Collaborative Practice Model Research Articles

Circadian principles: Behavioral health implications

In the context of inter‐disciplinary and collaborative practice models, this article introduces behavioral health clinicians to circadian concepts such as chronotype, phase‐response curve and entrainment as they impact self‐regulation, behavior, and neuro‐cognitive performance. A review of selected research studies and theoretical commentary represents the basis for describing chronobiologic principles and their pertinence to everyday mental health practice. Despite scholarly references to methodologic limitations in the research, environmental and clinical applications of chronobiologic knowledge/techniques, including but not limited to bright light therapy, for managing mood and the sleep‐wake balance, continue to be documented in the scientific literature with subjective as well as measurable benefit in practice and community settings. In the developed world, urban environments expose individuals to excessive and ill‐ timed artificial illumination across the 24‐hr period, leading to varying degrees of circadian shifting. Seasonal rhythms related to natural light availability, reflect additional, recurring disruptions in sleep‐wake patterning and impacts on behavior. Circadian management principles, mindful of external and internal clock time, and strategically integrated with psychological services, provide further clues to understanding downstream fluctuations in levels of alertness, neuro‐cognitive performance, mood and sleep quality and inform risk management practices.

Duel or Dual: An Interdisciplinary Approach to Parenting Coordination for Uber‐Conflicted Parenting Relationships

Parenting coordination for families struggling with severe conflict can be challenging for both the family and the parenting coordinator (PC). These families can put an inordinate strain on the PC as they lobby their positions and try to bias the PC against the other parent. The interdisciplinary dual‐PC model is an innovative approach using aspects of the collaborative practice model to enhance the efficacy of the process while utilizing the strengths of both disciplines. Through a case illustration, the identification of the family dynamics and situations that give rise to use of this approach shall become clear. This article also demonstrates the potential benefits to both the family and the PCs. All aspects synthesize into a cohesive, well‐balanced approach to the uber‐conflicted parenting relationships.

Collaborative Occupational Therapy: Teachers' Impressions of the Partnering for Change (P4C) Model

ABSTRACTAims: Occupational therapists (OTs) often face barriers when trying to collaborate with teachers in school-based settings. Partnering for change (P4C), a collaborative practice model designed to support children with developmental coordination disorder, could potentially support all students with special needs. Therefore, the aim of this study was to explore how teachers experience OT services delivered using the P4C model to support children with a variety of special needs. Methods: P4C was implemented at one elementary school in Courtenay, British Columbia. Eleven teachers participated in two focus groups and a one-on-one interview to gather descriptive, qualitative data. Grounded theory techniques were used for data analysis. Results: Four themes (collaborating in the thick of it all, learning and taking risks, managing limited time and resources, and appreciating responsive OT support) represented teachers' experiences of P4C. Conclusions: Teachers strongly preferred collaborative OT services based on the P4C model. Students with a variety of special needs were supported within their classrooms as teachers learned new strategies from the OT and found ways to embed these strategies into their daily routines.

Understanding the drivers of interprofessional collaborative practice among HIV primary care providers and case managers in HIV care programmes

ABSTRACTCare coordination programmes are an important aspect of HIV management whose success depends largely on HIV primary care provider (PCP) and case manager collaboration. Factors influencing collaboration among HIV PCPs and case managers remain to be studied. The study objective was to test an existing theoretical model of interprofessional collaborative practice and determine which factors play the most important role in facilitating collaboration. A self-administered, anonymous mail survey was sent to HIV PCPs and case managers in New York City. An adapted survey instrument elicited information on demographic, contextual, and perceived social exchange (trustworthiness, role specification, and relationship initiation) characteristics. The dependent variable, perceived interprofessional practice, was constructed from a validated scale. A sequential block wise regression model specifying variable entry order examined the relative importance of each group of factors and of individual variables. The analysis showed that social exchange factors were the dominant drivers of collaboration. Relationship initiation was the most important predictor of interprofessional collaboration. Additional influential factors included organisational leadership support of collaboration, practice settings, and frequency of interprofessional meetings. Addressing factors influencing collaboration among providers will help public health programmes optimally design their structural, hiring, and training strategies to foster effective social exchanges and promote collaborative working relationships.

