title: Integrating patient safety and clinical pharmacy services into the care of a high-risk, ambulatory population: a collaborative approach.
abstract: OBJECTIVE
  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.
authors.affiliation: Pharmacy Services, Lincoln Community Health Center, Durham Regional Hospital/Duke University Health System, Durham, NC 27707, USA. carolyn.robbins@duke.edu
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Robbins
authors.forename: Tracy
authors.initials: T
authors.lastname: Stillwell
authors.forename: Deborah
authors.initials: D
authors.lastname: Johnson
authors.forename: Sally
authors.initials: S
authors.lastname: Wilson
authors.forename: Lynn
authors.initials: L
authors.lastname: Fitzgerald
mesh_terms: D003157:Community Pharmacy Services / Q000458:organization & administration*; D003299:Cooperative Behavior; D019033:Delivery of Health Care, Integrated; D064420:Drug-Related Side Effects and Adverse Reactions / Q000208:ethnology / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D008508:Medication Errors / Q000517:prevention & control; D059065:Medication Reconciliation; D008875:Middle Aged; D008913:Minority Groups; D009657:North Carolina / Q000453:epidemiology; D009765:Obesity / Q000175:diagnosis / Q000208:ethnology; D010348:Patient Care Team; D061214:Patient Safety; D012307:Risk Factors; D014481:United States