Pharmacists Boost Patient Safety in Ambulatory Settings

A recent government report highlighted the role pharmacists play in promoting patient safety within ambulatory settings.

The Agency for Healthcare Research and Quality (AHRQ), the performance evaluation arm of the US Department of Health and Human Services (HHS), released a draft report investigating how hospital patient safety practices may be applicable to the ambulatory care setting.

“Even though the majority of medical care occurs in ambulatory settings, the patient safety movement originated in and has been mainly focused on adverse events among hospitalized patients,” the AHRQ report read. “It is increasingly clear that the ambulatory setting is critically important; the Institute of Medicine recently opined that adverse events may be more common in ambulatory settings compared to acute settings.”

AHRQ analyzed published literature and input from key informants to identify elements of hospital-based patient safety practices applicable to outpatient safety.

Six strategic areas to improve ambulatory patient safety include:

• Communication
• Teams
• Patient and family engagement
• Organizational approaches
• Health information technology
• Safety culture

Within these 6 strategic areas, the AHRQ report identified pharmacist-led interventions as 1 of 28 specific practices most relevant to ambulatory care safety, especially with respect to supporting optimal medication safety outcomes.

AHRQ’s assertions were consistent with recommendations from the American Society of Health-System Pharmacists (ASHP) and the ASHP Foundation, which held a joint summit in 2014 to define the value and future of pharmacy in ambulatory care.

“As members of the interprofessional patient care team, pharmacists who provide ambulatory care services perform patient assessments; have prescribing authority to manage disease through medication use and provide collaborative drug therapy managements; interpret orders and monitor medication therapy-related tests; coordinate care and other health services for wellness and prevention of disease; provide education to patients and caregivers incorporating principles of health literacy and cultural sensitivity; and document care processes in the medical record,” the ASHP and ASHP Foundation jointly noted.

To that end, leaders from those organizations recommended that “across the continuum of ambulatory care, patients should have access to and have an opportunity to be evaluated by pharmacists who provide ambulatory care.”

AHRQ is currently accepting comments to its draft report. It is unclear when the agency will publish ambulatory care safety guidelines.