Estimated Cost-Effectiveness, Cost Benefit, and Risk Reduction Associated with an Endocrinologist-Pharmacist Diabetes Intense Medical Management "Tune-Up" Clinic.

In 2012 U.S. diabetes costs were estimated to be $245 billion, with $176 billion related to direct diabetes treatment and associated complications. Although a few studies have reported positive glycemic and economic benefits for diabetes patients treated under primary care physician (PCP)-pharmacist collaborative practice models, no studies have evaluated the cost-effectiveness of an endocrinologist-pharmacist collaborative practice model treating complex diabetes patients versus usual PCP care for similar patients. To estimate the cost-effectiveness and cost benefit of a collaborative endocrinologist-pharmacist Diabetes Intense Medical Management (DIMM) "Tune-Up" clinic for complex diabetes patients versus usual PCP care from 3 perspectives (clinic, health system, payer) and time frames. Data from a retrospective cohort study of adult patients with type 2 diabetes mellitus (T2DM) and glycosylated hemoglobin A1c (A1c) ≥ 8% who were referred to the DIMM clinic at the Veterans Affairs San Diego Health System were used for cost analyses against a comparator group of PCP patients meeting the same criteria. The DIMM clinic took more time with patients, compared with usual PCP visits. It provided personalized care in three 60-minute visits over 6 months, combining medication therapy management with patient-specific diabetes education, to achieve A1c treatment goals before discharge back to the PCP. Data for DIMM versus PCP patients were used to evaluate cost-effectiveness and cost benefit. Analyses included incremental cost-effectiveness ratios (ICERs) at 6 months, 3-year estimated total medical costs avoided and return on investment (ROI), absolute risk reduction of complications, resultant medical costs, and quality-adjusted life-years (QALYs) over 10 years. Base case ICER results indicated that from the clinic perspective, the DIMM clinic costs $21 per additional percentage point of A1c improvement and $115-$164 per additional patient at target A1c goal level compared with the PCP group. From the health system perspective, medical cost avoidance due to improved A1c was $8,793 per DIMM patient versus $3,506 per PCP patient (P = 0.009), resulting in an ROI of $9.01 per dollar spent. From the payer perspective, DIMM patients had estimated lower total medical costs, a greater number of QALYs gained, and appreciable risk reductions for diabetes-related complications over 2-, 5- and 10-year time frames, indicating that the DIMM clinic was dominant. Sensitivity analyses indicated results were robust, and overall conclusions did not change appreciably when key parameters (including DIMM clinic effectiveness and cost) were varied within plausible ranges. The DIMM clinic endocrinologist-pharmacist collaborative practice model, in which the pharmacist spent more time providing personalized care, improved glycemic control at a minimal cost per additional A1c benefit gained and produced greater cost avoidance, appreciable ROI, reduction in long-term complication risk, and lower cost for a greater gain in QALYs. Overall, the DIMM clinic represents an advanced pharmacy practice model with proven clinical and economic benefits from multiple perspectives for patients with T2DM and high medication and comorbidity complexity. No outside funding supported this study. The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Preliminary versions of the study data were presented in abstract form at the American Pharmacists Association Annual Meeting & Exposition; March 27, 2015; San Diego, California, and the Academy of Managed Care Pharmacy Annual Meeting; April 21, 2016; San Francisco, California. Study concept and design were contributed by Hirsch, Bounthavong, and Edelman, along with Morello and Morreale. Arjmand, Ourth, Ha, Cadiz, and Zimmerman collected the data. Data interpretation was performed by Ha, Morreale, and Morello, along with Cadiz, Ourth, and Hirsch. The manuscript was written primarily by Hirsch and Zimmerman, along with Arjamand, Ourth, and Morello, and was revised by Hirsch and Cadiz, along with Bounthavong, Ha, Morreale, and Morello.

