Expanding care through a layered learning practice model.

Area of Science:

• Pharmacy Practice
• Clinical Pharmacy
• Health Outcomes Research

Background:

• Direct patient care by pharmacists is crucial for improving health outcomes.
• Traditional pharmacy models may limit the scope of pharmacist involvement in patient care.
• A structured learning model can facilitate expanded pharmacist services.

Purpose of the Study:

• To evaluate a patient-centered layered learning practice model (LLPM).
• To assess the impact of a clinical specialist managing a pharmacy team for direct patient care.
• To expand pharmacist care services through a team-based approach.

Main Methods:

• Two 30-day evaluations were conducted in acute care malignant hematology and medical oncology services.
• The study focused on designing an LLPM to expand pharmacist care services.
• The primary outcome measured was the discharge capture rate (medication reconciliation and counseling).

Main Results:

• The overall discharge capture rate was 51%, with 61 patients receiving reconciliation and counseling.
• Malignant hematology patients received a mean of 11 prescriptions at discharge; oncology patients received 9.83.
• An average of 1.26 medication-related problems were identified in hematology and 2.1 in oncology patients.

Conclusions:

• The LLPM successfully provided discharge medication reconciliation and counseling to oncology patients.
• Pharmacy students/residents managed by attending pharmacists improved clinical outcomes.
• The model demonstrated an improvement in all measured clinical outcomes and encounters.