Integration of a Clinical Pharmacist into an Interdisciplinary Palliative Care Outpatient Clinic. 2017

Sandra Lee DiScala, and Sarah Onofrio, and Maura Miller, and Mitchell Nazario, and Michael Silverman
1 Department of Pharmacy Service (119), West Palm Beach Veterans Affairs Medical Center, Riviera Beach, FL, USA.

OBJECTIVE The primary objective of this quality improvement (QI) project was to determine if the Interdisciplinary Palliative Care Outpatient Clinic (IPCOC) at the West Palm Beach Veterans Affairs Medical Center offered improved symptom assessment and palliative care treatment outcomes. Secondary objectives were to identify, classify, and resolve medication problems and calculate the number of pharmacist recommendations accepted by prescribing providers. METHODS An IPCOC was created by selecting disciplines for a core group including a nurse practitioner, clinical pharmacist, social worker, chaplain, and physician. Consult referrals were recruited by providing educational sessions. The patient assessments were completed using the Edmonton Symptom Assessment System: (revised version; ESAS-R). The clinical pharmacist classified and resolved drug-related problems. The pharmacy resident telephoned veterans for completion of the "Patient Assessment: Overall Satisfaction with Outpatient Palliative Care Clinic." RESULTS Seventeen consults were received, 6 patients were excluded, and 11 were seen in clinic. One (9%) of 11 patients met the outcomes measure of system assessment documentation in the past year. At completion, 11 (100%) of 11 patients met the outcomes data measure. The Patient Satisfaction Assessment revealed veterans strongly agree to recommend the IPCOC. The clinical pharmacist identified 20 drug-related problems, made 16 recommendations, had a 93.7% implementation rate, and facilitated implementation of medication changes. CONCLUSIONS This QI project demonstrates that an IPCOC improved symptom assessment and palliative care outcomes in addition to resolution of medication prescribing issues in veterans with advanced cancer by integration of a clinical pharmacist into the core team.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010166 Palliative Care Care alleviating symptoms without curing the underlying disease. (Stedman, 25th ed) Palliative Treatment,Palliative Supportive Care,Palliative Surgery,Palliative Therapy,Surgery, Palliative,Therapy, Palliative,Care, Palliative,Palliative Treatments,Supportive Care, Palliative,Treatment, Palliative,Treatments, Palliative
D010348 Patient Care Team Care of patients by a multidisciplinary team usually organized under the leadership of a physician; each member of the team has specific responsibilities and the whole team contributes to the care of the patient. Health Care Team,Interdisciplinary Health Team,Medical Care Team,Multidisciplinary Care Team,Multidisciplinary Health Team,Healthcare Team,Care Team, Health,Care Team, Medical,Care Team, Multidisciplinary,Care Team, Patient,Care Teams, Health,Care Teams, Patient,Health Care Teams,Health Team, Interdisciplinary,Health Team, Multidisciplinary,Healthcare Teams,Interdisciplinary Health Teams,Medical Care Teams,Multidisciplinary Care Teams,Multidisciplinary Health Teams,Patient Care Teams,Team, Health Care,Team, Healthcare,Team, Interdisciplinary Health,Team, Medical Care,Team, Multidisciplinary Care,Team, Multidisciplinary Health,Team, Patient Care,Teams, Interdisciplinary Health
D010595 Pharmacists Those persons legally qualified by education and training to engage in the practice of pharmacy. Clinical Pharmacists,Community Pharmacists,Retail Pharmacists,Clinical Pharmacist,Community Pharmacist,Pharmacist,Pharmacist, Clinical,Pharmacist, Community,Pharmacist, Retail,Pharmacists, Clinical,Pharmacists, Community,Pharmacists, Retail,Retail Pharmacist
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D000554 Ambulatory Care Facilities Those facilities which administer health services to individuals who do not require hospitalization or institutionalization. Clinics, Free-Standing,Health Centers, Ambulatory,Outpatient Clinics,Abortion Centers,Abortion Clinics,Ambulatory Care Facilities, Non Hospital,Ambulatory Care Facilities, Non-Hospital,Ambulatory Care Facilities, Nonhospital,Clinic Activities,Family Planning Centers,Outpatient Clinic,Urgent Care Centers,Urgent Care Clinics,Abortion Center,Abortion Clinic,Activities, Clinic,Activity, Clinic,Ambulatory Care Facility,Ambulatory Health Center,Ambulatory Health Centers,Care Center, Urgent,Care Centers, Urgent,Care Clinic, Urgent,Care Clinics, Urgent,Center, Abortion,Center, Ambulatory Health,Center, Family Planning,Center, Urgent Care,Centers, Abortion,Centers, Ambulatory Health,Centers, Family Planning,Centers, Urgent Care,Clinic Activity,Clinic, Abortion,Clinic, Free-Standing,Clinic, Outpatient,Clinic, Urgent Care,Clinics, Abortion,Clinics, Free Standing,Clinics, Outpatient,Clinics, Urgent Care,Facilities, Ambulatory Care,Facility, Ambulatory Care,Family Planning Center,Free-Standing Clinic,Free-Standing Clinics,Health Center, Ambulatory,Urgent Care Center,Urgent Care Clinic

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