4. Addressing Determinants of Health and Unmet Preventive Health Needs of Underserved, Older Adults: A Collaborative Practice Model

4. Addressing Determinants of Health and Unmet Preventive Health Needs of Underserved, Older Adults: A Collaborative Practice Model

F10-A Sharing the Burden: Schwartz Rounds® as a Compassionate Collaborative Practice Model in Long-Term Care

F10-A Sharing the Burden: Schwartz Rounds® as a Compassionate Collaborative Practice Model in Long-Term Care

Providing primary care using an interprofessional collaborative practice model: What clinicians have learned.

This article details a nurse-led, interprofessional collaborative practice (IPCP) model that was developed to provide primary care to a medically indigent population in Birmingham, Alabama. Funding to develop and implement this project came from a federal Nurse Education, Practice, Quality and Retention award to the University of Alabama at Birmingham (UAB) School of Nursing, with additional support coming from the UAB Hospital and Health System. The clinic is housed within a local community-based, non-profit organization and all services, including supplies and pharmaceuticals, are provided free of charge to this vulnerable population. The IPCP model that was developed includes three primary care teams and incorporates faculty clinicians from a variety of disciplines, including nursing, medicine, optometry, nutrition, mental health, social work and informatics. Evaluation of the project has included annual structured interviews of project personnel, a variety of survey instruments completed electronically at various intervals, and assessments by students as well as patients experiencing team-based care. The focus of this article is the qualitative data collected from structured interviews of clinician faculty annually over the three years of the funded project. The learning, understanding and growth that have taken place by the experienced clinicians from multiple disciplines regarding IPCP are detailed.

Collaborative practice model for management of pain in patients with cancer.

The use of a collaborative drug therapy agreement (CDTA) by oncology pharmacists in a comprehensive pain clinic is described. Recognizing the complex clinical services required by patients with cancer, the Seattle Cancer Care Alliance began offering cancer pain management through a specialized pain service. Initially, the clinic was staffed by one attending physician; however, as the volume of patient referrals increased, the clinic expanded into an interprofessional team that includes physicians, advanced practice providers, nurses, and pharmacists. Through an extensive credentialing process and under the guidance of a CDTA, pharmacists in the pain clinic are able to evaluate patients, develop treatment plans, and prescribe pain medication therapies for oncology patients. By having pharmacists provide these services, the pain clinic can improve medication dosing, ensure that medications are managed consistently, improve patients' quality of care, and save providers time by allowing tasks to be completed by appropriately trained ancillary staff. For cancer-related pain, the pharmacist, in conjunction with the attending provider, develops a pain medication plan following the principles of the World Health Organization's analgesic ladder. The pain clinic has implemented the routine use of several validated tools for screening and assessment of opioid risk as well as state guidelines for managing chronic opioid therapy. The pharmacists in the pain clinic also emphasize functional goals and improvement in functional status rather than complete relief of pain. As members of an interprofessional pain clinic team, oncology pharmacists use their specialized knowledge of cancer and pharmacotherapy to help manage and treat pain in complex cancer cases.

Experiences of nurse practitioners and medical practitioners working in collaborative practice models in primary healthcare in Australia - a multiple case study using mixed methods.

