Increasing Access to Primary Care Using Pharmacist Providers
Last updated
Share PrintThrough a multi-modal approach, a team at the Madison VA positioned our pharmacist providers to offload 27% of primary care provider appointments, increase referrals through education, improve team satisfaction, and save primary care providers 20 minutes on average for new patients, which they were then able to reallocate time to necessary patient care needs.
Origin:
September 2014, William S. Middleton Memorial Veterans' Hospital (Madison)
Adoptions:
22 successful
Awards and Recognition:
VHA Shark Tank Winner
Partners:
Clinical Pharmacy Practice Office, Diffusion of Excellence, Office of Primary Care, Office of Rural Health
Recent Updates
Overview
The problem
The solution
The results
Diffusion tracker
Does not include Clinical Resource Hubs (CRH)
Multimedia
Images
Above:
First time that this PACT team (including the pharmacist provider) was all in the same room together discussing how they would conduct team meetings and provide more proactive team based care.
Above:
A critical component of this practice is engaging front-line staff actually doing the work in co-design of the processes. In this picture, you can see leadership together with front-line pharmacists, LPNs, MSAs, RNs, and PCPs designing how the new processes will work.
Above:
Director of El Paso at the time, Gail Graham was heavily engaged in the implementation of this practice and provided unrelenting support. Her collaborative and supportive mindset helped set the stage for adoption of this practice.
Videos
Above:
A conversation with Dr. Ryan Vega and Dr. Ellina Seckel about the Diffusion of Excellence Gold Status Practice - Increasing Access to Primary Care Using Pharmacist Providers
Implementation
Timeline
-
2 weeks
Engage front-line PACTs in education of PACT CPS role and full PACT CPS team integration (including weekly team meetings) -
2-4 weeks
Ensure full ancillary support provided (LPNs performing vitals, schedulers performing scheduling) -
Initial design of grids 2 weeks, implementation of new grids 6 weeks
Re-vamp PACT CPS grids to be consistent with CPPO guidance and bookable hours requirements -
8 weeks
Implement population management strategies to address facility strategic priorities (SAIL ACSC, HEDIS, shifting appointments from PCP to CPS, etc) -
6 months
PACT CPS tracks impact (access, quality measures, team satisfaction) and reports out to facility leadership -
6 months
Additional resource request submitted IF needed to meet minimum PACT Handbook ratios -
12 months and onward
Expansion/Sustainment of practice model
Departments
- Pharmacy
- Geriatrics
- Administration
- Primary care
Core Resources
| Resource type | Resource description |
|---|---|
PEOPLE |
|
Files
- Article describing the practice and how Pharmacist Providers open access to care. CPS Improving Access in Primary Care - Pharmacy Practice News
- Description of Pharmacist Provider practice model. Get the Medications Right
- Description of Team Based Care and Pharmacists' role in comprehensive medication management. CMM Practice in Real Life
Links
- Pharmacy Society of Wisconsin article describing the Gold Status Practice. Description of the Gold Status Practice
- Resources for Clinical Pharmacy Managers. Clinical Pharmacy Managers Homepage
- Webcast interview of the teams in Madison and Kansas City with implementing optimal use of Pharmacist Providers to open access to care. Improving Access through Pharmacist Providers
Risks and mitigations
| Risk | Mitigation |
|---|---|
| Resistance to change from PCPs | Engage PCPs in co-design of process and adjust approach to solve PCP problems |
| Lack of ancillary support due to staffing shortages | Engage front-line LPNs and MSAs in co-design of process and show how pharmacist can be another provider resource for LPNs/MSAs |
| Resistance to change from PACT Pharmacist Providers | Understand practice gaps, ensure PACT Pharmacist Providers feel heard, provider appropriate training, ensure competency through assessments |
About
Origin story
Original team
Ellina.Seckel@va.gov
Gold Status Fellow
Kyleigh.Gould@va.gov
Implementation Fellow
Julie.Groppi@va.gov
Clinical Pharmacy Practice Office
Michael.McFarland2@va.gov
Clinical Pharmacy Practice Office
Comment
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