Presentation Outline ICHP Annual Meeting September 13-15

More documents

Recommendations

Info

Revise Clinical Intervention Module Appropriate and Effectiveness Safety (pADE/ADE) Non Adherence and Patient Variables Miscellaneous pADE/ADE Classification pADE Severity Rating Educate Pharmacists, APPE PharmD Students One on One orientation/training 1 hour presentation included as a part of site orientation (paper and computer) Safety (pADE/ADE) • Abnormal lab • Allergy • Contraindication • Illegible Order • Incomplete Order • Order Clarifications • Drug Dose Excessive for therapeutic Goals • Therapeutic Duplication Updated Clinical Intervention Documentation Time period: 4 week period Total Number of Clinical Interventions documented Total Number of interventions sampled 636 69 Number of MRPs reviewed 69 pADE Classification Cost Avoidance Occurrence Rate 3% Average Cost of ADE $ 2182 Yearly Projection of Med Intervention 7261 Estimated ADEs avoided (Annualized) 218 Estimated Savings $ 475,298 Adapted from Medication Reconciliation Tracking Tool. John Hopkins University. Accessed at: http://www.ihi.org/knowledge/Pages/Tools/ReconciliationTrackingTool.aspx on 8/6/12 8/29/2012 11
ASHP PPMI Case Study Adding Value: Prevention Prescribing Errors through Pharmacist Interventions Utilizing a Severity Rating Scale Relevant PPMI Recommendation B24. Every pharmacy department should: m. Track and trend pharmacist interventions • Pi Primary IIntended t d dOOutcome t – Demonstrate clinical relevance, via use of a severity rating scale, of prescribing errors intercepted by pharmacists Palmer K, Shane R Adding Value: Preventing Prescribing Errors through Pharmacist Interventions Utilizing a Severity Rating Scale http://www.ashpmedia.org/ppmi/case-studies.html, Accessed August 6, 2012. ASHP PPMI Case Study • Outcome Measures – Demonstrated the value of clinical pharmacy services to the organization – Did not result in an increase FTE; however, it supported the need for pharmacist staffing throughout the patient care areas. Palmer K, Shane R Adding Value: Preventing Prescribing Errors through Pharmacist Interventions Utilizing a Severity Rating Scale http://www.ashpmedia.org/ppmi/case-studies.html, Accessed August 6, 2012. Post Test Case Study 60‐year‐old Hispanic female who presents for diabetes MTM. She has been experiencing what she describes as ~10 “really bad” hypoglycemic episodes since her last visit with her primary care provider. She claims that she has not changed her diet nor activity level. She checked her blood glucose levels during g several of these episodes p and the readings g ranged from 60 to 70 mg/dL; she managed these episodes by consuming fruit juice or bread and rechecking her blood glucose every 15 minutes as directed. Upon completing your medication reconciliation, you find out that her dose of glyburide was recently increased from 10 mg BID to 20 mg BID. ASHP PPMI Case Study • Pharmacists document intercepted prescribing errors and their potential severity, utilizing the NCC MERP Index in the electronic health record. • Analyzed Data used in numerous ways – Included in the hospital performance improvement program – Reported to P&T Committee and Medical Staff Committees • Physician Education • Medical Staff Credentialing process – Pharmacy Department • Clinical Skills Assessment for pharmacy residents • Shared with pharmacy staff on a routine basis Palmer K, Shane R Adding Value: Preventing Prescribing Errors through Pharmacist Interventions Utilizing a Severity Rating Scale http://www.ashpmedia.org/ppmi/case-studies.html, Accessed August 6, 2012. References 1. Bates et. al. Incidence of adverse drug events and potential adverse drug events. Implications for prevention. ADE Prevention Study Group. JAMA. 1995; 274:29‐34 2. Gandhi et. al. Adverse drug events in ambulatory care. N Engl J Med. 2003;348:1556‐64 3. Fattinger, et al. Epidemiology of drug exposure and adverse drug reactions in two Swiss deprtmetns of internal medicine. Br J Clin Pharmacol. 200;49:158‐67 4. Budnitz DS, Pollock DA, Weidenbach KN, Mendelsohn AB, Schroeder TJ, Annest JL. National surveillance of emergency department visits for outpatient adverse drug events. JAMA 2006;296:1858‐66. 