Content uploaded by Mark L Britton
Author content
All content in this area was uploaded by Mark L Britton on Jan 29, 2015
Content may be subject to copyright.
Collaboration between a college of pharmacy and a for-profit health system at an academic medical center
Abstract
The genesis and growth of a successful 14-year partnership between the University of Oklahoma (OU) college of pharmacy and the OU Medical Center (OUMC) department of pharmacy are described.
Pursuant to a 1998 joint operating agreement, the medical center and pharmacy school have achieved a high degree of collaboration on a wide range of educational and clinical initiatives. The close relationship has conferred a number of benefits on both institutions, including (1) expanded experiential education opportunities for pharmacy students, (2) joint faculty and staff funding arrangements that have facilitated the development and accreditation of OU pharmacy residency programs, and (3) patient care initiatives that have increased awareness of pharmacists' important contributions in areas such as venous thromboembolism prophylaxis, antibiotic stewardship, and core measures compliance. In addition to the formal integration of the college of pharmacy into the OUMC organizational structure, ongoing teamwork by clinicians and administrators at the two institutions has strengthened the 14-year partnership while helping to identify creative solutions to evolving communications, technology, and reimbursement challenges. Potential growth opportunities include the expansion of pharmacy services into additional service areas and greater involvement by OU pharmacy school faculty in the training of medical, nursing, and allied health professionals.
A large for-profit academic medical center and a college of pharmacy developed a successful collaboration that is mutually beneficial and provides increased clinical, educational, and scholarly opportunities, advancing the mission of both institutions.
... From a partnership perspective, JOAs facilitates better continuity of care in both referral sources and care transitions to inpatient facilities when needed. Bird et al. (2012) find that a JOA relationship creates more significant opportunities for collaborative teaching, research and student engagement through programs such as residencies and fellowships. The result for the hospital is increased intellectual and human capital while the academic institution gains opportunities for faculty, staff, and students. ...
The purpose of this study was to develop and test a Conceptual Framework for an evaluation model for compliance and regulatory programs in specialty academic medicine. The Framework was built on three research questions to determine the following items within a specialty academic medical institution: (i) the Program Elements for effective and sustainable compliance and regulatory programs, (ii) the required knowledge and skills for stakeholder groups, and (iii) the motivation and organizational influences which improve stakeholder efficacy and program sustainability. There was a total of 21 Program Elements derived from both professional and theoretical literature. Those elements were then matched against the gap analysis model for assessing organizational performance based on knowledge and skills, motivational, and organizational influences as developed by Clark and Estes (2008). Finally, 15 recommendations were developed, along with each of the required elements for evaluation and implementation using the New World Model developed by James D. Kirkpatrick and Wendy Kayser Kirkpatrick (2016). Items such as leading indicators, critical behaviors, required drivers, and several other components provide content and context for immediate and long-term summative assessment, to address the program sustainability, aim of the study.
... The results from this study build on the existing literature on academic practice partnerships in pharmacy education that provide rich descriptions of formalized partnerships, but did not pair that information with patient or student learning outcomes resulting from the partnership. [26][27][28] With data from multiple assessment points, this study demonstrates clear benefits from the partnership agreement that advance the missions of both organizations. In examining patient medication outcomes, the addition of a pharmacist on an interprofessional team decreased the average amount of medications at week 4 and week 7-12. ...
Introduction: The purpose of this mixed-methods study was to evaluate an interprofessional academic-practice partnership in end of life care by examining patient medication outcomes, the contributions of student pharmacists and a pharmacy preceptor to care teams, and student learning experiences.
Methods: Retrospective chart review assessed polypharmacy differences in hospice patients with a primary terminal diagnosis of non-Alzheimer’s dementia between two patient groups; Group 1 managed on interprofessional care teams within the pharmacy partnership, and Group 2, managed on teams without a pharmacist. Team members who interacted with student pharmacists and the pharmacy preceptor participated in semi-structured key informant interviews to document perceptions of pharmacy contributions to care teams and the organization. At the end of their APPE, students completed reflective writings regarding their learning.
