I am very excited to begin serving you as ACCP President for the next year! One of my main goals will be to do what I can to help sustain the high level of energy and momentum that was generated during the recent ACCP Global Conference on Clinical Pharmacy in San Francisco, California. The meeting truly was an outstanding forum for learning and idea exchange among all attendees. And of course, a good time was certainly had by all in a beautiful city that offered rich and diverse cultural experiences.

During my Incoming President’s Address on Sunday, October 18, I shared my theme for the upcoming year. My focus will be on “Closing the Gap: Implementing Policies, Programs, and Evidence-Based Practices.” The context for my emphasis starts with an understanding of and appreciation for the tremendous gaps that exist in health care and clinical pharmacy between solid evidence-based knowledge and contemporary clinical practice. One of our chief problems, I think, is implementation related. Clinicians, health systems, educational institutions, and payers often inefficiently and ineffectively translate knowledge into practice. Don’t get me wrong, I do believe that we generally provide “good” care, and we definitely are not lacking in effort. But many indicators suggest that our health care delivery continues to be plagued by suboptimal performance on national quality measures and wide practice variations, which contribute to significant health disparities. In short, we can do better!

My presidential theme is consistent with ACCP core values and several key ACCP strategic plan initiatives. It also logically continues the sequence of previous themes of past ACCP presidents (see Table). Perhaps the most illustrative example is the recent $2.5 million grant offered by ACCP and the ACCP Research Institute to fund a landmark trial that will measure meaningful outcomes related to the implementation of comprehensive medication management (CMM) in contemporary primary care medical practices. This study, awarded to investigators at the University of North Carolina’s Eshelman School of Pharmacy and its collaborators, aims to evaluate how CMM can be replicated, scaled, and sustained in a team-based care environment. In addition, the theme is closely aligned with the national emphasis on practice transformation and the implementation of a standardized process of care for pharmacist-delivered direct patient care services. Finally, it dovetails nicely with efforts to implement interprofessional health care education in new and revised curricula in colleges and schools of pharmacy.

The good news is that there is a rapidly developing field known as dissemination and implementation (D&I) science, also called knowledge translation, which can inform us as we implement new programs, policies, and evidence-based practices. Overall, uptake of D&I science has been greater in the disciplines of medicine, nursing, social work, and mental health than in pharmacy or clinical pharmacy. Although a quick literature search reveals many publications that describe the implementation of pharmacy services, either clinical services or medication use systems, only a handful of papers have ever systematically applied D&I science principles or rigorously measured implementation outcomes.

So my goal in this column is merely to recognize what I believe is a significant problem in health care in general and in clinical pharmacy in particular. For now, I only intend to introduce a potential solution and make a pledge to use additional ACCP forums and resources to further spread the word about implementation science throughout the coming year. Toward that end, I strongly encourage you to read a recently published introductory paper on implementation science¹ (see http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4573926/).

Now is the time to begin having conversations with your colleagues about opportunities to use D&I science to improve the scope and quality of your practice. The possibilities for its application to clinical pharmacy are endless. In addition to CMM, other contemporary examples include clinical decision support for meaningful use, collaborative practice agreements, medication reconciliation, antibiotic stewardship, and clinical practice guidelines. I am convinced that, through these conversations, there will be value for you and your institution, regardless of your practice setting or mission!

Table

Reference:

1. Bauer MS, Damschroder L, Hagedorn H, et al. An introduction to implementation science for the non-specialist. BMC Psychol 2015;3:32.