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Integrating Patient Safety and Clinical Pharmacy Services Into the Care of a High-Risk, Ambulatory Population: A Collaborative Approach

Robbins, Carolyn M. RPH, PharmD*; Stillwell, Tracy RPh, PharmD*; Johnson, Deborah MD; Wilson, Sally MDiv; Fitzgerald, Lynn PharmD, MA§

doi: 10.1097/PTS.0b013e318281b879
Original Articles

Objectives Lincoln Community Health Center participated in a Health Resources and Services Administration-sponsored Patient Safety and Clinical Pharmacy Services Collaborative aimed at facilitating integration of pharmacy services proven to enhance patient safety into care provided to a high-risk, ambulatory population.

Methods The Collaborative used the Plan-Do-Study-Act (PDSA) cycle of learning from the Model for Improvement endorsed by the Institute for Healthcare Improvement to guide changes. Outcomes targeted for improvement included medication reconciliation, obesity screening and follow-up planning, adverse drug events (patient safety), and delivery of clinical pharmacy services.

Results Primary changes that resulted from conducting 54 PDSA cycles of learning included enhanced data access, centralized medication access through formulary expansion, implemented a medication reconciliation guideline, designated a single point of accountability in the pharmacy, improved efficiency, staff performed nontraditional roles, extended the existing adverse drug event program, and improved communication.

Conclusions Changes made to integrate patient safety and clinical pharmacy services into the care of a high-risk, ambulatory population not only improved all targeted outcomes but also helped establish Lincoln Community Health Center as the patient’s medical home.

From the *Pharmacy Services, Lincoln Community Health Center, a service ofDurham Regional Hospital/Duke University Health System; †Lincoln Community Health Center; ‡Project Access of Durham County; and §Pharmacy Services, Lincoln Community Health Center, a service of Durham Regional Hospital/Duke University Health System and Insight Health Promotions, Apex, North Carolina.

Correspondence: Carolyn M. Robbins, RPH, PharmD, Pharmacy Services, Lincoln Community Health Center Durham Regional Hospital/Duke University Health System, 1301 Fayetteville Street, Durham, NC 27707 (email:

Conflicts of Interest and Source of Funding: The authors declare no conflicts of interest or sources of funding.

At the time of the Collaborative, Dr. Johnson served as Chief of Adult Medicine at Lincoln Community Health Center.

© 2013 by Lippincott Williams & Wilkins