Patient care process

Like Medical Care, Nursing Care etcetera PC consists of core components the philosophy, the patient care process, and the practical management system to support the practice. PC was developed from Clinical Pharmacy Services (see below) with more focus on the patients need and on the practitioners (pharmacist) responsibilities towards the patient and the outcome of the drug therapy. To be able to show the improved process of care a categorisation system for drug-related problems was developed. The taxonomy has been further developed into seven categories (Cipolle et al. 1998). This can be used for practice and in studies. 

The policies and procedures document should be kept at the pharmacy, used as a training tool for pharmacists and other personnel, and referred to as needed during the patient care process. It should be easy to access information in the manual. A table of contents should be included, sections tabbed, and an appendix created containing the forms that will be part of the... 

All health care professions have a unique philosophy, process of care, and practice management system. The commonly held purpose of a practice is its philosophy. The knowledge and expertise that a health care professional brings to care for a patient are done so within a common patient care process. The practice management system is vital to support the practice by facilitating application of the philosophy and process of care. By... 

The scope of pharmaceutical care is drug therapy problems, defined as any aspect of a patient s drug therapy that is interfering with a desired, positive patient therapeutic outcome.Before the advent of pharmaceutical care, there was no evidence of a consistent and systematic patient care process applied to the use of medications therefore, pharmaceutical care practitioners responsibilities are to ensure that therapeutic outcomes are achieved and to identify, resolve, and prevent drug therapy problems that hinder achievment of desirable therapeutic outcomes. 

The patient care process clearly describes how a pharmaceutical care practitioner fulfills responsibilities outlined in the philosophy of care. The fhree sfeps in the patient care process are assessment, care plan, and evaluation. These three steps are continuous, or may be viewed as being cyclical in nature. The initial assessment helps the practitioner formulate a care plan in concert with the patient, and follow-up evaluation includes documenfation of acfual patienf oufcomes, leading back to assessment of new drug-relafed needs. 

By using rules applied to health care professions, if is noted fhaf all other health care professionals have a single patient care process guiding the care delivered. Although within any given health care profession fhe practitioner may execute the patient care process in a slightly different manner, there is still only one patient care process that helps the practitioner fulfill patienf care responsibilities. 

Pharmaceutical care practitioners have established patient care process criteria for providing pharmaceutical care, which were developed to help pharmacists team this new approach to patient care as well as to help others determine how well a pharmacist does in delivering care to patients. The criteria used to evaluate performance within the patient care process included ... 

The patient care process for providing pharmaceutical care is briefly described next. 

National Homo Infusion Association. Resources for Payers, Physicians Providers Patient Care Process in Home Infusion Therapy, www.nhianet.org. 

Pharmaceutical care is very different from other cognitive patient care services such as clinical pharmacy and disease state management programs. It is not a separate service that is superimposed on an existing practice but a comprehensive professional practice much like medicine and nursing. Consequently, it has a clearly defined philosophy of practice, patient care process, and practice management system. The remainder of this article describes the essential principles and processes involved in the practice of pharmaceutical care. 

The patient care process (Fig. 1) describes how an individual practitioner fulfills the responsibilities delineated in the philosophy of practice. This process includes three distinct elements that must be completed for each patient 1) patient assessment 2) creation of a pharmaceutical care plan and 3) follow-up evaluation. The success of the process depends on the quality of the therapeutic relationship established with the patient. 

The Pharmacist s Workup of Drug Therapy (PWDT) is a tool available to practitioners that serves as a guide through the steps of the patient care process. It offers a standardized format for efficient documentation of patient-specific information needed for a financially viable pharmaceutical care practice. 

Fig. 1 The patient care process within a pharmaceutical care practice. Adapted from Cipolle, R.J. Strand, L.M. Morley, P.C. Pharmaceutical Care Practice, McGraw-Hill New York, 1998, p. 129.

Drug therapy problems drive subsequent steps in the patient care process therefore, they are stated clearly and with a high level of specificity. Moreover, they are prioritized according to their degree of urgency as determined by the severity of potential harm to the patient. 

Patient care processes use a minimum number of steps and handoffs. Patient care processes are designed with built-in opportunities to recover from critical error (e.g., reversing agent for overdosing of medication). 

Patient care processes are designed such that safe, zero-defect care requires minimum effort to deliver. 

Everyone involved in healthcare shonld work to ensure that patient care processes flow smoothly. Crossing the Quality Chasm defines evidence-based medicine as the integration of best research evidence with clinical expertise and patient values. This definition includes three critical factors ... 

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