Integrating patient safety and clinical pharmacy services into the care of a high-risk, ambulatory population: a collaborative approach.

OBJECTIVES Lincoln Community Health Center participated in a Health Resources and Services Administration-sponsored Patient Safety and Clinical Pharmacy Services Collaborative aimed at facilitating integration of pharmacy services proven to enhance patient safety into care provided to a high-risk, ambulatory population. METHODS The Collaborative used the Plan-Do-Study-Act (PDSA) cycle of learning from the Model for Improvement endorsed by the Institute for Healthcare Improvement to guide changes. Outcomes targeted for improvement included medication reconciliation, obesity screening and follow-up planning, adverse drug events (patient safety), and delivery of clinical pharmacy services. RESULTS Primary changes that resulted from conducting 54 PDSA cycles of learning included enhanced data access, centralized medication access through formulary expansion, implemented a medication reconciliation guideline, designated a single point of accountability in the pharmacy, improved efficiency, staff performed nontraditional roles, extended the existing adverse drug event program, and improved communication. CONCLUSIONS Changes made to integrate patient safety and clinical pharmacy services into the care of a high-risk, ambulatory population not only improved all targeted outcomes but also helped establish Lincoln Community Health Center as the patient's medical home.