SYSTEMIC APPROACH TO ANSWERING QUESTIONS

Background Essential component within pharmacy practice is the ability to effectively answer questions posed by health care professionals and the lay public

Systemic Approach to Answering Questions Step I. Secure demographics of requestor Step II. Obtain background information Step III. Determine and categorize ultimate question Step IV. Develop strategy and conduct research Step V. Perform evaluation, analysis, and synthesis Step VI. Formulate and provide response Step VII. Conduct follow-up and documentation

 Step I. Secure demographics of requestor Determine the requestor’s position, training, and anticipated knowledge Secure a mechanism for delivery of the response

 Step II. Obtain background information Why is the requestor asking for this information ? Whether the request is concerning a specific patient’s condition or is truly academic Ascertain which resource(s) the requestor has checked or used Requestor who are intermediaries in the transfer of information present a special challenge for obtaining background

 Step III. Determine and categorize ultimate question The ultimate question may essentially be the same or different as the original question The fact: 85% of the question was significantly different than the original question Refocusing the requestor’s question was useful for most of the drug information requests in the survey It is imperative that the requestor confirms the ultimate question prior to categorization and the development of a search strategy

 Step IV. Develop strategy and conduct research The categorization of the ultimate question prompts the resource selection process. For example, the categorization of a question as “adverse effect” suggests the use of adverse effect oriented resources Once resources have been selected, they are prioritized based on the probability of their containing the information or data desired

 Step V. Perform evaluation, analysis, and synthesis The information retrieved must be objectively critiqued The techniques and skills for literature evaluation and clinical application of statistical analysis are applied It is one of the opportunities to differentiate the professional from the technician through using the systemic approach

 Step VI. Formulate and provide response Pharmacist has a professional responsibility to clearly inform the requestor when one course of action is clearly more desirable than an alternate action. If the literature includes conflicting data that must be presented to the requestor, one may need to use a logical argument. The formulated response must be succinct yet adequately comprehensive. The provision of response is essential  if its not provided in a timely manner or is delivered at an inappropriate level of sophistication, the effort would be wasted.

 Step VII. Conduct follow-up and documentation Follow-up is the process of verifying the appropriateness, correctness, and completeness of a response following the communication. Follow-through is the process of readdressing a request based on the availability of new data or a change in the situation or circumstances that were decisive factors in the synthesis of a response. Thorough documentation is essential for reducing liability and potentially promoting the development of a continual service.

FORMULATING EFFECTIVE RESPONSES AND RECOMMENDATIONS: A STRUCTURED APPROACH

Background  Pharmacist should recognize that their responsibility extends beyond simply providing an answer to a question  Requestors of information are typically vague in verbalizing their needs and provide specific information only when asked  Critical information that defines the problem and elucidates the context of the question is not easily volunteered, but must be expertly elicited by the pharmacist using questioning strategies

Background  Providing responses and offering recommendations without knowledge of pertinent patient information, the context of the request, or how the information will be applied is irresponsible and potentially dangerous.  This is not only compromises the pharmacist’s credibility but also can jeopardize patient care.