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      The high-value pharmacy enterprise framework: Advancing pharmacy practice in health systems through a consensus-based, strategic approach

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          Abstract

          Purpose

          The high-value pharmacy enterprise (HVPE) framework and constituent best practice consensus statements are presented, and the methods used to develop the framework’s 8 domains are described.

          Summary

          A panel of pharmacy leaders used an evidence- and expert opinion–based approach to define core and aspirational elements of practice that should be established within contemporary health-system pharmacy enterprises by calendar year 2025. Eight domains of an HVPE were identified: Patient Care Services; Business Services; Ambulatory and Specialty Pharmacy Services; Inpatient Operations; Safety and Quality; Pharmacy Workforce; Information Technology, Data, and Information Management; and Leadership. Phase 1 of the project consisted of the development of draft practice statements, performance elements, and supporting evidence for each domain by panelists, followed by a phase 2 in-person meeting for review and development of consensus for statements and performance elements in each domain. During phase 3, the project cochairs and panelists finalized the domain drafts and incorporated them into a full technical report and this summary report.

          Conclusion

          The HVPE framework is a strategic roadmap to advance pharmacy practice by ensuring safe, effective, and patient-centered medication management and business practices throughout the health-system pharmacy enterprise. Grounded in evidence and expert recommendations, the statements and associated performance elements can be used to identify strategic priorities to improve patient outcomes and add value within health systems.

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          Most cited references35

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          Pharmacist contributions as members of the multidisciplinary ICU team.

          Critical care pharmacy services in the ICU have expanded from traditional dispensing responsibilities to being recognized as an essential component of multidisciplinary care for critically ill patients. Augmented by technology and resource utilization, this shift in roles has allowed pharmacists to provide valuable services in the form of assisting physicians and clinicians with pharmacotherapy decision-making, reducing medication errors, and improving medication safety systems to optimize patient outcomes. Documented improvements in the management of infections, anticoagulation therapy, sedation, and analgesia for patients receiving mechanical ventilation and in emergency response help to justify the need for clinical pharmacy services for critically ill patients. Contributions to quality improvement initiatives, scholarly and research activities, and the education and training of interdisciplinary personnel are also valued services offered by clinical pharmacists. Partnering with physician and nursing champions can garner support from hospital administrators for the addition of clinical pharmacy critical care services. The addition of a pharmacist to an interprofessional critical care team should be encouraged as health-care systems focus on improving the quality and efficiency of care delivered to improve patient outcomes.
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            Advancing Patient Care Through Specialty Pharmacy Services in an Academic Health System

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              Evaluation of a Pharmacist-Directed Vancomycin Dosing and Monitoring Pilot Program at a Tertiary Academic Medical Center.

              Consensus guidelines recommend vancomycin doses of 15 to 20 mg/kg every 8 to 12 hours in patients with normal renal function.
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                Author and article information

                Journal
                American Journal of Health-System Pharmacy
                Oxford University Press (OUP)
                1079-2082
                1535-2900
                February 04 2021
                February 04 2021
                Affiliations
                [1 ]Visante, Madison, WI
                [2 ]Cedars-Sinai Medical Center, Los Angeles, CA, and UCSF School of Pharmacy, San Francisco, CA
                [3 ]Lee Health, Fort Myers, FL
                [4 ]Mayo Clinic, Rochester, MN
                [5 ]Froedtert and the Medical College of Wisconsin, Milwaukee, WI
                [6 ]American Society of Health-System Pharmacists, Bethesda, MD
                [7 ]Lifespan, Providence, RI
                [8 ]Wake Forest Baptist Health, Winston-Salem, NC
                [9 ]UW Health, Madison, WI
                [10 ]Cedars-Sinai Medical Center, Los Angeles, CA
                [11 ]American Pharmacists Association, Washington, DC
                [12 ]University of California San Francisco, San Francisco, CA, and UCSF Health, San Francisco, CA
                [13 ]Winston-Salem, NC
                [14 ]Ochsner Health, New Orleans, LA
                [15 ]Brown University School of Public Health, Providence, RI
                [16 ]University of Kentucky, Lexington, KY, and UK HealthCare, Lexington, KY
                Article
                10.1093/ajhp/zxaa431
                50c2ce36-8de2-4cc8-8eec-970a92fe563b
                © 2021

                https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model

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