American College of Clinical Pharmacy
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ACCP Report - April 2018

Highlights from the CMM Effectiveness and Implementation Grant: A Report from the Study Team


The ACCP Report features regular columns written by the CMM study team to provide ACCP members with highlights and learnings from the CMM project. Previous reports can be found at www.accp.com/cmmupdates.

In This Quarter's Report

To revisit the aims of the CMM study, please visit www.accp.com/061601. In this quarterly installment, we provide a summary of the work that has been completed as well as the work that remains. We also highlight the creation of a new e-mail list to engage clinical pharmacists interested in advancing CMM within their practices and organizations. This need arose from a successful series of workshops held during the ACCP Updates in Therapeutics® 2018 meeting in Jacksonville, Florida. Finally, we discuss the ongoing work to create and validate a tool designed to assess "implementation outcomes" for clinical pharmacists delivering CMM as well as those interested in implementing CMM. Validation of this survey, which would serve as a useful and important tool within the profession, requires that we recruit a large number of clinical pharmacists to complete the survey (extending outside the study sites). Therefore, we provide more information about this survey together with a request to consider completing it for individuals who meet the eligibility criteria.

Study Updates

Work completed so far has:

  • Established five core tenets that represent a CMM philosophy of practice;
  • Established a common language for the delivery of CMM in patient-centered, team-based care environments;
  • Developed a CMM self-assessment tool (electronic version currently under development);
  • Developed a tool to assess practice management (i.e., identified the elements of CMM that are core to ensuring the efficient, effective, and sustainable delivery of the CMM electronic version currently under development); and
  • Completed a series of multiple PDSA (Plan-Do-Study-Act) improvement cycles with enrolled practice sites to advance the delivery of CMM within their sites and generate the lessons learned (the lessons learned are forthcoming in a manuscript this summer).

The study continues to extend across many different facets of understanding, implementing, and justifying CMM services in primary care settings. Areas of ongoing work within the study include:

  • Measuring the impact of CMM on clinical quality measures, health care costs, and the return on investment that can be realized from CMM (aim 4 of the study);
  • Evaluating the role of a defined process of improvement cycles for scaling up the delivery of CMM services;
  • Developing, implementing, and validating a measure of fidelity to CMM;
  • Assessing provider perception of value of CMM and the influence of CMM on medical provider well-being and burnout in primary care settings;
  • Assessing patient engagement and satisfaction with CMM services;
  • Developing strategies for accelerating CMM implementation and practice improvement, including educational programming to engage existing and new sites in CMM advancement and improvement work;
  • Developing a technology platform that will give clinical pharmacists and organizations access to resources and self-assessment tools to enhance their own practices (available summer 2018); and
  • Developing strategies to accelerate the adoption and scale of CMM through a fall CMM summit (final date to be determined) that engages payers and policy-makers in a discussion of CMM study findings and brings together key stakeholders to develop an action plan for advancing the scale and sustainability of CMM.

In February 2018, we offered educational programming during the ACCP Updates in Therapeutics® meeting in Jacksonville, Florida. This 3-day workshop series was very well received and was considered a huge success by those in attendance. Throughout this program, we engaged participants in interactive CMM practice advancement and improvement exercises and discussions. We were joined by several guest speakers, including experienced clinical pharmacists practicing in ambulatory care clinics throughout the United States, physician providers, representatives from the Centers for Medicare & Medicaid Services, and other key stakeholders who shared insights into payment and policy reform in the context of optimizing medication use. Importantly, participants were actively engaged in assessing their own CMM practice and were provided practical tools and opportunities to work alongside others to develop action-oriented plans to accelerate the advancement of CMM back at their home practices and organizations.

At the 2018 ACCP Patient-Centered Team-Based Practice Forum, participants expressed the need for a mechanism to continue discussions unique to their work around CMM implementation and scalability, as well as a vehicle to network and establish potential mentor-mentee relationships. As ACCP continues to offer educational programming, it is also pleased to provide an opportunity to facilitate important conversations and has created an e-mail list that is available to both ACCP member and nonmember participants - you need not be an ACCP member to participate. For more information or to join, please e-mail Dan Aistrope at DAistrope@accp.com.

Request to Complete a Survey Regarding Implementation Outcomes

As part of the CMM study, we are looking to validate the first Implementation Outcomes survey for pharmacy practice. ACCP member participation will help shape future CMM implementation that is scalable and sustainable. This survey is designed to assess diverse implementation outcomes associated with delivery of a clinical pharmacy service - in this case, CMM. We encourage members to complete the survey to help us develop and validate the role of implementation outcomes in the delivery of CMM. More information about the survey is provided below.

What are Implementation Outcomes?

Implementation outcomes serve as indicators of implementation quality and will be key in achieving the study's desired clinical and economic outcomes.

Who should complete the survey?

Clinical pharmacists who:

  • Provide direct patient care AND
  • Wish to implement CMM OR are currently delivering CMM at their practice sites.

What will survey participants gain?

By completing this survey, participants will both receive a summary of their results that can be used to improve their own implementation or practice of CMM and contribute to validating the first Implementation Outcomes survey for pharmacy practice.

How long will it take to complete the survey?

This survey has several parts. A participant's specific answers will determine the sections to be completed. The survey may take 30-60 minutes.

When must the survey be completed?

We ask that participants complete the survey by April 27, 2018.

What can participants expect while completing the survey?

Once participants click on the survey link, they will first be taken to a set of survey instructions and a consent form. The consent form is necessary because these data will also be used to validate the survey for pharmacy practice. Once the consent form is completed, assessment items will follow.

Access the survey at www.accp.com/ImplOutcomesSurvey.

We appreciate ACCP member participation. Questions regarding this survey should be addressed to Mary Yannayon at mary_yannayon@unc.edu. On behalf of the investigators and study team, we hope these highlights are informative. Please feel free to contact Mary Roth McClurg at mroth@unc.edu or Todd Sorensen at soren042@umn.edu at any time with questions about this project or any of the items noted above.