BackgroundIn 2010 policy changes were introduced to the Australian healthcare system that granted nurse practitioners access to the public health insurance scheme (Medicare) subject to a collaborative arrangement with a medical practitioner. These changes facilitated nurse practitioner practice in primary healthcare settings. This study investigated the experiences and perceptions of nurse practitioners and medical practitioners who worked together under the new policies and aimed to identify enablers of collaborative practice models.MethodsA multiple case study of five primary healthcare sites was undertaken, applying mixed methods research. Six nurse practitioners, 13 medical practitioners and three practice managers participated in the study. Data were collected through direct observations, documents and semi-structured interviews as well as questionnaires including validated scales to measure the level of collaboration, satisfaction with collaboration and beliefs in the benefits of collaboration. Thematic analysis was undertaken for qualitative data from interviews, observations and documents, followed by deductive analysis whereby thematic categories were compared to two theoretical models of collaboration. Questionnaire responses were summarised using descriptive statistics.ResultsUsing the scale measurements, nurse practitioners and medical practitioners reported high levels of collaboration, were highly satisfied with their collaborative relationship and strongly believed that collaboration benefited the patient. The three themes developed from qualitative data showed a more complex and nuanced picture: 1) Structures such as government policy requirements and local infrastructure disadvantaged nurse practitioners financially and professionally in collaborative practice models; 2) Participants experienced the influence and consequences of individual role enactment through the co-existence of overlapping, complementary, traditional and emerging roles, which blurred perceptions of legal liability and reimbursement for shared patient care; 3) Nurse practitioners’ and medical practitioners’ adjustment to new routines and facilitating the collaborative work relied on the willingness and personal commitment of individuals.ConclusionsFindings of this study suggest that the willingness of practitioners and their individual relationships partially overcame the effect of system restrictions. However, strategic support from healthcare reform decision-makers is needed to strengthen nurse practitioner positions and ensure the sustainability of collaborative practice models in primary healthcare.Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-016-0503-2) contains supplementary material, which is available to authorized users.

Introduction of a team-based care model in a general medical unit.

BackgroundAlberta Health Services is a provincial health authority responsible for healthcare for more than four million people. The organization recognized a need to change its care delivery model to make care more patient- and family-centred and use its health human resources more effectively by enhancing collaborative practice. A new care model including changes to how providers deliver care and skill mix changes to support the new processes was piloted on a medical unit in a large urban acute care hospital Evidence-based care processes were introduced, including an initial patient assessment and orientation, comfort rounds, bedside shift reports, patient whiteboards, Name Occupation Duty, rapid rounds, and team huddles. Small teams of nurses cared for a portion of patients on the unit. The model was intended to enhance safety and quality of care by allowing providers to work to full scope in a collaborative practice environment.MethodsWe evaluated the new model approximately one year after implementation using interviews with staff (n = 15), surveys of staff (n = 25 at baseline and at the final evaluation) and patients (n = 26 at baseline and 37 at the final evaluation), and administrative data pulled from organizational databases.ResultsStaff interviews revealed that overall, the new care processes and care teams worked quite well. Unit culture and collaboration were improved, as were role clarity, scope of practice, and patient care. Responses from staff surveys were also very positive, showing significant positive changes in most areas. Patient satisfaction surveys showed a few positive changes; scores overall were very high. Administrative data showed slight decreases in overall length of stay, 30-day readmissions, staff absenteeism, staff vacancies, and the overtime rate. We found no changes in unit length of stay, 30-day returns to emergency department, or nursing sensitive adverse events.ConclusionsConclusions from the evaluation were positive, providing initial support for the idea of the collaborative practice model vision for adult medical units across Alberta. There were also a few positive effects on patient care suggesting that models such as this one could improve the organization’s ability to deliver sustainable, high-quality, patient- and family-centred care without compromising quality.

Measuring the impact of clinically relevant interprofessional education on undergraduate medical and nursing student competencies: A longitudinal mixed methods approach

