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INTRODUCTION

Health professionals who provide direct patient care are often called practitioners. Health professionals practice when they use their unique knowledge and skills to serve patients. A healthcare practice is not a physical location or simply a list of activities. Rather, a professional practice requires three essential elements: (1) a philosophy of practice, (2) a process of care, and (3) a practice management system.

A practice philosophy is the moral purpose and commonly held set of values that guides the profession. It is the critical foundation on which the practices of pharmacy, medicine, nursing, and dentistry are built. Although the concept of pharmaceutical care is not formally included in the code of ethics for the pharmacy profession or the oath of a pharmacist, pharmacists understand that they have a unique responsibility for addressing the drug-related needs of patients and should be held accountable for preventing, identifying, and resolving drug therapy problems.

The patient care process is a fundamental series of actions that guide the activities of health professionals. 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 Pharmacists’ Patient Care Process. This process includes five essential steps: (1) collecting subjective and objective information about the patient; (2) assessing the collected data to identify problems, determine the adequacy of current treatments, and set priorities; (3) creating an individualized care plan that is evidence-based and cost-effective; (4) implementing the care plan; and (5) monitoring the patient over time during follow-up encounters to evaluate the effectiveness of the plan and modify it as needed (Fig. 1). In addition to the five fundamental steps, a patient-centered approach to decision making is essential.

FIGURE 1

The pharmacists’ patient care process. Joint Commission of Pharmacy Practitioners. Pharmacists’ Patient Care Process. May 29, 2014. Available at: https://jcpp.net/wp-content/uploads/2016/03/PatientCareProcess-with-supporting-organizations.pdf. Reprinted with permission.

A practice management system is necessary to support the efficient and effective delivery of services, including physical, financial, and human resources with policies and procedures to carry out the work of patient care.

This chapter provides a brief summary of the patient care process applied to drug therapy management and the practice management issues influencing adoption and application of this process by pharmacists.

IMPORTANCE OF A STANDARD CARE PROCESS

The stimulus for developing the patient care process for pharmacy was the wide variation observed as pharmacists provided direct patient care, often using the same terminology to describe diverse services or, conversely, using different terminology to describe the same service. Without a consistent patient care process, it has been challenging for the pharmacy profession to communicate the pharmacist’s role to external groups and establish the distinct value pharmacists bring to an interprofessional care team. Moreover, the patient ...

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