Assessing care team perspectives on integration of a community pharmacist into an ambulatory care practice

Objectives: The objective was to advance the integration of a community pharmacist within an accountable care organization (ACO) by assessing the desired roles of a pharmacist within the care team, satisfaction with the current arrangement of a pharmacist's involvement, and willingness to learn more about the roles of a community pharmacist. Setting: A community pharmacist from Realo Discount Drugs was embedded within 3 clinics associated with Coastal Carolina Quality Care, an ACO. Practice description: An independent community pharmacy established a partnership with an ACO that has multiple group practices and shares an electronic health record. Practice innovation: Care managers referred patients to the pharmacist. The goal of community pharmacist involvement within the clinic was to provide transitions-of-care services to recently hospitalized patients, reconciling medications and dosing after discharge. Evaluation: A 12-item online survey was conducted to evaluate the partnership. Health care team members were included; staff without expected involvement with the patient or pharmacist were excluded. Questionnaire items addressed provider type, desired role of the pharmacist, satisfaction with pharmacist involvement, and willingness to learn about or desire for more pharmacist involvement. The survey was open for 30 days with a reminder sent on day 15. Responses were thematically categorized, and content analysis was used to analyze results. Results: Sixteen survey responses were received. The care team most frequently requested that the community pharmacist provide medication reconciliation (50%), medication education (44%), cost-reduction strategies (44%), and drug-interaction evaluation (38%). Care team satisfaction was positive; no respondents were unsatisfied. One-third (37%) of respondents were unaware of the pharmacist's involvement, had not referred patients to the pharmacist, or desired more interaction with the pharmacist. Conclusion: Survey findings were used to advance community pharmacist integration within an ACO, resulting in meaningful changes to pharmacist-provided services within clinic workflow. (C) 2019 American Pharmacists Association (R). Published by Elsevier Inc. All rights reserved.