D.C. Mun. Regs. tit. 17, r. 17-10002

Current through Register Vol. 71, No. 49, December 6, 2024

Rule 17-10002 - USE OF A COLLABORATIVE PRACTICE AGREEMENT AND REQUIRED CONTENT

10002.1

The management of drug therapy pursuant to a collaborative practice agreement shall be initiated by an authorizing protocol that includes coverage of the patient(s) or a written referral from the licensed physician to the pharmacist for a specific patient.

10002.2

Whe n a patient encounter is initiated through an authorizing protocol, the pharmacist shall notify the authorizing physician in writing within twenty- four (24) hours or one (1) business day.

10002.3

The authority granted by the physician to the pharmacist must be within the scope of the physician's practice.

10002.4

The collaborative practice agreement may allow the pharmacist, within the pharmacist's scope of practice, to conduct activities approved by the physician pursuant to the agreement and within the authority established by the law and regulations.

10002.5

The collaborative practice agreement shall not prohibit the pharmacist from providing other pharmaceutical services that are within the pharmacist's scope of practice.

10002.6

A collaborative practice agreement shall be based upon treatment protocols that are generally accepted as the clinical standard of care within the medical and pharmacy professions, or approved by the Boards of Medicine and Pharmacy in accordance with § 10006 of this chapter, and shall include:

(a) Identification of the physicians(s) and pharmacist(s) who are parties to the agreement;

(b) The location(s) where the pharmacist(s) and physician(s) may provide services under the collaborative practice agreement;

(c) The name, address, and telephone number of the person(s) who are to receive correspondence from the Boards related to the collaborative practice agreement;

(d) A detailed description of the disease state or condition, drugs or drug categories, drug therapies, devices, and any necessary incidental tests, authorized by the physician, and the activities allowed in each case;

(e) A detailed description of the methods, procedures, decision criteria, and plan the pharmacist is to follow when conducting allowed activities;

(f) A detailed description of the activities and procedures that the pharmacist is to follow, including documentation of decisions made, and a plan or appropriate mechanism for communication, feedback, and reporting to the physician activities and results concerning specific decisions made;

(g) The conditions under which the pharmacist may initiate, modify, or discontinue a drug therapy;

(h) Directions concerning the monitoring of a drug therapy, including the conditions that would warrant a modification to the dose, dosage regime, or dosage form of the drug therapy;

(i) The frequency and the manner in which the pharmacist conducts the management of drug therapy;

(j) A method for the physician to monitor compliance with the agreement and clinical outcomes and to intercede where necessary;

(k) A description of the continuous quality improvement efforts used to evaluate effectiveness of patient care and ensure positive patient outcomes;

(l) A provision that allows the physician to override a collaborative practice decision made by the pharmacist whenever he or she deems it necessary or appropriate, with notification to the pharmacist of the override within twenty-four (24) hours or one (1) business day, or as noted in the collaborative practice agreement;

(m) A provision that allows either party to cancel the collaborative practice agreement by written notification;

(n) An effective date; and

(o) The signatures of all collaborating pharmacists and physicians who are party to the collaborative practice agreement, as well as dates of signing.

10002.7

The collaborative practice agreement may include treatment protocols that include a physician(s) delegation of authority to the pharmacist(s) to obtain laboratory tests provided the tests relate directly to the drug therapy management under the protocol.

10002.8

In addition to the requirements set forth in the collaborative practice agreement, documentation of each intervention, including changes in dose, duration or frequency of medication prescribed, shall be recorded in the pharmacist's prescription record, patient profile, a separate log book, or in some other appropriate system.

10002.9

Pharmacists engaging in collaborative practice shall not delegate any collaborative practice activities to any other staff.

10002.10

Documentation of allowed activities must be kept as part of the patient's permanent record and be readily available to other health care professionals providing care to that patient and who are authorized to receive it.

Documentation of allowed activities shall be considered protected health information.

10002.11

Oral communications between the physician and pharmacist shall be summarized in the documentation maintained by the pharmacist and forwarded to the physician.

10002.12

Unless an alternative time period is stated in the collaborative practice agreement, the pharmacist shall inform the physician within forty-eight (48) hours if the pharmacist modifies the drug dose or agent.

10002.13

Unless an alternative time period is stated in the collaborative practice agreement, the pharmacist shall inform the physician within twenty- four (24) hours if the pharmacist detects an abnormal result from an assessment activity.

10002.14

Amendments to a collaborative practice agreement must be documented, signed, and dated, and for collaborative practice agreements containing approved protocols outside the generally accepted clinical standard of care, the amendments must be approved by the Boards before they are implemented.

10002.15

At a minimum, the collaborative practice agreement shall have a documented review and, if necessary, be revised every year.

D.C. Mun. Regs. tit. 17, r. 17-10002

Final Rulemaking published at 65 DCR 8528 (8/17/2018)