A professional patient care practice is built on three essential elements: a philosophy of practice, a patient care process, and a practice management system.
A professional patient care practice is predicated on a patient-practitioner relationship established through respect, trust, and effective communication. Patients, and when appropriate caregivers and family, are actively engaged in decision making.
Adopting a uniform patient care process—a consistently implemented set of methods and procedures—serves as a framework for each patient encounter, increases quality and accountability, and creates shared language and expectations.
The patient care process includes five essential steps: collecting subjective and objective information about the patient; assessing the collected data to identify problems and set priorities; creating an individualized care plan that is evidence-based and cost-effective; implementing the care plan; and monitoring the patient over time during follow-up encounters to evaluate the effectiveness of the plan and modify it as needed.
The patient care process is supported by three inter-related elements: communication, collaboration, and documentation. Interprofessional teamwork and information technology facilitate the effective and efficient delivery of care.
A practice management system includes the infrastructure to deliver care. This includes physical space, documentation systems, payment for services, and qualified support personnel.
PRECLASS ENGAGED LEARNING ACTIVITY
For an overview of the importance of applying a consistent process of care in practice, listen to the following PharmacyForward podcast episodes:
The patient care process is a fundamental series of actions that guide the activities of health professionals. All health professionals who provide direct patient care should use a systematically and consistently applied process of care in their practice.1 Until recently, the language to describe the process for delivering comprehensive medication management services was ill-defined. In 2014, the Joint Commission for Pharmacy Practitioners (JCPP)—representing 11 national pharmacy organizations—endorsed a framework for providing clinically oriented patient care services called the Pharmacist's Patient Care Process.2 However, the framework and the language to describe the process are not unique to the profession of pharmacy. Indeed, medicine, nursing, and dentistry all follow a putatively similar process of care3 (see Table 1-1). For example, the American Nursing Association outlines the nursing process with steps that include assessment, diagnosis, outcomes/planning, implementation, and evaluation.4 The Academy of Nutrition and Dietetics collapses these general steps into four steps, outlining the nutrition care process to include nutrition assessment, diagnosis, intervention, and monitoring/evaluation.5 Although the care process is similar across disciplines, each health profession brings a unique set of knowledge, skills, attitudes, and values to the patient encounter.
Table 1-1Professional Standards of Care and Their Domains