Among the constant cacophony of contentious issues on Capitol Hill is a welcome discussion about pharmacists as essential members of the health care team, together with proposed legislation to formalize a mechanism for pharmacist reimbursement for cognitive activities. This discussion has been fostered by work done by national pharmacy organizations, including ACCP, over many years—most intensively since 2013.
Recently introduced legislation in the new Congress, the Pharmacy and Medically Underserved Areas Enhancement Act, has energized pharmacists around the country and increased legislator awareness of pharmacists. However, the complexity of the legislative process and the slow progression can be frustrating to those of us who do not spend time in that world. I strongly recommend the informative and detailed discussion by John McGlew in the February 2015 ACCP Report on this topic. This Washington Report summarizes ACCP’s goals for the advancement of clinical pharmacists and specialists, a strategic priority for our organization (http://www.accp.com/report/index.aspx?iss=0215&art=10).
The strategic priorities are driven by the College’s well-defined core values. We believe that the highly trained and credentialed clinical pharmacist who provides comprehensive medication management (CMM) within the context of collaborative, team-based care is essential to achieving optimal patient outcomes. Our important core values are listed on the ACCP Web site (www.accp.com/about/mission.aspx), but more importantly, they are reflected in how we practice as individuals, and they direct how your leadership wants to excel and maintain a consistent course of action. Simon Sinek, in Start with Why How Great Leaders Inspire Everyone to Take Action, has described how an organization that acts with discipline and does not veer from its vision is felt to be authentic. What this really means is that our consistent focus on clinical pharmacy and the important role of clinical pharmacists resonates with our members, much as devotion to Apple products and Apple’s vision to challenge the status quo in the world of consumer electronics has engendered an enthusiastic following. What we are doing must “feel right” to our members. Your awareness of the mission and values of ACCP will facilitate understanding of the positions we have taken as an organization.
Organizationally, we value the quest to constantly extend the frontiers of clinical pharmacy and applaud the development of new practice models and roles for clinical practitioners. As clinicians, we balance the need to maintain a standardized evidence-based practice while constantly asking how we can improve the status quo by acting on those ambitions. We also strive to achieve optimal outcomes for patients by inspiring our colleagues to maintain high standards of practice and helping our departments maximize their efficiency in the midst of a growing slate of direct patient care activities.
Even as we continue down a consistent advocacy path using the strong policy foundation established by the Board of Regents and the policy and advocacy staff, you will not hear a lot of “publicity” about these efforts until there are some substantial developments to discuss. We are asking for your support and trust while you maintain confidence that we are not sitting idly on the sidelines. We emulate the approach described as the “20-Mile March” by Jim Collins in Great by Choice, where two explorers are trying to reach the South Pole in 1911. The successful team prepared for potential failure and planned for years, studied survival in that unforgiving environment, and maintained a consistent rate of progress throughout its trek―never going too far in good weather in order to limit exhaustion and continuing to press forward in bad weather in order to stay on pace―seeking to cover a consistent 15–20 miles per day. The unsuccessful team had not prepared as thoroughly, did not plan for failure, and did not have redundancy in its processes. That team went as far as it could as fast as it could, eventually exhausting its resources and capacity to continue on.
The discipline to be consistent and true to our core values is not easily achieved as new potential opportunities are presented to ACCP and as the world around us in pharmacy becomes focused on a variety of other issues. Through consistent consideration of ACCP’s strategic plan priorities with respect to any new potential activity or initiative, the Board of Regents regularly revisits its vision for clinical pharmacists and reflects on ACCP’s core values (http://www.accp.com/docs/about/ACCP_Strategic_Plan.pdf). Charges to our many committees and task forces drive members’ work toward achieving the College’s strategic plan objectives. Organizationally, ACCP continues to grow, allowing us to expand efforts to further develop, advance, and position clinical pharmacists for the future. We seek to achieve an envisioned future where well-trained, credentialed clinical pharmacists consistently provide CMM and thereby optimize patient outcomes. The PRNs are similarly contributing to ACCP’s strategic priorities through their support for, and development of, ACCP members. Many of the PRNs have supported member attendance at the ACCP Research Institute’s FIT Program (see http://www.accpri.org/fit/index.aspx) and now will similarly support participation in the new MeRIT Program (see http://www.accpri.org/merit/). These programs represent important steps by ACCP toward helping to develop clinical pharmacists who will advance the profession through their research and scholarly activities. I have also challenged the Critical Care PRN to reexamine and update a foundational document on critical care clinical pharmacist services (Pharmacotherapy 2000;20:1400-6). Similarly, I ask that other PRNs consider feasible projects that could measure the impact of CMM on patient outcomes in their respective practice settings. We should all be working toward our shared vision of clinical pharmacists as recognized members of the health care team who help achieve better medication-related outcomes for patients.
PRN members who work with the rapidly growing number of student chapters are in an ideal position to educate students about ACCP, its mission, and its vision and to inspire them to establish high standards for their future practices. My recent visits to colleges of pharmacy, which afforded me the opportunity to meet with highly motivated students and their faculty, have affirmed my belief that ACCP’s core values will continue to resonate with this new generation of clinical pharmacists.
On the legislative front, be assured that our efforts to position clinical pharmacists as essential providers, in collaboration with key physician organizations and interprofessional organizations like the Patient-Centered Primary Care Collaborative, are continuing. Although we would like to see rapid advancement of ACCP’s Medicare Initiative, we understand that successful legislative efforts take time. Furthermore, we cannot ignore the current fiscal environment within Congress, which necessitates a funding offset for any contemplated new governmental expense. We hope the momentum and enthusiasm of early adopters of CMM will help drive us toward a tipping point. But for the immediate term, a steady and rigorous quest to publish data on the impact of CMM persists while we continue to raise awareness of the clinical pharmacist’s contributions to patient care.