Academic journal article American Journal of Pharmaceutical Education

Cost Savings Associated with Pharmacy Student Interventions during APPEs

Academic journal article American Journal of Pharmaceutical Education

Cost Savings Associated with Pharmacy Student Interventions during APPEs

Article excerpt

INTRODUCTION

One of the challenges facing many colleges and schools of pharmacy is finding enough experiential sites and preceptors to train students during practice experiences. (1,2) This is more difficult than it was a decade ago for several reasons. There are more pharmacy colleges and schools today and they are enrolling students who will all need to complete IPPEs and APPEs. Introductory pharmacy practice experiences are now a requirement for all colleges seeking accreditation. (3) There is also a higher demand for residency programs. (4) As more practice sites try to meet this need, it places additional pressure on preceptors to continually mentor more people, be it IPPE students, APPE students, or residents. (1) However, pharmacy students are capable of providing meaningful clinical services for the practice sites and can generate financial savings, which have been well documented in the literature. (5-16) Mersfelder and Bouthillier published a review of these studies dating back to the early 1990s. (17) Most either enrolled few students or were conducted over a relatively short period of time, often just a few months. Some studies were limited in terms of experience type or practice sites and only tracked interventions made during inpatient experiences or in critical care environments at specific institutions. Other studies did not include a financial assessment and only looked at the number of interventions made by students and acceptance rates by the primary care providers. This report expands upon the existing literature and provides more evidence to support the value of pharmacy students during APPEs. It includes 4 years of student interventions over various practice settings and experience types and provides more detailed information about the clinical interventions made by students. The interventions were documented through a commercially available Web-based documentation program. The most common student interventions as well as the most economically valuable interventions are presented and discussed. The objective of this study was to quantify the impact of pharmacy students' clinical interventions in terms of number and cost savings throughout advanced pharmacy practice experiences (APPEs) using a Web-based documentation program.

METHODS

For the past 4 years, each PharmD class of approximately 160 students (580 total students participated) were asked to document their clinical interventions during their APPEs in the fourth year of the degree program. Each student completed 10 consecutive 4-week APPEs beginning in May and finishing in April. They were not assigned to an APPE during three 4-week blocks during this year. At least 7 of the 10 APPEs they completed were required patient care APPEs. Patient care APPEs were in ambulatory care practice, inpatient adult medicine or specialty practice, community pharmacy practice, or hospital health-system pharmacy practice.

Prior to beginning their APPEs, students were trained to use Clinical Measures (Elsevier/Gold Standard), a Web-based documentation program purchased by the college. (18) This documentation program was primarily designed for use by health systems as a way of tracking clinical pharmacist interventions on a regular basis. By entering the students' names in as pharmacists and entering the physician's name in place of the practice site, the software was easily modified to collect data on student interventions at any practice site during any APPE. It also did not require patient-specific data to be entered, only information about the specific intervention made. Preceptors were able to check these interventions after the students entered them. The system was reasonably priced (approximately $3500 per year). One of the most impressive features was the ability to generate reports quickly and easily as PDFs that could illustrate student interventions and cost savings. Other similar Web-based systems such as Quntifi and PxDx have been used at other institutions. …

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