Abstract
Our goal was to help prevent drug-related morbidity and mortality by developing a collaborative multidisciplinary team care (MTC) service model using a service design framework that addressed the unmet needs and perspectives of diverse stakeholders. Our service model was based on a “4D” framework that included Discover, Define, Design, and Develop phases. In the “discover” phase, we conducted desk research and field research of stakeholders to identify the unmet needs in existing patient care services. We used service design tools, including service safaris, user shadowing, and customer journey maps to identify pain and opportunity points in the current services. We also performed focus group discussions and in-depth interviews with stakeholders to explore the needs for improved services. In the “define” phase, we generated the service concept by mind mapping and brainstorming about the needs of stakeholders. The service concept was defined to be a Patient-oriented, Collaborative, Advanced, Renovated, and Excellent (P-CARE) service. We named the service “DrugTEAM” (Drug Therapy Evaluation And Management). In the “design” phase, we designed and refined four prototypes based on results from validation tests for their application towards following services: 1) medication reconciliation, 2) medication evaluation and management, 3) evidence-based drug information, and 4) pharmaceutical care transition services. During the “develop” phase, we implemented four services in a longitudinal chronic care model, considering the time spent by patients for each inpatient and outpatient setting. In conclusion, this is a study to develop a collaborative MTC service model using service design framework, focused on managing the unmet needs of patients and healthcare providers. As a result of implementing this service model, we expect to strengthen the professional relationship between pharmacists and stakeholders to ultimately create better patient outcomes.
Highlights
Patients who take multiple medications due to chronic disease have a high risk of drug duplication, interaction, or adverse side effects, which could result in extended hospital stays and higher costs [1]
Several studies have reported that multidisciplinary team care (MTC) service improved patient outcomes compared to user-cared patients [7, 8]
Using analytic hierarchy https://doi.org/10.1371/journal.pone.0201705.g001 process (AHP) analysis, we determined that the priority groups that would require collaborative MTC services were patients with diabetes mellitus, chronic heart disease, and chronic kidney disease [14]
Summary
Patients who take multiple medications due to chronic disease have a high risk of drug duplication, interaction, or adverse side effects, which could result in extended hospital stays and higher costs [1]. Previous studies have shown that pharmacists’ services had positive effects on clinical and economic outcomes [4,5,6] These pharmacist services included participation in rounds to optimize medication use, therapeutic drug monitoring, and providing drug information, patient and caregiver education, or medication reconciliation at admission or discharge. Services in hospital pharmacies are limited to medication counseling, anticoagulation counseling, therapeutic drug monitoring, and similar services, despite the high risk of medication-related problems [10]. For this reason, advanced pharmaceutical care services for patients who may have medication-related problems are in high demand. A team approach, such as MTC, is necessary to properly care for patients with chronic complex diseases
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