Patient Care Process
Introduction
The patient care process is a fundamental series of actions that guide the activities of health professionals. In 2014, the Joint Commission for Pharmacy Practitioners (JCPP) - representing 11 national pharmacy organizations - endorsed a framework for providing clinically oriented patient care services called the Pharmacist's Patient Care Process.
The Five Essential Steps
- Collect subjective and objective information about the patient to understand the relevant medical/medication history and clinical status of the patient.
- Assess the information collected and analyses the clinical effects of the patient's therapy in the context of the patient's overall health goals to identify and prioritize problems and achieve optimal care.
- Develop and individualized plan that is evidence-based and cost-effective
- Implement the care plan
- Monitor and evaluate the effectiveness of the care plan and modify it as needed.
Patient-Centred Approach
In addition to the 5 fundamental steps, a patient-centred approach to decision-making is essential. To be patient-centred, it requires
- Effective communication and seeking to understand the patient's needs, preferences, and values
- Interprofessional collaboration - working with other health professionals to development and implement a shared plan of care
- Each step of the process must be documented
Knowledge and Skill
While the process of care is common to all, each profession has a unique body of knowledge and skills they bring to bear when assessing the data and formulating plans.
- For pharmacy, the patient care process is focused on a patient's medication-related needs and their experience with medication therapy.
- For pharmacists providing comprehensive medication management, the assessment step involves a systemic examination of the indication, effectiveness, safety, and adherence for each of the patient's medications.
NOTE: When assessing information collected from a patient (e.g. history of present illness, physical examination, laboratory data), physicians employ a clinical reasoning process called "differential diagnosis" to weight the probability of one disease over other diseases that possibly account for the patient's signs and symptoms.
Important Note
This care process can be applied in any setting when providing comprehensive medication management. What often varies is the information collected and its source as well as the duration of time to complete the process.
- For example, in an ambulatory care clinic the patient is often the most important source of information but in a critical care unit of a hospital there is a greater reliance on laboratory tests and special diagnostic studies.
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