Strategies for reimbursement.
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Biomedical subjects
Publications and source records attributed to M T Rupp.
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Interventions performed by 89 community pharmacists in 5 states to correct the prescribing problems they identified on new prescription orders were documented by trained observers. Pharmacists intervened to resolve a prescribing-related problem in 623 (1.9%) of 33,011 new prescription orders that were screened and dispensed during the study period. A panel of three expert evaluators concluded that 28.3% of the prescribing problems identified during the study could have caused patient harm if the pharmacist had not intervened to correct the problem. The rate at which pharmacists identified prescribing problems was negatively related to the number of prescriptions they dispensed per hour, suggesting that in pursuing distributive efficiency, some pharmacists may be exceeding their safe dispensing threshold. The authors recommend that the interprofessional system of oversight and verification (i.e., "checks and balances") in the delivery of pharmaceutical care in the community setting should be maintained and strengthened.
OBJECTIVE: The purpose of this analysis was to estimate the economic value created by community pharmacists who routinely screen for and correct prescribing-related problems during the course of their dispensing activities. DESIGN: Three expert judges evaluated the documented interventions of community pharmacists practicing in five states. RESULTS: The judges agreed that 28.3 percent of the identified problems could have resulted in patient harm had the pharmacist not intervened to correct the problem. The direct cost of medical care that was avoided as a result of pharmacists' intervention activities was estimated to be $122.98 per problematic prescription, or +f42.32 per each new prescription order that was screened during the study. CONCLUSIONS: Clinical pharmacy services can and do create significant value by enhancing the achievement of positive patient outcomes and by avoiding negative outcomes. Research to develop reliable methods for measuring and monitoring the value of clinical pharmacy services must continue. Mechanisms must be created to encourage and reward pharmacists who consistently provide services that add measurable value to patient care.
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This article illustrates application of (1) Nominal Group Technique and (2) Importance-Performance Analysis, both commonly used planning strategies, to the programmatic planning of a university-based biomedical communications center. The method described may prove useful when successful implementation of such a plan depends upon cooperation between diverse client groups within the organization.