In April 2013, I wrote my first blog for the American Association of Diabetes Educators in which I reflected on my recent endeavor in clinical practice. In the past six years of practicing and maintaining pharmacy services at a family medicine clinic. The team I work with has changed. We are now ten healthcare professionals at this large practice — six medical providers, two nurse practitioners and two physician assistants. As the first clinical pharmacy specialist at this practice, I had an opportunity to add value to the practice and to its clients. I did this by transferring the skills I acquired during my residency, when I maintained established, pharmacist-run clinics for cardiovascular and metabolic disorders, and from my previous job at a Veterans Affairs Medical Center, where I started a successful pharmacist-run “pharmacotherapy” clinic.
Applying the SMART goals to a clinical practice or service can allow any diabetes educator to improve the chance of their practice’s achievement and success.
I set up a collaborative practice agreement for the clinical pharmacy services at the family medicine office in order to establish a consolidated referral process between the practice’s physicians, providers and myself, the clinical pharmacy specialist. Through this consensus we sought to improve outcomes and address drug-related needs of the patient population. I updated the collaborative practice agreement in 2016, based on the number of referrals for obesity management. It currently also includes diabetes, hypertension and hyperlipidemia.
As I reflect, I think about the variety of resources available to me that allowed me to start my own services — books, articles, toolkits and advice from mentors and leaders. As I continue to reflect and think about how to improve clinical services for the patients of the family medicine office, I wanted to share the simplified approach that I wrote about in April 2013. We teach our patients about the SMART goals… why not tailor the approach to providing clinical services? Applying the SMART goals to a clinical practice or service can allow any diabetes educator to improve the chance of their practice’s achievement and success.
Specific: There may have been a general idea for a clinical service, but applying the five W’s will help in clearly defining the service. Questions may include: What is the patient care model — population-based service and/or disease-based focus? Who is the specific patient population? It is important to have input from the stakeholders to define the clinical service based on the need.
Measurable: For a clinical service, there should be concrete criteria in order for you to remain on track. To define the criteria, a business plan may be necessary to market your practice model to people with diabetes you serve. The business plan can be expanded as a policy and procedure manual for the stakeholders.
Attainable: It is important to have action-oriented verbs related to the clinical service. These verbs will be the foundation of your responsibilities in the clinic service. For example, what will you do for each face-to-face visit with a patient? All of your responsibilities should be explained in the policy and procedure manual.
Relevant: For you and the stakeholder, quality assurance is a key point of any clinical service. What endpoints or outcomes will be evaluated to determine the success of this service? Are the outcomes important to the stakeholders?
Time-framed: Be realistic in your time frame. It will take time, effort and patience to build the clinical services at any practice setting. When will you and the stakeholders evaluate the progress of the clinical service? Or, will the clinical services be broken into phases for implementation? Based on the quality assurance, you may consider expanding clinical services for other interested stakeholders.
I hope you can implement this approach to your clinical services this year, so that you and everyone you serve has a great new year full of improved health outcomes.
About the Author
Jennifer Clements received her Doctorate of Pharmacy from Campbell University in 2006 and completed a primary care residency at a Veterans Affairs Medical Center in 2007. She is also a certified diabetes educator and board certified in pharmacotherapy. Currently, she is an Associate Professor of Pharmacy Practice at Presbyterian College School of Pharmacy.