Use of protocol-driven medication refills by pharmacists decreases rheumatologist in-basket work and improves rheumatologist satisfaction

BMJ Open Quality

article

Eva I Rottmann¹  Jonida Cote¹  Swana Thomas¹  Dante M Grassi¹  Joseph Chronowski¹  Lisa L Schroeder¹  David Pugliese¹  Eric Newman¹ 

[1] MC 2152 Dept Rheumatology , Geisinger Medical Center

关键词: burnout;    professional;    clinical practice guidelines;    collaborative;    breakthrough groups;    quality improvement methodologies;    pharmacists;   

DOI  :  10.1136/bmjoq-2021-001566

学科分类：药学

来源: BMJ Publishing Group

【 摘 要 】

Burn-out among US physicians has been on the rise in the past few decades. Similarly, rheumatologists in the Geisinger Health System have experienced professional dissatisfaction through significant administrative burden and in-basket work. We embedded pharmacists into our rheumatology team in 2019 with the aim of reallocating medication refills to pharmacists, trained professionals in this domain, to help reduce physician workload and burn-out and increase satisfaction. Protocol-driven medication refill parameters per the American College of Rheumatology guidelines and new refill workflows for disease-modifying antirheumatic drugs (DMARDs) and non-DMARDs were created for use by our rheumatology pharmacists. Monthly data on medication refill volume and time saved for rheumatologists were collected from 1 January 2019 to 31 March 2021. Statistical analysis was completed via Shewhart p-charts. The volume of refills by rheumatologists decreased by 73% and the time saved per month for all the rheumatologists increased to 41.5 hours within 6 months. Physicians’ feedback was obtained via anonymous electronic surveys preintervention and postintervention. The statistical difference between the presurveys and postsurveys was calculated via two-tailed unpaired t-testing. It demonstrated reduced burn-out and improved workplace satisfaction. This study showed that the integration of rheumatology pharmacists into our practice can help improve the work life of the rheumatologists. It is important for physicians’ well-being to practice at the top of their scope and achieve work–life balance.burnoutprofessionalclinical practice guidelinescollaborativebreakthrough groupsquality improvement methodologiespharmacistsData availability statementAll data relevant to the study are included in the article.http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

【 授权许可】

CC BY-NC|CC BY|CC BY-NC-ND