Integrating pharmacists into diverse diabetes care teams: Implementation tactics from Project IMPACT: Diabetes

Objective: To describe local implementation tactics used by the 25 Project IMPACT: Diabetes communities and partnering organizations to help patients who are disproportionately affected by diabetes. Setting: Care was delivered in 25 communities within 17 states at federally qualified health centers, community pharmacies, free clinics, employer work sites, medical clinics, physician offices, and other settings. Practice description: In addition to pharmacists, practices included physicians, nurse practitioners, dietitians, physician assistants, social workers, behavioral therapists, and other types of health professionals. Insurance status and the predominant ethnicity of patients differed between communities. Each community had at least one community champion responsible for leading local implementation who was supported by an American Pharmacists Association Foundation community coordinator and Foundation staff. Practice innovation: The key innovations within each of the 25 communities were the integration of pharmacists on diabetes care teams, use of the Patient Self-Management Credential for Diabetes at baseline, and collection of a standardized minimum dataset. Communities deployed other practice innovations to support the care model, including group education classes, grocery store tours, joint provider visits, and provision of patient incentives. Evaluation: The specific components of each community's implementation and innovation were aggregated via postproject surveys. Clinical and process measures were also collected and are published separately. Results: Each community is characterized based on the people involved and the care delivered. Aspects of the communities described include health care provider teams, population characteristics, practice settings, care components, data collection methods, incentives provided, and self-reported service sustainability. Conclusion: Pharmacists can be integrated successfully into a diverse array of practice settings and teams to help a wide variety of patients through the provision of team-based, patient-centered care. Flexibility in implementation strategies allows for customization of the care provided to best meet population needs.