Winner
isolation with no clear direction as how to carry out effective, patient focused reviews that improve outcomes that can be audited. As well as working in partnership with GPs practices to attain the desired information and data transfer to enable efficient review documentation and a system that at any stage can be audited.
“The process needed to be robust enough to be scrutinised and efficient enough to identify beneficial outcomes at any stage. Currently, until this project this has not been the case. I, as a Pharmacy Manager, as well as a Respiratory Prescribing Practice Pharmacist have a foot in both camps (CP and GP practice) and have for many years worked with many HCPs to drive the outcomes within respiratory care to a place that they should be.”
This service development utilised the skill set and knowledge that John has attained to educate and train pharmacists into performing appropriate patient centred reviews with improved outcomes. In particular the information that GP Practice would benefit from CP review of one of its patients.
He developed a pro forma (triplicate- 1CP, 1GP, 1Patient) with guidance on appropriate information that needs to be collated whilst carrying out respiratory MURS, lung function tests as well as a section for suitable auditing of the process.
He continues, “This innovative service development now allows CP to excel in this field as the outcome data clearly indicates that we no longer have a service that is not fit for purpose but a robust cost effective, auditable service that improves patients understanding and management of their condition. This also works to fulfil all of our GP counterparts QOF criteria and promotes joined up care within the primary care setting.
“I attended the regional UCA event for Belfast presenting the concept and appealed for volunteers to assist in this project. The outcome was 15 practices signing up to help and run the programme from September until December.
“I have worked in many GP practices and my observations are that many cannot get their respiratory patients into practice for review (40% at best) and when they attend their opinion is that they haven’t benefited from the process as they feel in many instances that it is just a box ticking exercise. “I feel very strongly that CP is ideally situated to perform these reviews to an exceptional standard with the patient as the key focus and excel in
advancing their future management through simple yet very effective review techniques; It would be hoped that following this project with a bit more further work industry standards can be set to ensure universal quality and standard of care in this field can be achieved leading to better informed patients whom have a better chance of living their lives a great deal better with improved symptoms control.”
John worked with several GP practices and their nurses to glean their needs and acknowledge their concerns whilst at the same time promoting the contribution that pharmacist can make to their situation. When explained clearly the benefits for them with this service development then they all welcomed the prospect of targeting pharmacists targeting their problematic patients whom they had difficulty in getting into surgery to assess. These same HCP contributed to the pro forma developed.
“I also used Pharma industry to obtain non recurrent funding to get the triplicate forms printed for use in the pilot study.”
There are a number of measureable outcomes to have arisen from this initiative: • Improved understanding of their condition educated and trained on what Asthma/COPD is and is not • Improved management of their condition from improved understanding the patent make a clear breakthrough in how to better manage their symptoms and prevent possible deterioration in control and disease progression. • Accurate check if correct device being used with every patient used the in check dial device to firstly check if they had sufficient inspiratory capacity to use their prescribed medication in the first instance. • Simple lung function tests performed PEFR where necessary to identify poor lung function • Correct demonstration of correct inhaler technique again using the in check dial device inhalation technique was initially observed and advice given on how to optimise lung deposition. Following on from this further checks are carried out to ensure consistent ability. If not alternative devices ability checked to advise GP/ prescriber to amend device necessary. This was a very common outcome.
John adds, “This project aims to offer quality patient focused respiratory review with measurable outcomes which hopefully will enhance the management and care of all respective patents currently being prescribed inhaled therapies have worked in many GP practices and my observations are that many cannot get their respiratory patients into practice for review (40% at best) and when
“This Award shows that what community pharmacy does is extremely fundamentally beneficial and important to the community at large”
they attend their opinion is that they haven’t benefited from the process as they feel in many instances that it is just a box ticking exercise.
“I feel very strongly that CP is ideally situated to perform these reviews to an exceptional standard with the patient as the key focus and excel in advancing their future management through simple yet very effective review techniques.
“This project shows enthusiasm and commitment to the enhancement of an essential service in community pharmacy in Northern Ireland delivering exceptional quality above and beyond what is expected.
“The process was driven forward against the grain having been met with objections consistently from many. But through passion and determination succeeded in winning the doubters over resulting in a very important breakthrough for CP practice as we can now claim to offer a robust patient orientated and outcome based review process that is fit for purpose and can be standardised across the whole Health Board going forward.
“This was a pioneering new model/ system that improve pharmacists’ ability to enhance their customer service offering with the real winners being the end user -the patient and equally important is that it is robust enough to show end outcomes in a clear and distinct manner for auditing purposes.
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“The outcomes and efficiency is measurable and the benefits of the initiative which are so important and clear, set out at its inception can be clearly documented. It gives the Respiratory patient the opportunity to take responsibility and control of their condition through ensuring the basics are covered properly e.g. “right medicine (ICS vas SABA) , the right way(correct inhaler device), the right time (compliance), right reason(correct treatment) going forward (management plan) across the spectrum(standardise quality of care)”.
Collecting the Award on behalf of the team John Hamill said, “This is an Award for community Pharmacy. I have taken a very good initiative and just extrapolated it out to where it is going to be more beneficial for the profession and patients. I saw inadequacies within that service and in winning this Award will be able to show how what I have done will help improve patent lives.
“This Award shows that what community Pharmacy does is extremely fundamentally beneficial and important to the community at large.” n
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