Perspectives on Diabetes Care

Building a Valuable Service for Patients, Providers, and Yourself

Apr 16, 2013, 01:00 AM

I wanted to take advantage of my first blog by reflecting on my recent endeavor in clinical practice. 

I am currently starting pharmacy services at a family medicine clinic, which has seven medical providers, two nurse practitioners, and one physician assistant.  This clinic has never had a clinical pharmacist. So this is a new venture for us both.  During my residency, I maintained established, pharmacist-run clinics for cardiovascular and metabolic disorders.  At my previous job, I started a pharmacist-run, “pharmacotherapy” clinic, which was successful through this particular Veterans Affairs Medical Center. 

As I have begun to develop services at my current site, I wanted to reflect on a simple approach to this endeavor.  There are numerous, lengthy books about how to start a service.  We can read these books and listen to our peers about their experiences, but what is a simple way to inform the future diabetes educators.  We teach our patients about the SMART goals… why not explain the approach to providing clinical services using the same acronym? 

1. Specific: There may have been a general idea for a clinical service, but applying the five W’s will help in clearly defining the service.  Certain questions may be:  What is the patient care model – population-based service and/or disease-based focus?  Who is the specific patient population?  It is important to have input from the stakeholders to define the clinical service, based on the need.
2. Measurable: For a clinical service, there should be concrete criteria in order for you to remain on track.  To define the criteria, a business plan may be necessary to market your practice model to patients you serve.  The business plan can be expanded as a policy and procedure manual for the stakeholders.   
3. Attainable: It is important to have action-oriented verbs related to the clinical service.  These verbs will be the foundation of your responsibilities in the clinic service.  For example, what will you do for each face-to-face visit with a patient?  All of your responsibilities should be explained in the policy and procedure manual.
4. Relevant: For you and the stakeholder, quality assurance is a key point of any clinical service.  What endpoints or outcomes will be evaluated to determine the success of this service?  Are the outcomes important to the stakeholders? 
5. Time-framed: Be realistic in your time frame.  It will take time, effort and patience to build the clinical services at any practice setting.  When will you and the stakeholders evaluate the progress of the clinical service?  Or, will the clinical services be broken into phases for implementation?  Based on the quality assurance, you may consider expanding clinical services for other interested stakeholders. 

Applying the SMART goals to a clinical practice or service can allow any diabetes educator to improve the chance of achievement and success.  I wish everyone the best for improving your current or future clinical services in the field of diabetes!