmacotherapy. 2011;31(1):31-38. doi: 10.1592/phco.31.1.31
8. Till LT, Voris JC, Horst JB. Assessment of clinical pharmacist management of lipid-lowering therapy in a primary care setting. J Manag Care Pharm. 2003;9(3):269-273.
9. Rudd KM, Dier JG. Comparison of two different models of anticoagulation management services with usual medical care. Pharmacotherapy. 2010;30(4):330-338. doi: 10.1592/phco.30.4.330
10. Gonzalvo JD, Papineau EC, Ramsey DC, Vincent AH, Walton AM, Weber ZA, Wilhoite J. Patient Perceptions of Pharmacist-Managed Clinics: A Qualitative Analysis. J Pharm Technol. 2012;28(1):10-15.
11. Gourley GK, Gourley DR, La Monica Rigolosi E, Reed P, Solomon DK, Washington E. Development and validation of the pharmaceutical care satisfaction questionnaire. Am J Manag Care. 2001;7(5):461-466.
12. Larson LN, Rovers JP, MacKeigan LD. Patient satisfaction with pharmaceutical care: update of a validated instrument. J Am Pharm Assoc (Wash). 2002;42(1):44-50.
13. Knight DE, Caudill JA. Implementation of a patient perception survey in a pharmacist-managed primary care clinic and analysis with a unique HFMEA method. J Am Pharm Assoc (2003). 2010;50(1):78-83. doi: 10.1331/JAPhA.2010.08101
14. DeRosier J, Stalhandske E, Bagian JP, Nudell T. Using health care Failure Mode and Effect Analysis: the VA National Center for Patient Safety’s prospective risk analysis system. Jt Comm J Qual Improv. 2002;28(5):248-267.
15. Kimehi-Woods J, Shultz JP. Using HFMEA to assess potential for patient harm from tubing misconnections. Jt Comm J Qual Patient Saf. 2006;32(7):373-381.
16. Yarnall KS, Pollak KI, Østbye T, Krause KM, Michener JL. Primary care: is there enough time for prevention? Am J Public Health. 2003;93(4):635-641.
17. Østbye T, Yarnall KS, Krause KM, Pollak KI, Gradison M, Michener JL. Is there time for management of patients with chronic diseases in primary care? Ann Fam Med. 2005;3(3):209-214.