MPA | Pharmacy News

By Malak Abbas, Pharm.D. candidate 2017, Wayne State University and Amber Lanae Martirosov, Pharm.D., BCPS, clinical pharmacy specialist, ambulatory care, Henry Ford Hospital, Detroit, and clinical assistant professor, Wayne State University,


In 2014, the American Society of Health-System Pharmacists (ASHP) held a summit for the advancement of ambulatory pharmacy services.  Pharmacy leaders and experienced practitioners from around the country developed recommendations aimed at advancing patient care and optimizing pharmacists’ roles in ambulatory care settings.1 Since that time, the ASHP Foundation has expanded the Pharmacy Practice Model Initiative (PPMI) to include more pharmacy practice settings. The PPMI was also rebranded the Practice Advancement Initiative (PAI). The overarching goal of the PAI is to “significantly advance patient health by developing and disseminating futuristic practice recommendations that support pharmacists’ roles as direct patient care providers.”2 The PAI is comprised of five pillars that maximize the pharmacist’s role in patient care in acute and ambulatory care settings. The key recommendations from the PPMI and the Ambulatory Care Summits lay the foundation for practice advancement in the acute and ambulatory care settings, respectively.


Given that ambulatory care is the largest growing area in pharmacy, Michigan Pharmacists Association (MPA) has utilized the PAI to expand resources and opportunities for pharmacists who practice in outpatient settings. Recently, the Michigan Society of Health-System Pharmacists (MSHP) Ambulatory Care Committee developed an Ambulatory Care Toolkit to provide Michigan pharmacists with tremendous resources for starting and advancing their ambulatory care practice. Find that toolkit here. Additionally, the Committee reviewed the ASHP Ambulatory Care Self-Assessment Tool. This assessment tool was developed by an expert panel to promote ambulatory practice alignment with the Ambulatory Care Summit recommendations.


The ASHP Ambulatory Care Self-Assessment Tool is designed to identify possible gaps in the ambulatory practice site and aid in identifying resources to improve adherence to practice standards. The tool includes two different assessment tracks: system track or practitioner track. The system track is designed to provide those with administrative roles, including supervisors, an outlook on operations beyond a single ambulatory practice setting; whereas the practitioner track provides a perspective for a single practice site.3 There are a total of eight sections to be completed including: (1) Demographics, (2) Program Development & Sustainable Business Models, (3) Pharmacist Training & Credentials, (4) Program Planning, (5) Patient-Care Delivery & Integration, (6) Health Information Technology, (7) Pharmacy Technicians and (8) Outcomes Evaluation.3 Once the assessment is completed, pharmacists are given the opportunity to develop an action plan that focuses on individualized practice or health-system priorities. A list of resources are provided with the action plan to help the user implement practice changes.


To gain the most from the self-assessment, ASHP recommends that ambulatory care pharmacists complete the action plan immediately following the self-assessment, utilizing the resources provided. The tool also provides comparative reports for multi-site health-systems and states. This allows users to see how their action plan compares to others. Additionally, users can determine how their individual answers compare to aggregate data from other assessments to further advance their practice models. Pharmacists are encouraged to revisit the assessment regularly or annually to assess advancement progress.


The benefits of the Ambulatory Care Assessment Tool are numerous and include: (1) providing an internal benchmark for practice advancement in ambulatory care, (2) showcasing alignment with recommendations provided during the ASHP Ambulatory Care Summit, (3) providing resources to develop or expand upon existing opportunities, (4) creating an action plan post self-assessment evaluation that identifies priorities based on feasibility and impact, (5) contributing to the strategic planning of department or affiliated health-system and (6) identifying both strengths and areas of improvement for a practice site.4,5  The tool can also be used to discuss recommendations from the Ambulatory Care Summit with pharmacy students and residents. Additionally, it can help state pharmacy organizations understand the priorities for clinical pharmacy services and identify opportunities for practice advancement.5

As of October 2016, Michigan ranks second nationally for utilization of the Ambulatory Care Self-Assessment, with over seven completed System assessments and 19 completed Practitioner assessments.4 Since the tool provides a framework and support system for advancing ambulatory care practice, we encourage all Michigan pharmacists who practice in outpatient settings to complete the tool. By increasing utilization of the tool, we can transform how pharmacists care for patients in ambulatory settings throughout Michigan. 



1. American Society of Health-System Pharmacists. Ambulatory Care Summit: Recommendations of the Summit. Am J Health Syst Pharm. 2014;71(16):1390-1391.

2. American Society of Health-System Pharmacists. ASHP Practice Advancement Initiative. ASHP website. Accessed May 2017.

3. American Society of Health-System Pharmacists. ASHP Ambulatory Care Self-Assessment Tool. ASHP website. Accessed May 2017.

4. Maroyka EM. Practice Advancement Initiative: Pharmacist Roles in Public Health (webinar). Accessed January 2017.

5. Boyle J. The ASHP Ambulatory Care Self-Assessment: Putting Practice Advancement into Action (webinar). Accessed May 2017. 

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