Leveraging quality improvement principles in comprehensive medication management pharmacy practice: A case example

Abstract

ObjectiveTo maximize the time pharmacists providing comprehensive medication management (CMM) services spend providing direct patient care by tracking their time spent on various activities. SettingFifteen primary care clinics within an integrated health care system in Minnesota. Practice descriptionEleven pharmacists provide comprehensive medication management services in 15 clinic sites; 12 primary care clinics, 1 family medicine residency training clinic, and 2 specialty clinics. Practice innovationA team of pharmacists providing CMM developed and completed a self-reported workload sheet to document how much time they spent on various activities. These sheets were completed at 4 different points over 6 years to guide efficiency efforts to increase pharmacists’ time spent in value-added activities such as direct patient care. EvaluationBeginning in 2014, each CMM pharmacist was asked to complete the workload tally sheet to track the time they spent on all their daily activities for a 5-day period. The workload sheets were collected in 2014, 2016, 2017, and 2019 and represent a snapshot of activity at 1 point during each year. Workload sheets from each pharmacist were compiled and analyzed each year to assess time spent in direct patient care and other value-added activities. ResultsFrom 2014 to 2019, CMM pharmacists increased their time providing value-added services from 47.1% to 72% and increased time in direct patient care from 26.7% to 52.5%. This was achieved through a number of workflow optimization strategies, including appropriation of staff to schedule and recruit CMM patients, developing expanded collaborative practice agreements, and creating documentation efficiencies. ConclusionCollecting CMM pharmacist workload data across the years demonstrated the amount of time pharmacists were spending on various clinic-related activities and served to identify areas where workflow and processes could be improved to increase the time pharmacists spend in value-added services. As CMM practices continue to develop and expand, tracking and optimizing pharmacists’ time is essential to leverage efficiency and value of pharmacy services.