Application of process mapping to understand integration of high risk medicine care bundles within community pharmacy practice

Weir, N. M., Newham, R., Corcoran, E. D., Ali Atallah Al-Gethami, A., Mohammed Abd Alridha, A., Bowie, P., Watson, A. and Bennie, M. (2018) Application of process mapping to understand integration of high risk medicine care bundles within community pharmacy practice. Research in Social and Administrative Pharmacy, 14(10), pp. 944-950. (doi:10.1016/j.sapharm.2017.11.009) (PMID:29198732)

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Abstract

Objective: The Scottish Patient Safety Programme – Pharmacy in Primary Care collaborative is a quality improvement initiative adopting the Institute of Healthcare Improvement Breakthrough Series collaborative approach. The programme developed and piloted High Risk Medicine (HRM) Care Bundles (CB), focused on warfarin and non-steroidal anti-inflammatories (NSAIDs), within 27 community pharmacies over 4 NHS Regions. Each CB involves clinical assessment and patient education, although the CB content varies between regions. To support national implementation, this study aims to understand how the pilot pharmacies integrated the HRM CBs into routine practice to inform the development of a generic HRM CB process map. Methods: Regional process maps were developed in 4 pharmacies through simulation of the CB process, staff interviews and documentation of resources. Commonalities were collated to develop a process map for each HRM, which were used to explore variation at a national event. A single, generic process map was developed which underwent validation by case study testing. Results: The findings allowed development of a generic process map applicable to warfarin and NSAID CB implementation. Five steps were identified as required for successful CB delivery: patient identification; clinical assessment; pharmacy CB prompt; CB delivery; and documentation. The generic HRM CB process map encompasses the staff and patients' journey and the CB's integration into routine community pharmacy practice. Pharmacist involvement was required only for clinical assessment, indicating suitability for whole-team involvement. Conclusions: Understanding CB integration into routine practice has positive implications for successful implementation. The generic process map can be used to develop targeted resources, and/or be disseminated to facilitate CB delivery and foster whole team involvement. Similar methods could be utilised within other settings, to allow those developing novel services to distil the key processes and consider their integration within routine workflows to effect maximal, efficient implementation and benefit to patient care.

Item Type:Articles
Keywords:Implementation, patient safety, primary care, quality improvement, variation.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Bowie, Dr Paul
Authors: Weir, N. M., Newham, R., Corcoran, E. D., Ali Atallah Al-Gethami, A., Mohammed Abd Alridha, A., Bowie, P., Watson, A., and Bennie, M.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
Journal Name:Research in Social and Administrative Pharmacy
Publisher:Elsevier
ISSN:1551-7411
ISSN (Online):1934-8150
Published Online:21 November 2017

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