Effective collaboration between doctors and pharmacists
By Sandeep Nijjer, MPharm, MRPharmS, Jasdeep Gill, MB ChB, and Sukhjinder
Nijjer, MB ChB, MRCP
|
Although greater collaboration between healthcare professions
has been widely advocated, little has yet been done to improve doctor-pharmacist
relationships in UK hospitals. This article suggests actions that
organisations and individuals might take to promote collaboration |
This article as FULL TEXT PDF (60K) |
Communicating
through patients’ notes
Collaboration between pharmacists and nursing staff |
Sandeep
Nijjer is
a pharmacist and a clinical lecturer in the department of practice
and policy at the University of London School of Pharmacy
Jasdeep
Gill is a foundation doctor at Southampton General Hospital
and
Sukhjinder Nijjer is a specialty registrar,
cardiology, at the Royal Brompton Hospital, London
Correspondence
to
Sandeep Nijjer
e-mail sandeep.nijjer@pharmacy.ac.uk |
Rmarmion/Dreamstime.com
Close collaboration between doctors and pharmacists has been shown
to improve the cost-effectiveness of prescribing |
SUMMARY
The latest buzzword in healthcare is “collaboration”. Despite
its overuse and associated political spin, the premise of bringing together
distinct professionals is admirable, and it presents ideals of improving
service quality for patients and increasing efficiency and skills for professionals.
The Oxford English Dictionary defines the word “collaborate” as “to
work jointly on an activity or project” and as “to co-operate
traitorously with an enemy”.
Many healthcare professionals may think
of this latter definition when having to work closely with others traditionally
considered a separate breed.
Political and professional thinking has changed
and collaboration exists at some level between groups, for example, between
nursing staff and physiotherapists.
Medical schools are also sending
student doctors on nursing shifts to help them understand the nursing
role.
It is notable, then, that the doctor-pharmacist relationship has not
been brought more to the fore.
We argue that, although it may bring
new terminology
and new ways of working that
may initially be an affront to traditional healthcare roles, collaboration
will bring greater satisfaction in working on busy hospital wards
and bring in a new era in patient safety.
Panel 1: Communicating through
patients’ notes
Medical teams communicate with each other using patients’ notes,
recording findings, thoughts and actions in a standardised way. Many
pharmacists do not routinely document their comments in a patient’s
notes. Instead, comments are made verbally or on the drug chart,
using coloured pens or repositionable notes in the hope that they
will be spotted on the next ward round.
There is no guarantee that
these comments will be seen, read or even actioned by the doctor.
This practice may increase delays in communication between doctors
and pharmacists, resulting in delays in patient management or errors.
Most other healthcare professionals formally document their patient
interactions and their comments. For example, nurses produce formal
nursing notes and physiotherapists produce therapy notes.
Furthermore,
there is a trend to create “patient pathways” or proformas
to streamline communication between different teams and ensure
that protocols are followed for routine admissions.
Encouraging pharmacists to document their input in patients’ notes
may help to ensure that information is transferred, acknowledged
and acted on. Indeed, with the current change in doctors’ working
shift patterns, a doctor who is given a verbal message today
may not be the doctor who manages the patient tomorrow.
Documentation
should be legible, objective and useful to the care of the patient.
Many hospitals already encourage pharmacists to write in patients’ notes.
In our experience, doctors are much more likely to record their
responses to a comment made by a pharmacist formally if it is left
in the notes.
Therefore, a medico-legally clear chain of thought and decision-making
has been made. |
Collaboration between
pharmacists and nursing staff
Collaboration between pharmacists and nursing staff
is essential to ensure drugs are administered appropriately, that
ward stocks are replete and that nurses are aware of common and dangerous
side effects of medicines. This is important on specialist wards
such as oncology or cardiology, where errors can be costly.
However,
it is perhaps even more important on general wards, where collaboration
between professionals can overcome deficiencies in knowledge and
experience. |
|
Hospital
Pharmacist