Development and implementation of Next Generation Clinical Pharmacy Services (NGPS) at Kaiser Permanente Colorado

Service or Program: Primary Care Clinical Pharmacy Services (PCCPS) Kaiser Permanente Colorado (KPCO) is a decentralized service of 37 clinical pharmacy specialists within 26 medical offices around Denver/Boulder and the Front Range. KPCO is a group model, integrated health care delivery system where PCCPS work collaboratively alongside physicians and healthcare professionals to provide education and support optimal medication use. Direct patient care activities, predominantly via telephone, include chronic disease state management and quality, safety, and affordability medication initiatives. Justification/Documentation: With ongoing membership growth, increased demand for PCCPS services, and no new resources, it became apparent the PCCPS model needed modification to support members and healthcare teams. Additionally, there was interest in PCCPS incorporating more longitudinal chronic disease state management alongside usual responsibilities. The new model includes four groups of approximately 10 PCCPS to provide electronic medical record (EMR) consult cross coverage and coverage for PCCPS during longitudinal patient care. Focused time for longitudinal care is felt to be more efficient. Team members appreciate balance between individual and population patient care. The new model better distributes workload without moving PCCPS to distant clinics or splitting time between clinics. Transferability: The NGPS model is applicable to settings where multiple clinical pharmacists are providing patient care via EMR. Team-based EMR support allows for built-in coverage for administrative time and vacations, less EMR consult fatigue, and focused time to complete regional medication quality and affordability initiatives. Impact: Multiple PDSA cycles (Plan, Do, Study, Act), resulted in four NGPS teams. Optimization of patient care occurred through more efficient management of consults and designated time for longitudinal population management and initiatives. Team productivity increased by 18.5%. Greater than 90% of individuals are satisfied with the new model. There is less EMR consult fatigue, improved ability to cover time off and increased camaraderie among team members.