Collaborative team-based care implementation in ambulatory gynecological and lung cancer clinics

Abstract

Introduction

Patients with cancer are at risk for experiencing adverse health outcomes, including drug therapy problems (DTPs). Multidisciplinary approaches to team-based care (TBC) are important in improving patient health outcomes and patient safety, while reducing redundancy and increasing efficiency.

Objectives

The primary objective was to design and test a care model that integrated a residency-trained pharmacist into an interprofessional team, including medical oncologists and nurses, in order to optimize TBC and provision of patient-centred care. Secondary objectives were to determine the numbers and types of clinical pharmacy key performance indicators (cpKPIs) and DTPs identified and resolved pre- and post-TBC pharmacist implementation in ambulatory gynecological and lung cancer clinics.

Methods

This was a prospective, non-randomized, non-blinded study, focused on implementing a collaborative TBC model in ambulatory oncology clinics, which treated patients with gynecological or lung cancers. Applicable evidence-based literature and local expertise were used to inform the processes for engaging team members and determining evaluative metrics, which highlight successes and opportunities for improvement.

Results

A residency-trained pharmacist was successfully integrated into the existing multidisciplinary ambulatory oncology team, focused on treating patients with gynecological and lung cancers. One hundred and sixty-five clinically important cpKPIs and DTPs were identified post-TBC pharmacist implementation, as compared to thirty-two interventions at baseline. The most common documented cpKPI and DTP were medication reconciliation and drug interactions, respectively.

Conclusion

A collaborative, multidisciplinary TBC environment works well for delivering cancer care. The addition of a pharmacist to TBC assists with identifying and resolving clinically important cpKPIs and DTPs.