PDL has chosen to describe the charting and prescribing activity by hospital pharmacists as Collaborative Pharmacist-led Charting and Prescribing (CPCP), though it may also be known as Partnered Pharmacist Medication Charting (PPMC), Partnered Pharmacist Medication Prescribing (PPMP), Collaborative Optimisation and Ordering of Medications (COOM) or other descriptors.
PDL acknowledges there are benefits from these activities including quality, timeliness and efficiency of patient care, plus positive outcomes for organisations, prescribers and pharmacists. A review of the literature on Australian studies and pilots of the CPCP model has shown that it has been safe and effective in those studies.
The PDL Master Policy will provide indemnity insurance cover for a PDL member who has the education, competence and authority to undertake a CPCP activity and where there is accountability for the pharmacist’s actions personally and within the organisation. The authority to be involved in the CPCP activity may be via credentialing but may become available through other means in the future. Accountability would be expected to be achieved through means such as development of clinical governance policies, including oversight and reporting responsibilities for individual practitioners as well as the organisation.
PDL expects the demonstration of those attributes would be through the development of a framework, policy or program by the organisation and via the training and credentialing of any pharmacist planning to undertake the activity.
PDL believes the following points would need to be satisfied to achieve the attributes:
- The organisation has an approved protocol for CPCP.
- Confirmation the practice is supported by local legislation and/or regulations, or via an exemption to local legislation and/or regulations provided by the relevant authority. This should be undertaken by the organisation and addressed in any protocol.
- The organisation has a training and credentialing program developed and approved by a health service or is in line with guidelines or standards developed and published by an appropriate organisation, e.g. hospital management, local health service, state health department, AdPha.
- The literature identifies several models for CPCP including various forms of collaboration or initiation of certain medicines, and each CPCP service needs to be approved by relevant authorities for the specific activities intended.
- The pharmacist has successfully completed the credentialing program and recognises the credentialing may only apply to a particular site, and re-credentialing may be required at another site.
- The approved protocol may be limited to a specific location and the activity should only be provided in the specific location, e.g. a ward or unit within the facility or as otherwise described.
- The pharmacist complies with all protocols that apply at the location and are set by the organisation.
- The pharmacist completes any re-credentialing requirements set by the institution.
- PDL members report any incidents or near misses to PDL as per policy requirements.
- Any pilot program being developed has appropriate evaluations and feedback that would support a CQI framework.
Given that a medication chart in a private hospital may also be a PBS prescription, consideration would need to be given to ensure the legality of CPCP when PBS charts/prescriptions are used in private hospitals.
PDL is satisfied with the existing training and implementation of the CPCP services that have been developed in some organisations and jurisdictions.
However, PDL reminds pharmacists of the need to understand regulatory processes and oversight in each jurisdiction, and reiterates the importance of PDL members contacting PDL if they are invited to participate in this service in a new trial, pilot or location.
For immediate advice and incident support, call PDL on 1300 854 838 to speak with one of our Professional Officers. We are here to support our pharmacist members 24/7.