Results: Patients in Group 1 were on statistically significant fewer medications than Group 2 at both week 4 and weeks 7-12 following admission. Five conceptual themes emerged from interviews: pharmacists as team medication experts, improved patient outcomes, interprofessional collaboration, patient/caregiver trust in medication regimens, and desire for sustainability. Student reflections included the following learning themes: teamwork, respect, value, and patient-centered care.
Conclusions: The addition of a pharmacist on interprofessional care teams decreased the average number of medications in the non-Alzheimer’s end of life patient population. Team members identified value-added contributions of student pharmacists and the pharmacy preceptor that enhanced team efficiency and patient care. Student pharmacists recognized these contributions and the experience served as an exemplar of interprofessional practice.
... Clinical pharmacists have not been fully accepted by doctors, nurses or patients, and cooperation between clinical pharmacists and other clinical practitioners is limited too [55]. One survey revealed that full-time clinical pharmacy services have made limited progress in China until recently and physicians' perceptions and attitudes toward clinical pharmacy services or clinical pharmacists are not positive enough [56]. ...
... This includes partnering with health systems and academic medical centers, and developing new services with community health centers and pharmacies. [1][2][3] Innovative approaches to scheduling have also been demonstrated in the literature. Hatton and Weitzel described the benefits of complete-block scheduling for APPEs, such as increased student participation in patient care and medication use responsibilities, in-depth learning experiences, student participation in institutional research and projects, and improved preceptor satisfaction. ...
Objective. To evaluate the rotation capacity at the University of Maryland School of Pharmacy and see if the implementation of clinical track programs across the state correlates to an increase in rotation capacity for the school. Methods. The following information was collected: number of preceptors over the years in the school’s experiential learning program, number of clinical track programs from 2012 to 2015, rotation type, availability submissions per rotation type per year, and availability submissions per hospital participant in the clinical track program per year. The rotation capacity and rotation types from 2012 to 2015 academic years were assessed and compared to see if there was any impact on the clinical track programs implemented. Results. There was no statistically significant difference in the frequency distribution of rotation types among all sites from 2012 through 2015 academic years. However, there was a statistically significant difference in the total number/capacity of rotations from 2012 to 2015 academic years. There were also statistically significant differences in the rotation capacity in all sites except for three sites. Conclusion. Adding clinical track programs can help increase the capacity of a school’s clinical rotations. © 2017, American Association of Colleges of Pharmacy. All rights reserved.
... To provide pharmacy students with experiences at large teaching facilities, some colleges of pharmacy have developed formal relationships with otherwise unaffi liated hospitals and health systems. [6][7][8][9][10] The partnership between an academic health system and college of pharmacy can be mutually benefi cial. 11 We describe our experience with a joint initiative between a private academic health system and a private college of pharmacy. ...
Advanced experiential education represents the culmination of a pharmacy student's training, where students can apply the knowledge they have learned in the classroom to real patients. Unfortunately, opportunities for students to provide the direct patient care recommended by pharmacy organizations and accrediting bodies are lacking. Additionally, academic health systems that can provide these experiences for students are experiencing hardships that have stalled the expansion of postgraduate training programs and services. Formal cooperation between unaffiliated colleges of pharmacies and academic health systems has the potential to increase the number of experiential students completing rotations in an academic environment, expand postgraduate education training programs, enhance the development of resident educators, increase research and scholarly opportunities, and expand clinical pharmacy services. This article describes the formation of a unique joint initiative between a private academic health system without a college of pharmacy and a private college of pharmacy without a hospital. The successful cultivation of the relationship has resulted in professional growth at both institutions and can be implemented at other sites around the country to synergize the efforts of academic health systems and colleges of pharmacy.
Description of the problem: Providing experiential experiences for student pharmacists within health systems can be challenging for schools of pharmacy. Establishing clinical faculty practices within health systems enables schools to increase student placements, however the clinical faculty typically prioritize experiential education within their individual clinical practice and may not be positioned to develop experiential education opportunities across the site.
