title: Physician-Pharmacist collaboration in a pay for performance healthcare environment.
abstract: Healthcare is becoming more complex and costly in both European (Slovak) and American models. Healthcare in the United States (U.S.) is undergoing a particularly dramatic change. Physician and hospital reimbursement are becoming less procedure focused and increasingly outcome focused. Efforts at Mercy Hospital have shown promise in terms of collaborative team based care improving performance on glucose control outcome metrics, linked to reimbursement. Our performance on the Centers for Medicare and Medicaid Services (CMS) post-operative glucose control metric for cardiac surgery patients increased from a 63.6% pass rate to a 95.1% pass rate after implementing interventions involving physician-pharmacist team based care.Having a multidisciplinary team that is able to adapt quickly to changing expectations in the healthcare environment has aided our institution. As healthcare becomes increasingly saturated with technology, data and quality metrics, collaborative efforts resulting in increased quality and physician efficiency are desirable.
  
  
  CONCLUSIONS
  Multidisciplinary collaboration (including physician-pharmacist collaboration) appears to be a viable route to improved performance in an outcome based healthcare system (Fig. 2, Ref. 12).
authors.forename: T M
authors.initials: TM
authors.lastname: Farley
authors.forename: M
authors.initials: M
authors.lastname: Izakovic
mesh_terms: D001786:Blood Glucose; D006348:Cardiac Surgical Procedures; D014487:Centers for Medicare and Medicaid Services, U.S.; D003299:Cooperative Behavior; D019983:Guideline Adherence / Q000592:standards; D006761:Hospitals; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D010595:Pharmacists; D010820:Physicians; D011182:Postoperative Care / Q000379:methods / Q000592:standards*; D012052:Reimbursement, Incentive; D014481:United States
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin
keywords: clinical metrics; collaboration; pay for performance; pharmacist; physician; quality improvement.