Impact of an integrated medication management model on the collaborative working relationship among healthcare professionals in a hospital: an explanatory mixed methods study

ABSTRACT

An integrated medication management (IMM) model was implemented in a medical center ward to improve the delivery of clinical pharmaceutical services (CPSs). This model incorporated a ward-based clinical pharmacist who performed medication reconciliation and medication reviews. It was perceived to promote interprofessional collaboration between pharmacists and non-pharmacist healthcare professionals (NPHPs, including attending physicians, nurse practitioners, and registered nurses). This study aimed to evaluate the effects of the IMM on NPHPs’ intentions to collaborate with pharmacists and understand the mechanism of the impact of the IMM on interprofessional collaboration. A sequential explanatory mixed methods design was employed in the study. Initially, a questionnaire was administered to assess the effects of the IMM on NPHPs’ intentions to collaborate with pharmacists. The NPHPs’ experiences with the IMM were then documented using semi-structured interviews with inductive thematic analysis. Fifty-eight NPHPs completed the questionnaire, and NPHPs from the intervention ward reported a higher intention to discuss patient-related medication issues with pharmacists, indicating collaboration. Eleven NPHPs were interviewed, and they stated having better working relationships with pharmacists, experiencing more effective CPSs, and noting improved communication with pharmacists. The integration of quantitative and qualitative findings demonstrates that the critical mechanism of the IMM in promoting collaborative relationships is to integrate pharmacists into medical practice, which familiarizes NPHPs with pharmacists’ roles, improves communication, and enables pharmacists to identify NPHPs’ needs. To summarize, allowing ward-based pharmacists to engage in medical teams on a regular basis appears vital for improving interprofessional teamwork. Furthermore, stakeholders aiming to promote CPS in their institutions should consider the needs and communication channels among NPHPs.

KEYWORDS:

• clinical pharmacy service
• collaborative working relationship
• interprofessional collaboration
• evaluation research
• collaborative practice

Acknowledgments

The authors would like to thank Ms. Yu-Ting Huang, the clinical pharmacist at the time of the study; Mr. Chien-Chih Wu and Ms. Ming-Fang Wen for developing the IMM model; and Dr. Jiun-Hau Huang, Mr. Chien-Chih Wu, and Dr. Fang-Ju Lin for verifying the questionnaire.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Authors contributions

Kuan-Lin Chen: Conceptualization, methodology, software, formal analysis, investigation, write-original draft, editing, visualization, and funding acquisition. Yen-Ming Huang: Methodology, software, validation, formal analysis, and write-review and editing. Chih-Fen Huang: Conceptualization, resources, and writing-review and editing. Wang-Huei Sheng: Resources and write-review and editing. Yu-Kuei Chen: Resources and write-review and editing. Li-Jiuan Shen: Conceptualization, methodology, validation, writing- review and editing, supervision, and project administration. Chi-Chuan Wang: Conceptualization, methodology, validation, write-review and editing, supervision, and project administration.

Data availability statement

The data generated and analyzed in this study are not publicly available because they may contain private information. Furthermore, informed consent ensured that the data could only be used for this study.

Additional information

Funding

This study was supported by an NTUH grant for employees [grant no. 109-M4455]. As a funding party, the NTUH was not directly involved in any aspect of the study design or conduct. The grant only supports reimbursement for consumables, editing services, and publication charges and not for other additional personnel expenses. Therefore, the researchers were independent of the executive management of the NTUH in the design of the study, data analysis, interpretation of the results, and writing of the manuscript.

Notes on contributors

Kuan-Lin Chen

Kuan-Lin Chen is a Ph.D. student at the Graduate Institute of Clinical Pharmacy, National Taiwan University, and a pharmacist at the National Taiwan University Hospital.

Yen-Ming Huang

Yen-Ming Huang is an Assistant Professor at the Graduate Institute of Clinical Pharmacy, National Taiwan University.

Chih-Fen Huang

Chih-Fen Huang is the Director of the Department of Pharmacy, National Taiwan University, and a Clinical Associate Professor at the School of Pharmacy, National Taiwan University.

Wang-Huei Sheng

Wang-Huei Sheng is an attending physician at the Department of Internal Medicine, National Taiwan University Hospital, and a Professor at School of Medicine, National Taiwan University.

Yu-Kuei Chen

Yu-Kuei Chen is a Supervisor of the Department of Nursing, National Taiwan University Hospital.

Li-Jiuan Shen

Li-Jiuan Shen is a Professor at the School of Pharmacy, National Taiwan University.

Chi-Chuan Wang

Chi-Chuan Wang is an Associate Professor at the School of Pharmacy, National Taiwan University.