ABSTRACT
OBJECTIVE: To determine the acceptance and attitudes of family medicine physicians, clinical and nonclinical office staff, pharmacists, and patients during pharmacist integration into a medical home. DESIGN: Qualitative study. SETTING: Pittsburgh, PA, area from August 2009 to June 2010. PARTICIPANTS: Physicians, staff, pharmacists, and patients at four single-specialty family medicine office practices functioning as medical homes. MAIN OUTCOME MEASURES: Attitudes, acceptance, barriers, and problems identified by participants. RESULTS: A total of 84 interviews were conducted: 21 interviews with family medicine physicians, 26 with patient care staff, 9 with nonclinical staff, 13 with patients, 6 with pharmacists, and 8 with office managers. Five main themes emerged from each group regarding the integration of a pharmacist, including positive overall feeling; clinical, educational, and time-saving benefits to the various groups; challenges understanding the role of the pharmacist; improved workflow and integration resulting from pharmacist flexibility and motivation; and suggestions to increase the pharmacists' time in each office. Pharmacists felt that they were accepted within 6 months of the integration process and that time management was a challenge. CONCLUSION: Participants felt that inclusion of a pharmacist into their practice improves the quality of patient care, provides a valuable resource for all providers and staff, and empowers patients. The initial concerns of the clinical and nonclinical staff disappeared within the first months of pharmacist integration. These results provide guidance to clinicians and insight into strategies for building a pharmacist-integrated medical home team.
Subject(s)
Delivery of Health Care, Integrated/organization & administration , Patient-Centered Care/organization & administration , Pharmaceutical Services/organization & administration , Pharmacists/organization & administration , Attitude to Health , Data Collection , Family Practice/organization & administration , Female , Humans , Male , Middle Aged , Patient Acceptance of Health Care , Patient Care Team/organization & administration , Primary Health Care/organization & administration , Quality of Health Care , Time Factors , Time ManagementABSTRACT
PURPOSE: To evaluate the impact of lawsuits on the accessibility of company websites. METHOD: Convenience samples of websites for America Online (AOL), Southwest Airlines, Metropolitan Atlanta Rapid Transit Authority (MARTA), Priceline.com, and Claire's were evaluated for years surrounding their respective lawsuits. The results of each website were compared to a random control group of websites and to a reference website (of a similarly sized company that has not been sued and is in the same industry). Where possible, two archived instances of each website were collected per year. Accessibility was measured using the Web Accessibility Barrier (WAB) metric to evaluate the homepage and pages at level 1. Analysis of variance was computed on the common periods between each pairing of sued and reference websites. RESULTS: The case studies demonstrate mixed evidence that lawsuits work. In the cases of MARTA, Southwest and Priceline, there is supporting evidence that lawsuits have been successful. In the cases of AOL and Claire's, the evidence is weaker. CONCLUSION: This case study examination shows mixed evidence that lawsuits work to force companies to modify their websites to be more accessible to people with disabilities: three cases show evidence for the success and two show weaker supporting evidence.