Description of the innovation: A novel clinical faculty position, the experiential liaison (EL), established at the school’s largest health system partner to focus on improving the quality and quantity of experiential education across an academic medical center (AMC).
Critical analysis: University of Colorado Skaggs School of Pharmacy and Pharmaceutical Science (SSPPS) identified interested preceptors, recognized and coordinated preceptor development, and facilitated development of quality experiential activities within the site through the establishment of the EL position. Since the establishment of the EL position, student placement at the site increased to 34% of SSPPS’s experiential placements in 2020. A high number of preceptors answered “strongly agree or agree” to understanding SSPPS’s curriculum, expectations from the school, how to utilize assessment tools to measure student performance on rotation, and how to provide feedback to the school. Preceptor development opportunities are routine and effective, and the relationship between the school and hospital is collaborative.
Implications: Establishing an experiential liaison clinical faculty position within a health system is a feasible strategy for schools to further increase experiential education placements in health systems.
Purpose
Pharmacy departments and schools of pharmacy have long held professional affiliations. However, the success of each entity is often not interdependent and aligned. In 2010, our institutions found ourselves in a position where the complementary motivations of each aligned to support a more meaningful and committed engagement, leading to the development of the Partnership in Patient Care. The impact of the partnership was evaluated 7 years postimplementation, and both the successes realized and the lessons learned are described.
Summary
The partnership provided many advantages to our pharmacy department and the school of pharmacy. This initial iteration of the partnership was a strong proof of concept that an intentional approach to the relationship between a school of pharmacy and a pharmacy department can lead to substantive improvements in a wide array of meaningful outcomes. We experienced an increase in the number of student rotation months completed, growth in the American Society of Health-System Pharmacists–accredited residency programs, and enhanced clinical services. However, the partnership was not without challenges. For instance, lack of a formalized tracking method made certain outcomes difficult to track.
Conclusion
The purposeful establishment of the Partnership in Patient Care, built on the needs of a school of pharmacy and an academic medical center pharmacy department, allowed our institutions to develop an intertwined mission and vision. Over the initial years of the partnership, many successes were realized and lessons were learned. Both the successes and the challenges are serving as the foundation for future iterations of the partnership.
Objective: To provide lessons learned for colleges of pharmacy and large health systems that are contemplating or in the process of undergoing integration. Method: This report describes the merger of an academic medical center and large health system with a focus on the implications of the merger for pharmacy from the perspectives of both a college of pharmacy and a health system’s pharmacy services. Results: Overarching pharmacy issues to consider include having an administrator from the college of pharmacy directly involved in the merger negotiation discussions, having at least one high-level administrator from the college of pharmacy and one high-level pharmacy administrator from the health system involved in ongoing discussions about implications of the merger and changes that are likely to affect teaching, research, and clinical service activities, having focused discussions between college and health system pharmacy administrators on the implications of the merger on experiential and research-related activities, and anticipating concerns by clinical faculty members affected by the merger. Conclusion: The integration of a college of pharmacy and a large health system during the acquisition of an academic medical center can be challenging for both organizations, but appropriate pre- and post-merger discussions between college and health system pharmacy administrators that include a strategic planning component can assuage concerns and problems that are likely to arise, increasing the likelihood of a mutually beneficial collaboration.
Purpose
Competition for pharmacy residencies has drastically increased in the past decade. It is not known if there is a correlation between the number of clinical advanced pharmacy practice experiences (APPEs) completed before the American Society of Health-System Pharmacists (ASHP) Midyear Clinical Meeting (Midyear) and an increased likelihood of matching to a residency program. Exposure to clinical experiences has many benefits. We examined here if there is a relationship between the number of clinical APPEs completed prior to Midyear and overall, and matching for a PGY1 residency in the University of Maryland School of Pharmacy Classes of 2012–2015.
Methods
Both the type and timing of APPEs for 238 students in the identified cohort who applied for residencies were analyzed. Statistical analyses were performed to determine if there is a significant effect of the number of clinical APPEs completed prior to Midyear, or an effect of the number of clinical APPEs completed during pharmacy school on matching for a PGY1 residency.
