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1.  Equipping Residents to Address Alcohol and Drug Abuse: The National SBIRT Residency Training Project 
The Screening, Brief Intervention and Referral to Treatment (SBIRT) service for unhealthy alcohol use has been shown to be one of the most cost-effective medical preventive services and has been associated with long-term reductions in alcohol use and health care utilization. Recent studies also indicate that SBIRT reduces illicit drug use. In 2008 and 2009, the Substance Abuse Mental Health Service Administration funded 17 grantees to develop and implement medical residency training programs that teach residents how to provide SBIRT services for individuals with alcohol and drug misuse conditions. This paper presents the curricular activities associated with this initiative.
We used an online survey delivery application (Qualtrics) to e-mail a survey instrument developed by the project directors of 4 SBIRT residency programs to each residency grantee's director. The survey included both quantitative and qualitative data.
All 17 (100%) grantees responded. Respondents encompassed residency programs in emergency medicine, family medicine, pediatrics, obstetrics-gynecology, psychiatry, surgery, and preventive medicine. Thirteen of 17 (76%) grantee programs used both online and in-person approaches to deliver the curriculum. All 17 grantees incorporated motivational interviewing and validated screening instruments in the curriculum. As of June 2011, 2867 residents had been trained, and project directors reported all residents were incorporating SBIRT into their practices. Consistently mentioned challenges in implementing an SBIRT curriculum included finding time in residents' schedules for the modules and the need for trained faculty to verify resident competence.
The SBIRT initiative has resulted in rapid development of educational programs and a cohort of residents who utilize SBIRT in practice. Skills verification, program dissemination, and sustainability after grant funding ends remain ongoing challenges.
PMCID: PMC3312535  PMID: 23451308
3.  Exploring successful community pharmacist-physician collaborative working relationships using mixed methods 
Collaborative working relationships (CWRs) between community pharmacists and physicians may foster the provision of medication therapy management services, disease state management, and other patient care activities; however, pharmacists have expressed difficulty in developing such relationships. Additional work is needed to understand the specific pharmacist-physician exchanges that effectively contribute to the development of CWR. Data from successful pairs of community pharmacists and physicians may provide further insights into these exchange variables and expand research on models of professional collaboration.
To describe the professional exchanges that occurred between community pharmacists and physicians engaged in successful CWRs, using a published conceptual model and tool for quantifying the extent of collaboration.
A national pool of experts in community pharmacy practice identified community pharmacists engaged in CWRs with physicians. Five pairs of community pharmacists and physician colleagues participated in individual semistructured interviews, and 4 of these pairs completed the Pharmacist-Physician Collaborative Index (PPCI). Main outcome measures include quantitative (ie, scores on the PPCI) and qualitative information about professional exchanges within 3 domains found previously to influence relationship development: relationship initiation, trustworthiness, and role specification.
On the PPCI, participants scored similarly on trustworthiness; however, physicians scored higher on relationship initiation and role specification. The qualitative interviews revealed that when initiating relationships, it was important for many pharmacists to establish open communication through face-to-face visits with physicians. Furthermore, physicians were able to recognize in these pharmacists a commitment for improved patient care. Trustworthiness was established by pharmacists making consistent contributions to care that improved patient outcomes over time. Open discussions regarding professional roles and an acknowledgment of professional norms (ie, physicians as decision makers) were essential.
The findings support and extend the literature on pharmacist-physician CWRs by examining the exchange domains of relationship initiation, trustworthiness, and role specification qualitatively and quantitatively among pairs of practitioners. Relationships appeared to develop in a manner consistent with a published model for CWRs, including the pharmacist as relationship initiator, the importance of communication during early stages of the relationship, and an emphasis on high-quality pharmacist contributions.
PMCID: PMC3004536  PMID: 21111388
Pharmacists; Physicians; Collaborative working relationships; Pharmacist-physician collaborative index; Community
4.  Not Waiting for Godot: The Evolution of Health Promotion at PPG Industries 
PPG Industries is a manufacturer of coatings, chemicals, optical products, specialty materials, glass, and fiberglass. The company's approach to healthcare combines perhaps 2 disparate concepts. The first is that employee health and behavior change relies to a large degree on employee awareness and ownership of their own health and second that “what gets measured gets done.” It is widely acknowledged that one of the best tools for employee awareness is the health risk appraisal tool. Additional components of employee awareness include knowing key individual health metrics and effectively engaging with healthcare providers. As a leading global manufacturer, PPG well understands the critical importance of cost accounting and financial metrics to drive business decisions. PPG's perhaps unique approach comes from the strong marriage of individual health/wellness promotion and frequent, timely, and informative financial metrics on health and the cost of care. Combining capacity building through the mobilization of volunteer wellness teams with expert interventions and financial discipline is a feature of the experience here described. This approach has resulted in both management and employee engagement in the issue and has allowed PPG to bend the curve of ever-increasing healthcare costs and achieve cost increases per employee at one half the reported national average for companies of comparable size. Because this journal is dedicated to health and drug benefits, we gathered an appropriately representative team composed of a physician, an epidemiologist who resides in a pharmacy school, and a benefits manager. The team evolved from a common vision to identify ways of improving employee health and well-being. The team presented both as keynote speakers and as contributors to a breakout session at the National Symposium on Work-Life organized in 2007 by the National Institute for Occupational Safety and Health, a federal agency of the Centers for Disease Control and Prevention in the Department of Health and Human Services. This article is an account of why and how such a unique team was formed.
PMCID: PMC4115318  PMID: 25126222

Results 1-4 (4)