ABSTRACTInterprofessional education (IPE) to improve collaborative competencies is essential for delivering high-quality care. Yet creating clinically relevant IPE and linking it to improvements in behaviours remains challenging, and few objective measurement instruments are available. We developed a process for creating IPE and objective observational tools through collaborative care best practice models (CCBPMs). These models describe the professional and interprofessional behaviours needed for specific patient populations, illnesses, and care settings. Four IPE workshops based on CCBPMs were implemented for all medical and nursing students during their clinical/clerkships years. Students in Cohort 1 completed two IPE workshops: rapid response and end-of-life. For Cohort 2, students completed four IPE workshops, adding chronic paediatric illness and transitions for the cognitively impaired. Valid and reliable collaborative behaviors observational assessment tools (CBOATs) derived from CCBPMs for the rapid response and end-of-life workshops were developed. CBOATs were used in the longitudinal assessment of student learning for both cohorts during two Interprofessional Teamwork Objective Structured Clinical Examinations (ITOSCEs) conducted before and after the students completed the IPE workshops. Over a 2-year period, 457 students completed the IPE simulations and ITOSCEs. Both medical and nursing students demonstrated significant improvement in CBOAT scores. Comparisons between the cohorts showed that participation in four versus two IPE experiences did not significantly improve most CBOAT scores. We conclude that undergraduate IPE simulation experiences based on CCBPMs result in measurable improvements in learner behaviours necessary for effective collaborative and team-based practice in specific care areas.

Using reflection to evaluate student learning in ambulatory care IPPEs

PurposeGather insight from student pharmacists about what they learned and whether objectives of an introductory pharmacy practice experience (IPPE) were achieved in an academic-based ambulatory care site. MethodsStudents wrote post-reflective essays after their first ambulatory care-site visit. They reflected upon their previous assumptions of ambulatory care, and the roles and skills required of pharmacists in this setting. Additionally, students ranked their interest in ambulatory care pre- and post-IPPE. Post-reflection essays were analyzed for recurring themes using a constant comparison method and a respondent validation method was employed to confirm these findings. Wilcoxon signed-rank sum test was used to analyze student interest in ambulatory care and descriptive statistics were used, as appropriate. ResultsOverall, 70 reflection articles were analyzed. Assumptions of ambulatory care were either incorrect or proved to be more than what was expected for 60% of students. Based on the themes identified, students learned most about the collaborative practice model, chronic disease state management, and the time commitment necessary for outcomes. Regarding skills required of a pharmacist, students discussed the need for a strong knowledge base, communication, and ability to transfer these skills from one setting to another. Interest in ambulatory care increased after the site visit (p <0.01) and 90% of students who wrote these reflections strongly agreed or agreed with the above findings. ConclusionsWith intentional reflection, ambulatory care IPPEs can serve as a meaningful outlet for learning while also achieving IPPE objectives.

Effectiveness of a Pharmacist-Physician Team-Based Collaboration to Improve Long-Term Blood Pressure Control at an Inner-City Safety-Net Clinic.

To evaluate the effectiveness of a pharmacist-physician collaborative practice model (PPCPM) to improve long-term blood pressure (BP) control rates in a primarily African-American underserved urban population. Volunteer physicians established initial diagnoses, whereas pharmacists provided most (more than 70%) of the medication management. During each scheduled visit, the pharmacist reconciled the medication list, completed a clinical interview, conducted a focused physical examination, developed and implemented a treatment plan, and provided documentation in a shared medical record. A retrospective chart review was performed to collect data for a longitudinal cohort of patients managed by the PPCPM from 2010-2013. Of 385 patients with at least two pharmacist visits during 2009, 172 patients received continuous care over the study period. At baseline, the mean age of the cohort was 51.3 years, 62% were female, and 76% were African-American. Approximately 65% were obese (body mass index 30 kg/m(2) or higher), and 39% were cigarette smokers. Mean baseline BP was 156/98 mm Hg, with only 17% of the cohort at their BP goal of lower than 140/90 mm Hg. The BP control rate improved to 66% during the first year and persisted throughout the study period, with 68% of patients at goal in 2013 (p<0.05 compared with baseline). The PPCPM BP control rate ranks in the 90th percentile of National Committee for Quality Assurance benchmarks and was superior even to the 2013 reported mean for commercial insurers. The PPCPM effectively improved hypertension control in an uninsured, primarily African-American, urban population despite significant health barriers. Key elements of this asynchronous care model included access to a common medical record, optimization of distinct interprofessional roles, frequent follow-up with evaluation, and collaborative practice agreement with sufficient scope of practice to implement medication changes at the time of the visit.

