Pharmacy Care Plans & Documentation: Integrated Resources
Pharmacy Practice has changed significantly over recent years and continues to evolve toward the provision of pharmaceutical care. Pharmaceutical care requires the effective use of care plans and documentation. This series of units describes a significant body of work undertaken by Canadian pharmacists, pharmacy regulators and pharmacy academics and highlights the many resources and tools developed by these groups as well as by their colleagues in the pharmaceutical industry.
Pharmacy Care Plans and Documentation go hand in hand. This Unit is intended to provide additional resources to those discussed in the first three units in this series. A number of excellent resources address both practice areas and provide tools which facilitate care planning and documentation. As well, resources are included that address Seamless Care, Call Back Services and Specific Disease Categories.
Ontario Pharmacists' Association 'Professional Practice Resources Manual'
The Ontario Pharmacists' Association originally developed this manual in September 1996 and subsequently updated it in April 1997. It provides pharmacists with example professional practice initiatives occurring across Ontario as well as ideas and practical tools for use in practice. The binder includes:
US documentation and care planning tools
From the American Pharmaceutical Association and National Wholesale Druggists' Association Program, "Implementing Pharmaceutical Care" the following tools are available:
- examples of documentation tools
- a guide to pharmaceutical care resources with sections on patient monitoring
- medical record documentation software and where to obtain these resources
To order, contact:
American Pharmaceutical Association
Phone: 1 800 878-0729
An effective pharmacy care plan serves the patient's needs through all stages of the care continuum from institutional care to home care to self care. The following tools and resources are available to facilitate this seamless approach to care.
Patient Centered Transfer of Medication Related information
Farrell et al (1997) developed a personal medication chart so that any health care professional could contribute to and use its components to avoid separate forms for each health care professional. Major components include:
- Description of how chart is organized
- Client consent form
- Client history
- Client's preferences and thoughts regarding treatment
- Current medication list (space for computerized list from pharmacy)
- Medication log
- Medications considered for this client but not being used
- Drug related issues and care plans
- Summary of hospital stay
- Health care professionals participating in client's care
Providing Seamless Care: Ontario Pharmacists Association
This is a teleconferenced program available through the Ontario Pharmacists' Association.
Pharmacy Discharge Plan for Continuity in Patient Care
Mallett et al. (1998) developed a discharge plan to promote hospital-community continuity of care.
"Call Backs" - Care Planning and Documentation
Continuity of care is essential to many patients, particularly those with chronic conditions. Pharmacists can play a valuable role in tracking medications referring patients to other health care professionals, record keeping and follow-up.
Patient follow-up is an important step in the care process and many pharmacists are managing this step through telephone call backs. Pharmacists schedule follow up reminders at the time of dispensing, to ensure follow up with the patient to review therapy and self-care. Tools are available to incorporate call backs into the care planning and monitoring process, and to assist in documenting these follow ups.
Documentation of call backs using Kroll and care plan reminders
Sloan-Beahm describes a patient call back program that uses Kroll menus as a tool for patient call backs or interventions. The system reminds pharmacists of scheduled call backs and the article suggests specific questions to ask.
Patient Call Back Service
Janke (1998) described increasing service provision with performance goals using call back services as an example.
Managing Patient Outcomes in Pharmaceutical care: Enhancing the Role of Call backs
Janke and Kennie (1996) published this document as part of Dalhousie's Pharmaceutical Care project, to address the role of the call back in patient monitoring.
Patient Call Back Manual, Patient Call Back Notification Reminder and Billing Tools
Boivin (1998) developed a set of tools to assist in documenting call backs. One tool is provided to the patient as a notification of the scheduled call back time, and encourages the patient to identify their questions in advance of the call. The other is a billing form for the call back service.
Documentation and Care Plans -
Resources that address specific diseases and assist in the care planning and documentation process for patients with those diseases are available from a number of sources.
These assist in developing pharmacy care plans for specific diseases and allow entry of pharmacist notes to identify steps taken to improve outcome.
Canadian Pharmacists Association (CPhA): Flow Chart for Assessment and Management of Acid-related Gastrointestinal Disorders
Assists the pharmacist to help patients make decisions about these disorders, and may form the basis of a care plan.
To order contact CPhA at http://www.pharmacists.ca/.
Information Materials from the industry - Pharmacy Practice
Review lists patient information materials available from the pharmaceutical industry, many of which assist in identifying and documenting components of the care plan.
AltiMed Patient Management Programs
Interactive workshops provide pharmacists with algorithms for drug-related problem identification and management for selected diseases. (Available through AltiMed sales representatives).
1. Apotex Professional Affairs
2. Value added Professional Services Guide for Pharmacists, British Columbia Pharmacy Association, 1996.
3. Professional Practice Resources Manual, Ontario Pharmacists' Association, 1997.
4. Implementing Pharmaceutical Care reference Kit. American Pharmaceutical Association and National Wholesale Druggists Association, 1997.
Continuity of care
1. Farrell B, Foisy M, Bajcar J. Patient Centred Transfer of Medication Related Information - Evolution of a Model. Can Pharm J 1997; Sep; 25.
2. Mallet L, Laprise R, Bergeron J. Pharmacy Discharge Plan for Continuity of Care. Can Pharm J 1998; Feb: 21-23
Call Back documentation
1. "Progress Notes" Pharmaceutical and managed care, Hoechst Marion Roussel
2. Janke KK. Increasing Service provision with performance goals: Increasing call backs. Can Pharm J 1998: Dec/Jan; 130(10):24-25.
3. Janke KK. Managing Patient Outcomes in Pharmaceutical Care: Enhancing the role of callbacks. Dalhousie's Pharmaceutical Care Project.1996.
Specific diseases and care plan components
1. Boivin M. Call Back Notification Program, 1998.
2. PharmAction. Selected Treatment Assessment tools
3. Acid Related Gastrointestinal Disorder, Canadian Pharmacists' Association. 1997
4. Patient Information Resources. Pharm Pract 1998
1. Janke KK. Analyzing pharmacy systems and optimizing dispensary functioning. Can Pharm J 1997; 130(2):37-8