Results
There was no significant effect of the number of clinical APPEs completed before Midyear on matching for a PGY1 residency (p = 0.214). The total number of clinical APPEs completed by graduation had no significant effect on matching for a PGY1 residency (p = 0.240).
Conclusion
While students may find great value in clinical APPEs as a strong foundational base for pursuing a PGY1 residency, there was no significant effect of the timing of clinical APPEs and matching to a residency. Further study into other contributing variables is warranted.
Purpose:
Identify and summarize articles that describe the value that pharmacy residency training offers to sponsoring health systems.
Summary:
There is a tremendous gap between the number of resident applicants and the number of pharmacy residencies available. Informing health-system administration executives about the proven value of residency training is key to expanding the number of available positions. To address this disparity, a comprehensive and systematic literature search to identify publications highlighting the value that pharmacy residency training provides to the sponsor hospital or health system was conducted. Articles were identified through query of PubMed and SciVerse SCOPUS and through review of bibliographies from relevant articles. Twenty articles were identified and summarized in this annotated bibliography that demonstrate perceived and quantitative value of pharmacy residency training for health systems that sponsor residency training.
Conclusion:
Pharmacy residency training programs are essential for pharmacists that will primarily engage in direct patient care activities. This annotated bibliography includes key publications that provide evidence of the value that pharmacy residents provide to the sponsoring health system. This manuscript will aid prospective residency directors interested in developing new residency positions at new institutions or for residency program directors interested in expanding the total number of resident positions available at the existing sites.
A Joint Cooperative Endeavor Agreement is a contract between a college of pharmacy and a hospital. Through this type of agreement, colleges are providing partially or fully funded faculty a teaching and practice site within both community and university hospitals. The purpose of this article is to discuss the benefits for both the colleges of pharmacy and the hospitals that engage in a joint agreement and to provide information for those wishing to establish such an agreement. This article will include details of the terms and conditions of joint agreements from two different state-funded universities. The details provided could be considered when establishing a joint agreement to ensure adequate division of responsibilities between the two entities; however, the agreement may need to be adapted based on specific university and hospital legal counsel.
The pharmacist’s role in health systems continues to evolve from a product-focused to a patient-centered care model that ensures the safe and effective use of medications in all practice settings. The best way to deploy pharmacists, technicians, and technology in support of the transition has been
Since 2007, the College of Pharmacy at the University of Tennessee has conducted a think tank program to study issues of importance to the college that are broader than the purview of any specific committee. A separate think tank group is appointed for each issue. Each group is charged with
Since 2007, the College of Pharmacy at the University of Tennessee has conducted a think tank program to study issues of importance to the college that are broader than the purview of any specific college committee. A separate think tank group is appointed for each issue. Each group is charged with
An educational program for pharmacists in a multifacility health care setting is described.
The expansion of pharmacy services at a university medical center from a centralized to a decentralized, unit-based model created the need for enhanced education of staff pharmacists. A steering committee with pharmacy department and school of pharmacy representation surveyed educational and professional needs related to the expanded services. Pharmacists indicated that they needed an educational program that was comprehensive, interactive, and accessible to all shifts. Pharmacy school clinical faculty members provided most of the initial educational sessions, which combined didactic presentations and case-based discussion. The needs survey was used in selecting topics that were most relevant to the pharmacists' expanded practice. Each major topic was covered in a series of one-hour sessions held at two-week intervals and scheduled at a time convenient for afternoon-shift pharmacists. Incentives were offered to encourage participation. The live presentations were recorded with video-streaming technology and made available via the Internet to pharmacists on all shifts in all facilities of the health system as well as to faculty members. Since program implementation in 2005, attendance at the live sessions has averaged 25. In postimplementation surveys, pharmacists indicated that the program was meeting their needs and improving patient care. Since 2008, pharmacists have been able to earn continuing-education (CE) credit for the sessions.
A collaborative educational series with online access, clinical content, and CE credit has been effective in meeting pharmacists' needs in a multifacility health care setting.