Integration of Clinical Pharmacist Services into an Underserved Primary Care Clinic Utilizing an Interprofessional Collaborative Practice Model.

This report describes the role of a clinical pharmacist serving onsite in an interprofessional collaborative practice care model at an urban underserved primary care clinic. It also overviews current health care legislative policy as it relates to expanding pharmacists roles as an integrated team member in medically underserved, vulnerable populations.

Pharmacist and Physician Collaborative Practice Model Improves Vancomycin Dosing in an Intensive Care Unit.

Objective:A pharmacist and physician collaborative practice intervention to improve the initial dosing of vancomycin was implemented with the goal of decreasing the number of subtherapeutic first troughs and increasing the number of therapeutic troughs.Methods:Using the best available evidence, a nomogram was created to determine the initial vancomycin dose. The nomogram utilized actual bodyweight and glomerular filtration rate (eGFR) estimated with the MDRD4 equation. The dose was based on the 2009 ASHP/IDSA/SIDP guidelines, which recommended 15–20 mg/kg every 8–12 hours. Providers ordered “vancomycin IV dosed per pharmacy”.Results:The pre- (n = 75) and post-intervention (n = 108) cohorts had similar age, gender distribution, weight, and eGFR. The median total daily vancomycin dose was similar in pre- and post-intervention groups (2000 mg), although the median first trough was higher following the intervention (13.0 vs. 14.8 mcg/ml, p = 0.03). Following the intervention, the proportion of first troughs under 10 mcg/ml decreased (32% to 13%, p = 0.003), while the proportion of troughs in the 10 – 20 mcg/ml therapeutic range increased (50.7% vs. 69.4%, p= 0.01). There was no difference in the proportion of troughs over 20 mcg/ml (17.3% vs. 17.6%, p= 0.96).Conclusions:A multi-disciplinary intervention utilizing a nomogram-based pharmacy collaborative practice model significantly improves the proportion of therapeutic initial vancomycin troughs and decreases the number of subtherapeutic troughs by half.

Sharing the burden: Schwartz rounds® as a compassionate collaborative practice and education model in long-term care

Sharing the burden: Schwartz rounds® as a compassionate collaborative practice and education model in long-term care

Clinical Outcomes Associated With a Collaborative Pharmacist-Endocrinologist Diabetes Intense Medical Management "Tune Up" Clinic in Complex Patients.

No previous studies exist examining the impact of a short-term pharmacist-endocrinologist collaborative practice model on glycemic control in complex patients. Evaluate outcomes associated with a PharmD-Endocrinologist Diabetes Intense Medical Management (DIMM) "tune up" clinic for complex patients. A retrospective cohort study of 99 patients referred to DIMM clinic versus a comparator group of 56 primary care provider (PCP) patients meeting the same criteria (adult type 2 diabetes patients, glycosylated hemoglobin [A1C] ≥ 8%, follow-up visit within 6 months) in a Veterans Affairs Medical Center. DIMM clinic used a short-term model that coupled personalized clinical care with real-time, patient-specific diabetes education during two to four 60-minute visits over 6 months. PCP patients received usual care. Primary outcome was mean A1C change after 6 months. Secondary measures included fasting blood glucose, lipids, blood pressure, weight, body mass index, and percentage of patients meeting goals. Patients in each group had an average of 8 and were taking 12 to 14 medications daily. Mean A1C (%) improvement in DIMM group was significantly greater at 6 months (-2.4 [SD = 2.1] vs -0.8 [SD = 1.7]; P < 0.001), than PCP group. Percentage meeting A1C goal levels (<7%, <8%, and <9%) was significantly greater at 3 and 6 months compared with baseline in the DIMM group (P < 0.001) versus (only <8%) at 3 and 6 months compared with baseline in PCP group. The DIMM clinic "tune up" model demonstrates a successful collaborative practice which helped complex diabetes patients achieve glycemic control in a 6-month period.

Retrospective Review of Nurse-Midwifery Care at a Large University Health System.

