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Appropriate Clinical Staffing Standards For Pharmacist Activities. Thomas Emmendorfer, PharmD VHA PBM – VA MedSAFE. Objectives. Overview VA Pharmacy Cost Workgroup findings Define goal of hero group survey Review selected results of survey
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Appropriate Clinical Staffing Standards For Pharmacist Activities Thomas Emmendorfer, PharmD VHA PBM – VA MedSAFE
Objectives • Overview VA Pharmacy Cost Workgroup findings • Define goal of hero group survey • Review selected results of survey • Develop clinical staffing model to define standards • Develop business plan for select clinics
Pharmacy Cost Workgroup: Findings • VISNs with fewer than average number of clinical pharmacists and higher than average pharmacy costs should increase the number of clinical pharmacists to reach the benchmark • VISNs with higher than average number of clinical pharmacists and high costs should evaluate manner in which those pharmacists are utilized Partial Listing of Findings
Goals of Survey • Define clinical activities • Quantify clinical activities across the VA • Determine best approach of developing staffing model
Clinical Pharmacy Activities • Definition used for survey • Those functions that are conducted by a licensed pharmacist in the support of direct patient care and/or through administrative activities
Clinical Pharmacy Activities • Do NOT include: • Verification, processing, or dispensing medication orders/prescriptions that were entered by a provider, or other functions related to product distribution; unless this is a function/duty incorporated into the clinical role
Clinical Pharmacist FTEE Per 10,000 Pharmacy Patient Uniques (FY 2006)
Clinical Pharmacy Services • 19 Different Categories to distribute FTEE • Examples: • Primary Care • Urology • HBPC • At least 1 facility reported FTEE dedicated to each of the 19 categories
Clinical Pharmacy Staffing Standard • Barriers to individualized standards • Wide range of clinical pharmacy services • Different services provided with similar clinic names • Solution • Establish workgroups for commonly established clinics • Clinical Pharmacy Staffing Standard Model • Develop business plans for requesting clinical pharmacy FTEE for select clinics
Staffing Model: Pharmacy Clinic for Face-to-Face Visit (Specialty Clinic)
Staffing Model: Pharmacy Clinic for Face-to-Face Visit (Primary Care)
Diabetes Sumita Biswas (Group Leader—Atlanta) Melissa Atwood (Minneapolis) Carrie Thomas (Durham) Kim Ho (El Paso) Hasmig Chilingirian (Long Beach) Kimberly R. Watson (Little Rock) Molly Kurpius (Jesse Brown—Chicago) Primary Care Donna Leslie (Group Leader—Jesse Brown—Chicago) Jon Folstad (Cleveland) Kevin Burns (Minneapolis) Robert Henault (Boston) Hilary Davis (Phoenix) Dana Frank (Jesse Brown—Chicago) Lipids Giselle Rivera (Group Leader—San Juan) Ana Vazquez (Bay Pines) Anticoagulation Maurice Jones (Cleveland) Jeffrey Sayers (GLAHS) Lisa Longo (PBM) Keith Trettin (NCPS) Business Plans for Requesting Clinical Pharmacy FTEE
Building Consensus • Staffing Standard Model • Reviewed by work groups • Distributed to those who completed original survey for feedback • Business Plans • Reviewed by work groups • Distributed to those who completed original survey for feedback
Future Direction • Implement staffing model and assess for outcomes • Recommend creating a SharePoint site to post staffing model and business plans • Consider a process to identify resources posted to the site as best practices • Encourage sites to post related resources to SharePoint site