Pharmacist Clinical Services Performance Evaluation - American ...

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Practice Management (2.0)To BeEvaluated2.1 Establish collaborative professional relationships with other health care professionalsinvolved in the care of patientsPerformance Rating5 4 3 2 12.2 Establish/maintain formal collaborative practice agreement(s) with other health care professionals(e.g., local physicians)2.3 Design a business plan for a new program/service or an enhanced program/service2.4 Contribute to the development and/or implementation of a marketing strategy to supportcurrent programs/services2.5 Proactively pursue revenue-generating opportunities for pharmacist-provided patient careservices (e.g., MTM, immunizations, health screenings) involving the entire organizationalteam2.6 Meet defined revenue goals and ensure that budget targets are met with the practice site’sgrowth plan2.7 Adhere to and integrate legal, regulatory, safety, and relevant accreditation requirementsinto patient programs and/or services2.8 Maintain patient confidentiality via an organized, secure documentation system2.9 Assist in recruitment, interview, and selection of personnel (e.g., pharmacy staff,pharmacists, technicians, and residents)2.10 Exhibit practice leadership in organizational and management activities2.11 Maintain consistent communications with pharmacy management and staff2.12 Convey a professional appearance, image, attitude, and behavior2.13 Additional criteria:SubtotalPractice Management (2.0)6Supervisor comments: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Evaluation of Patient Care Programs/Projects (3.0)To BeEvaluated3.1 Appropriately evaluate outcomes of programs/services and/or projects• Evaluations conducted:Performance Rating5 4 3 2 13.2 Appropriately conduct continuous quality improvement (CQI) activities on existing programs/services(e.g., analyze program(s)/service(s) for quality improvement)3.3 Present and/or publish program outcomes• Program outcomes presented and/or published:3.4 Appropriately assess impact and sustainability of program/service3.5 Additional criteria:SubtotalEvaluation of Patient Care Programs/Projects (3.0)Supervisor comments: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________7
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Page 3 and 4: Employee Name: ____________________
Page 5: Section I : Clinical Core Competenc
Page 9 and 10: Professional/Community Outreach (5.
Page 11 and 12: Section IV : Calculation of Perform

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