Date Approved


Graduate Degree Type


Degree Name

Nursing (D.N.P.)

Degree Program

College of Nursing

First Advisor

Dr. Della Hughes-Carter

Second Advisor

Dr. Amy Manderscheid

Academic Year



Background: Integration of clinical pharmacy specialists (CPS) into primary care has increased over the last decade. CPS are highly educated advanced practice providers and specialize in chronic disease and medication management, and offer additional support to both patients and PCPs. Despite their extensive training and expertise, the role of CPS is often unknown or misunderstood amongst PCPs and results in the underutilization of CPS services. As a result, referrals to their service remain low. The purpose of this quality improvement project is to increase referrals to embedded CPS and identify encounter types by associated diagnoses.

Objectives: Develop and implement a pre-visit pharmacy services screening tool, and educate staff about the value of CPS.

Methods: Quality improvement, pre-post comparison at a single-site primary care office in a state-designated health professional shortage area. Participants are adult patients referred to pharmacy services and staff. Data was collected for six weeks after implementation and compared to the same six-week period in 2022.

Results: Referrals increased from n = 7 to n = 23 after the intervention. A 2-sample Fisher’s exact test determined there was insufficient evidence to support a relationship between pre- and post-implementation rates of referrals categorized by purpose (p = 0.215).

Conclusions: Use of a pre-visit checklist and pharmacy services screening tool increased referrals compared to standard practice.

Implications: Further studies are needed to evaluate the impact on patient and organizational outcomes from the increase in patient referrals to CPS.

Keywords: interprofessional collaboration; clinical pharmacist; primary care; collaborative practice agreement; quality improvement