55. Institute of Medicine Medicine. Committee on Identifying and Preventing Medication Errors Errors. Preventing Medication Errors, Washington, DC: The National Academies Press 2006. 6. Classen DC, Pestotnik SL, Evans RS, et al. Adverse drug events in hospitalized patients. JAMA 1997;277(4):301‐6. 7. Cullen DJ, Sweitzer BJ, Bates DW, et al. Preventable adverse drug events in hospitalized patients: A comparative study of intensive care and general care units. Crit Care Med 1997;25(8):1289‐97. 8. Cullen DJ, Bates DW, Small SD, et al. The incident reporting system does not detect adverse drug events: A problem for quality improvement. Journal on Quality Improvement 1995;21(10):541‐8. Case Study Question 1. This adverse event is ___________________ and an example of a(n)__________________. a. inappropriate medication use, Side Effect b i di i dh b. appropriate medication use, Non‐adherence c. inappropriate medication use, Medication Error d. appropriate medication use, Adverse Drug Reaction 8/29/2012 12
Page 1 and 2:
ACTIVITY DESCRIPTION Target Audienc
Page 3 and 4:
Current Challenges • Expansion of
Page 5 and 6:
Examples of Medication Consideratio
Page 7 and 8:
Etiology (Dana Point, 2008) 1’. P
Page 9 and 10:
PAH Therapy Targets Schulze-Neick I
Page 11 and 12:
Chronic Adjuvant Therapies in PAH D
Page 13 and 14:
Cummulative suurvival Survival in I
Page 15 and 16:
ACCF/AHA Consensus PAH Treatment Al
Page 17 and 18:
Study Name Drug SUPER-1 Oral silden
Page 19 and 20:
IV Epoprostenol in PAH Due to Scler
Page 21 and 22:
70 60 50 40 30 20 10 Inhaled Ilopro
Page 23 and 24:
Conclusions • PAH therapy improve
Page 25 and 26:
ESC/ERS Guidelines Galie N, et al.
Page 27 and 28:
FUTURE DIRECTIONS WHICH MAY IMPACT
Page 29 and 30:
Rationale for “Front-Loaded” Ap
Page 31 and 32:
Addressing gthe Challenges g in PAH
Page 33 and 34:
Considerations • Central vs. peri
Page 35 and 36:
Pulmonary Hypertension • Approxim
Page 37 and 38:
Example Cassette Calculations • V
Page 39 and 40:
Assessment Question 1 Which of the
Page 41 and 42:
Illinois Council of Health‐System
Page 43 and 44:
Patient Activity ‐ 1 Patients in
Page 45 and 46:
Hospitalists National Trends • Ja
Page 47 and 48:
Pharmacy Landscape • PGY‐2: So
Page 49 and 50:
Primary Care Physicians by Field, F
Page 51 and 52:
Health Systems Pharmacy and TATAI
Page 53 and 54:
Readings The 21 Irrefutable Laws of
Page 55 and 56:
What is a “Practice Model”? •
Page 57 and 58:
Completing the Self Assessment •
Page 59 and 60:
Residency trained (B23p) Illinois N
Page 61 and 62:
Solving the PPMI Puzzle ‐ Here Ar
Page 63 and 64:
Overview of Value Based Purchasing
Page 65 and 66:
Implementation of Medication‐ rel
Page 67 and 68: Question #1 Within which programs a
Page 69 and 70: Solving the PPMI Puzzle‐ Here are
Page 71 and 72: Discharge Education/Med Rec • New
Page 73 and 74: Media‐Worthy Trials? Making Sense
Page 75 and 76: Prevention of Recurrent VTE • Unp
Page 77 and 78: VTE recurrence during study period
Page 79 and 80: Which patient might be a candidate
Page 81 and 82: Azithromycin and CV Death • Endpo
Page 83 and 84: Azithromycin and CV Death Azithromy
Page 85 and 86: Hormonal Contraception and VTE •
Page 87 and 88: • Age • Calendar year • Educa
Page 89 and 90: ARR=2.20, 2.28 for stroke, MI when
Page 91 and 92: Which of the following combinations
Page 93 and 94: 3 Months of Treatment for Latent TB
Page 95 and 96: 3 Months of Treatment for Latent TB
Page 97 and 98: T/F: Rifapentine in combination wit
Page 99 and 100: 2. Which of the following statement
Page 101 and 102: Fitting the Counseling Piece into M
Page 103 and 104: Current Evidence: Implementing Bund
Page 105 and 106: Teach Back Process • Step 1 Expla
Page 107 and 108: Questions for Consideration and Dis
Page 109 and 110: Why do we care about ADE? • Adver
Page 111 and 112: True or False • Medication errors
Page 113 and 114: Check Point Which of the following
Page 115 and 116: Proactive Screening Process Patient
Page 117: MTI Pilot at NAH PharmD Students tr
Page 121 and 122: Interdisciplinary Teamwork: How Phy
Page 123 and 124: Highly Effective Healthcare • Wha
Page 125 and 126: Inter‐Professional Teams ‐ Chan
Page 127 and 128: Meeting the PPMI Goals for Technolo
Page 129 and 130: Drug‐Bug Mismatch Example Con’t
