Survey of Pharmacist-Managed Primary Care Clinics Using Healthcare Failure Mode and Effect Analysis (HFMEA)

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Ashley H Vincent
Jasmine D Gonzalvo
Darin C Ramsey
Alison M Walton
Zachary A Weber
Jessica E Wilhoite


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.

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