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Dr. Chui is currently an assistant professor at the University of Wisconsin in Madison, Wisconsin. She earned a B.A. in biological sciences from the University of California—Davis, a Pharm.D. from Creighton University, and an M.S. and Ph.D. in pharmacy administration from Purdue University. Her research centers on applying human factors approaches and utilizing a systems perspective to characterizing community pharmacy practice and its practitioners to understand processes that impact medication safety and quality of care.

After completing this chapter, readers will be able to

  1. Discuss the different facets of the ECHO model and their application to evaluating existing and proposed pharmacy goods, services, and operations.

  2. Describe differences among the five types of economic analyses as tools for managerial decision-making.

  3. List the advantages and disadvantages of the various methods of measuring humanistic outcomes, and describe the role that humanistic outcomes play in evaluating goods, services, and operations.

  4. Identify the objectives of a service and determine the types of outcomes a pharmacist would need to measure in a pharmacy-related service.

  5. Identify the advantages and disadvantages of the various methods used to collect data when evaluating services.

  6. List and describe the uses of various outcomes evaluations and assessments.

Cynthia Marshall is a pharmacist who works at a closed-staff-model health maintenance organization (HMO) pharmacy. Pharmacists at this clinic have access to patient charts that can be used to supplement information given by the patient to the pharmacy staff and what is written on the prescription. Cynthia enjoys working at this pharmacy because she feels that the added information is helpful when she is assessing and counseling her patients. She also believes that the HMO she works for values high-quality health care and is seeking to improve its ratings on some of its quality indicators.

Cynthia sees a number of heart failure patients every month. These patients see their physicians (including primary care physician, cardiac specialist, and frequently one or two other specialists) annually. Many times, these physicians do not coordinate care or know about the other medications that her heart failure patients are taking. She notices that these patients can improve or deteriorate quickly, have a difficult time remembering the complicated medication regimen they are on, and that their health conditions frequently change from month to month. They occasionally complain that their symptoms get so bad that they have to go to the emergency room. She thinks that these patients could have better outcomes if they were better educated about their conditions and monitored more closely.

Cynthia approaches the cardiologists in her clinic with an idea that she could start a heart failure clinic to provide additional education and monitoring for these patients. While the physicians would oversee the clinic, she could conduct monthly educational seminars about heart failure for patients, order and assess laboratory tests, order medications and adjust dosages under physician-approved protocols, and communicate with patients' other physicians about concurrent medications to prevent medication ...

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