The purpose of the study is to characterize practice trends, outcomes, and changes over time of a full-scope midwifery service over the past 30 years from 1983 to 2013. The types of clients served and the evolution of the services provided and resulting outcomes are described as an exemplar of the changing nature of providing midwifery services in a tertiary care hospital setting. The overall data reveal that despite small increases in intervention practices, such as epidurals, inductions, and cesarean births, midwives have a commitment to providing safe, evidenced-based, woman-centered care within a collaborative practice model at a tertiary care center. The role of midwives as leaders in supporting physiologic birth in this setting and encouraging opportunities for interprofessional education and collaborative is demonstrated.

Report of the 2014-2015 Professional Affairs Standing Committee: Producing Practice-Ready Pharmacy Graduates in an Era of Value-Based Health Care

Background and Charges According to the Bylaws of the American Association of Colleges of Pharmacy (AACP), the Professional Affairs Committee is to study issues associated with the professional practice of pharmacy as they relate to pharmaceutical education, and to establish and improve working relationships with other organizations in the field of health affairs. The Committee is encouraged to address related agenda items relevant to its Bylaws charge and to identify issues for consideration by subsequent committees, task forces, commissions, or other groups. President Patricia Chase established the themes of Access, Affordability and Accountability for the 20142015 standing committees. (1) The 2014-2015 Professional Affairs Committee (PAC) was charged with examining the contributions of experiential education to the development of practice-ready pharmacy school graduates who are educated and trained for current and future practice. Experiential education, comprised of Introductory Pharmacy Practice Experiences (IPPEs) and Advanced Pharmacy Practice Experiences (APPEs) and represents up to 30% of the pharmacy school curricula, are the entry points for student pharmacists into pharmacy and patient care practice. Specifically, the 2014-2015 Professional Affairs Committee is charged to: (1) Describe the elements that should be present for access to exemplary experiential sites; (2) Identify how student pharmacist readiness for and contributions to experiential education should be considered to illustrate the value to experiential practice sites; and (3) Recommend strategies to the academy to demonstrate its accountability that graduates are practiceready. Members of the 2015 PAC include individuals representing multiple disciplines across various colleges and schools of pharmacy, as well as professional staff representation from the American Pharmacists Association (APhA), the American Society of Health-Systems Pharmacy (ASHP) and the National Association of Chain Drug Stores (NACDS). The committee began its work by reviewing pertinent background information and resource materials and participating in a conference call to develop an initial strategy for addressing committee charges. The committee members met for a day and a half in Crystal City, Virginia on October 27-28, 2014 to discuss the various facets related to the committee charges, as well as to develop a process and strategies for addressing the charges. Following the process development and delegation of assignments related to the committee charges, the PAC communicated via electronic communications as well as through personal exchanges via telephone and email. In developing the strategy to address their charges, the PAC considered numerous factors that contribute to the current needs, future needs and contributions of practice-ready pharmacists. Examination of pertinent issues relevant to both experiential education and pharmacy practice were explored from the perspectives of access, value (the PAC examined the value of experiential education as an applicable aspect of affordability) and accountability. The continued evolution of the healthcare environment, including implications for pharmacists and team-based care from the Patient Protection and Affordable Care Act (PPACA), (2) the expanding role of pharmacists in a dynamically-changing health care system, (3, 4 5 6) and emerging interprofessional, collaborative practice models, such as Patient Centered Medical Homes (4, 7 8) and Affordable Care Organizations, (9) were discussed. The Accreditation Council for Pharmacy Education (ACPE) release of Draft Standards 2016 (10) and the Guidance Document to Draft Standards 2016, (11) which was finalized February 2015, (12,13) are other important aspects that should forecast the content and impact of experiential education. The recently revised Joint Commission of Pharmacy Practitioners (JCPP) Vision for Pharmacists' Practice (14) and the recently approved Pharmacist Patient Care Model, (15) which describes a consistent process of care in the delivery of patient care services by pharmacists, are additional avenues that must be included in all aspects of pharmacy education. …