PubMed · 3148587
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J J Gervás, M M Pérez Fernández. [Ambulatory visit groups].. https://pubmed.ncbi.nlm.nih.gov/3148587/
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The participants agreed that integrated health systems of the future will provide the full continuum of care for patients. The characteristics of individual systems will be influenced by the basic elements the system controls and maintains inhouse and the elements that are outsourced. The challenge to pharmacists in these systems will be to ensure that key decision-makers have accurate information about the value of pharmacy and the need to include pharmacists on the care team. The medication-use process and the formulary system will be tied to disease-specific care plans or treatment protocols. Pharmacists will have a greater role in overall disease management. They will be involved with the patient before an office visit and will aggressively follow the patient to prevent or slow disease progression. Pharmacy managers have identified a number of core competencies their staffs must have. One participant summed these up as outstanding clinical knowledge, exceptional communication skills, and common sense.
Compliance with the National Cholesterol Education Program (NCEP II) Adult Treatment Panel II guidelines for lipid management in patients with coronary artery disease has not been widespread. Barriers to effective lipid management occur at numerous levels of interaction between the patient, provider, and healthcare organizations. Nurse care managers (NCMs), recognized in the inpatient and discharge planning settings, are emerging in new roles in the outpatient setting working in subspecialty areas including lipid/risk-reduction, heart failure, and anticoagulation clinics. To improve patient adherence to NCEP II goals, NCMs can help overcome treatment barriers by: (1) bridging inpatient/outpatient care; (2) securing long-term patient compliance and follow-up; (3) developing clinic policy and computerized patient databases; (4) implementing management algorithms; and (5) enhancing financial reimbursement from insurers. Additional graduate nursing programs and novel healthcare delivery models demonstrating the ability to overcome the barriers to improved patient care must be encouraged and supported.
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