Page 131 and 132: Drug‐Bug Mismatch Build Rules •
Page 135 and 136: Patient Scanning Compliance Sample
Page 139 and 140: Global Immunizations 3 • Jan 2012
Page 141 and 142: Mobile Devices: Beyond Angry Birds
Page 143 and 144: Google Play • Google Play - Inter
Page 145 and 146: Other Useful Productivity Apps •
Page 147 and 148: Mobile Devices: Beyond Angry Birds
Page 149 and 150: Net Activations by Industry Source:
Page 151 and 152: News Readers/Aggregators Features S
Page 153 and 154: Contact Information • E‐mail: -
Page 155 and 156: Early‐Onset Sepsis • Sign and s
Page 157 and 158: • BR is on day 2 of cefotaxime wi
Page 159 and 160: Immunizations: The Superheroes to P
Page 161 and 162: Current ACIP Recommendations Influe
Page 163 and 164: Herpes Zoster Vaccine Recommendatio
Page 165 and 166: Assessment Questions 1. What are th
Page 167 and 168: HIV Linkage and Retention in Care T
Page 169 and 170:
DHHS Guidelines, March 2012: When t
Page 171 and 172:
Protease Inhibitors • Require “
Page 173 and 174:
Mean Change (mg/ /dL) STARTMRK: Lip
Page 175 and 176:
RAL Drug Interactions • Does not
Page 177 and 178:
Instructions for Credit In order to
Page 179 and 180:
Staging Stage Criteria (Durie‐Sal
Page 181 and 182:
Salvage Therapy Partial List Regime
Page 183 and 184:
Bortezomib-Thalidomide-Dexamethason
Page 185 and 186:
Case 2 ST is a 76 y/o African Ameri
Page 187 and 188:
Thalidomide and Lenalidomide • Ad
Page 189 and 190:
Fixed Low-Dose Warfarin Study Thera
Page 191 and 192:
New Drugs 2012 Anna Nowobilski‐Va
Page 193 and 194:
Pulmonology » Cystic Fibrosis •
Page 195 and 196:
Oncology » MTX Toxicity • MTX 1o
Page 197 and 198:
NEW DRUGS AND BIOLOGICALS 2012 RESO
Page 199 and 200:
Disease State Reviews for Pharmacy
Page 201 and 202:
Chronic Obstructive Pulmonary Disea
Page 203 and 204:
Page 205 and 206:
Green Zone • Patient is not havin
Page 207 and 208:
Page 209 and 210:
• A hormone produced by the pancr
Page 211 and 212:
Unraveling Unraveling The The Puzzl
Page 213 and 214:
The Reward Center In time, serious
Page 215 and 216:
So what makes addicted pharmacists
Page 217 and 218:
How to find a treatment center Onli
Page 219 and 220:
Internet Drug Abuse Study conducted
Page 221 and 222:
NIAAA = best resource for alcohol d
Page 223 and 224:
Impact of Postoperative Pain • Pi
Page 225 and 226:
Safety Profile • Amar et al confi
Page 227 and 228:
References 1. Rømsing J, Møiniche
Page 229 and 230:
Society of Regional Anesthesia Meet
Page 231 and 232:
A New Approach IV Acetaminophen •
Page 233 and 234:
References • Schechter, Leslie N.
Page 235 and 236:
Bupivacaine liposome injectable sus
Page 237 and 238:
Error Potential • Inadvertent IV
Page 239 and 240:
Decolonization Methods • Anti-sep
Page 241 and 242:
Evidence: Inpatient ICU MRSA Coloni
Page 243 and 244:
Residency Project Pearls Adherence
Page 245 and 246:
650 subjects id identified tifi d R
Page 247 and 248:
Overtreatment versus Appropriate Tr
Page 249 and 250:
Adherence to and Outcomes Associate
Page 251 and 252:
Background • Lack of comprehensiv
Page 253 and 254:
Results Results‐User User Audits
Page 255 and 256:
Special thanks to: • Carol Heunis
Page 257 and 258:
Antibiotic Prophylaxis American Hea
Page 259 and 260:
Study Limitations • Dependent on
Page 261 and 262:
Study Background • Observation of
Page 263 and 264:
A patient has a CrCl of 25 mL/min.
Page 265 and 266:
• Cysteine hydrochloride: antioxi
Page 267 and 268:
Sample Preparation • Intravenous
Page 269 and 270:
Questions? Residency Project Pearls
Page 271 and 272:
The Interview: Your Preparation •
Page 273 and 274:
PGY1 Residency Options Carol Heunis
Page 275 and 276:
RESIDENCY PROGRAM BASICS • Progra
Page 277 and 278:
CV: The key to a top curriculum vit
Page 279 and 280:
Tips for a Top Notch CV • Focus o
Page 281 and 282:
What is PhORCAS? • PhORCAS is the
Page 283 and 284:
Piecing together the new CHEST guid
Page 285 and 286:
Initiating therapy CHEST 2012 2.1.8
Page 287 and 288:
What is “Consistently Stable?”
Page 289 and 290:
Puzzle # 2A: patient has just compl
Page 291 and 292:
What would you do for JJ? • A. Ho
Page 293 and 294:
Considerations for SB • Bleeding
show all

Presentation Outline ICHP Annual Meeting September 13-15

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?