Presentation Outline ICHP Annual Meeting September 13-15

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PPMI Hospital Self‐Assessment Illinois vs. Nation Strengths: • Existence of at least some pharmacist‐facilitated medication reconciliation • Some discharge education provided by Pharmacists • Education of pharmacy students in transitions of care Opportunities: • Establish processes for medication‐related continuity of care for discharge patients • Expand reach of pharmacists’ role in transitions of care What opportunities are there ffor our profession? f i ? 3 Why are care transitions so iimportant? t t? Affordable Care Act • Value Based Purchasing • Readmission Reduction • Healthcare Acquired Conditions 8/29/2012 2
Overview of Value Based Purchasing Program • Improve quality and safety for Medicare beneficiaries by linking payment to quality of care 4 • VBP Program is continuously updated as part of the annual rulemaking • Hospital performance for each measure is compared to national performance standards 5 • Points awarded for: 1.) Achieving high quality and 2.) Improving towards goals 6 Value Based Purchasing Program: <strong>13</strong> Clinical Process Measures: 45% •AMI ‐7a, AMI‐8a •HF‐1 •PN‐3b, PN‐6 • SCIP‐Inf‐1 SCIP Inf 1, SCIP‐Inf‐2 SCIP Inf 2, SCIP‐Inf‐3, SCIP‐Inf‐4, SCIP‐Inf‐9 •SCIP‐Card‐2, SCIP‐VTE‐1, SCIP‐VTE‐2 Proposed Federal Fiscal Year 2014 8 HCAHPS Domains: 30% • Communication with Nurses • Communication with Doctors • Responsiveness of Hospital Staff • Pain Management • Communication About Medicines • Cleanliness and Quietness of Hospital Environment • Discharge Information • Overall Rating of Hospital 3 Mortality Measures: 25% • AMI 30 day mortality • HF 30 day mortality • PN 30 day mortality The Readmission Issue • 19.6% of readmissions within 30 days and approximately 76% may be preventable 7 • Over 50% of readmitted patients received no care or follow up in the 30 days after hospitalization • CMS estimates that unplanned readmissions cost Medicare over $17 billion annually 6 Value Based Purchasing Program: 12 Clinical Process Measures: 70% • AMI ‐7a 7a, AMI‐8a AMI 8a •HF‐1 •PN‐3b, PN‐6 •SCIP‐Inf‐1, SCIP‐Inf‐2, SCIP‐Inf‐3, SCIP‐ Inf‐4 •SCIP‐Card‐2, SCIP‐VTE‐1, SCIP‐VTE‐2 Federal Fiscal Year 20<strong>13</strong> 8 HCAHPS Domains: 30% • Communication with Nurses • Communication with Doctors • Responsiveness of Hospital Staff • Pain Management • Communication About Medicines • Cleanliness and Quietness of Hospital Environment • Discharge Information • Overall Rating of Hospital Readmission Reduction Readmission Initiatives from Medicare and Medicaid – Improve quality of care and experience for patient – Trend to reduce or deny payments for preventable readmissions Most Common Reasons for Avoidable Admissions (AHRQ) 8 • Poor discharge instruction • Poor transfer of information/handoff communication • Lack of timely post‐discharge physician visit • Poor medication reconciliation 8/29/2012 3
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ACTIVITY DESCRIPTION Target Audienc
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Current Challenges • Expansion of
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Examples of Medication Consideratio
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Etiology (Dana Point, 2008) 1’. P
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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: Solving the PPMI Puzzle ‐ Here Ar
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
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Check Point Which of the following
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Proactive Screening Process Patient
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MTI Pilot at NAH PharmD Students tr
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ASHP PPMI Case Study Adding Value:
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Interdisciplinary Teamwork: How Phy
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Highly Effective Healthcare • Wha
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Inter‐Professional Teams ‐ Chan
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Meeting the PPMI Goals for Technolo
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Drug‐Bug Mismatch Example Con’t
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Drug‐Bug Mismatch Build Rules •
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Patient Scanning Compliance Sample
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Global Immunizations 3 • Jan 2012
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Mobile Devices: Beyond Angry Birds
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Google Play • Google Play - Inter
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Other Useful Productivity Apps •
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Mobile Devices: Beyond Angry Birds
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Net Activations by Industry Source:
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News Readers/Aggregators Features S
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Contact Information • E‐mail: -
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Early‐Onset Sepsis • Sign and s
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• BR is on day 2 of cefotaxime wi
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Immunizations: The Superheroes to P
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Current ACIP Recommendations Influe
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Herpes Zoster Vaccine Recommendatio
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Assessment Questions 1. What are th
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HIV Linkage and Retention in Care T
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DHHS Guidelines, March 2012: When t
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Protease Inhibitors • Require “
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Mean Change (mg/ /dL) STARTMRK: Lip
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RAL Drug Interactions • Does not
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Instructions for Credit In order to
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Staging Stage Criteria (Durie‐Sal
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Salvage Therapy Partial List Regime
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Bortezomib-Thalidomide-Dexamethason
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Case 2 ST is a 76 y/o African Ameri
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Thalidomide and Lenalidomide • Ad
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Fixed Low-Dose Warfarin Study Thera
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New Drugs 2012 Anna Nowobilski‐Va
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Pulmonology » Cystic Fibrosis •
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Oncology » MTX Toxicity • MTX 1o
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NEW DRUGS AND BIOLOGICALS 2012 RESO
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Disease State Reviews for Pharmacy
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Chronic Obstructive Pulmonary Disea
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Green Zone • Patient is not havin
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• A hormone produced by the pancr
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Unraveling Unraveling The The Puzzl
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The Reward Center In time, serious
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So what makes addicted pharmacists
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How to find a treatment center Onli
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Internet Drug Abuse Study conducted
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NIAAA = best resource for alcohol d
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Impact of Postoperative Pain • Pi
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Safety Profile • Amar et al confi
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References 1. Rømsing J, Møiniche
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Society of Regional Anesthesia Meet
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A New Approach IV Acetaminophen •
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References • Schechter, Leslie N.
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Bupivacaine liposome injectable sus
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Error Potential • Inadvertent IV
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Decolonization Methods • Anti-sep
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Evidence: Inpatient ICU MRSA Coloni
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Residency Project Pearls Adherence
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650 subjects id identified tifi d R
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Overtreatment versus Appropriate Tr
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Adherence to and Outcomes Associate
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Background • Lack of comprehensiv
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Results Results‐User User Audits
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Special thanks to: • Carol Heunis
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Antibiotic Prophylaxis American Hea
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Study Limitations • Dependent on
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Study Background • Observation of
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A patient has a CrCl of 25 mL/min.
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• Cysteine hydrochloride: antioxi
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Sample Preparation • Intravenous
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Questions? Residency Project Pearls
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The Interview: Your Preparation •
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PGY1 Residency Options Carol Heunis
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RESIDENCY PROGRAM BASICS • Progra
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CV: The key to a top curriculum vit
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Tips for a Top Notch CV • Focus o
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What is PhORCAS? • PhORCAS is the
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Piecing together the new CHEST guid
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Initiating therapy CHEST 2012 2.1.8
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What is “Consistently Stable?”
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Puzzle # 2A: patient has just compl
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What would you do for JJ? • A. Ho
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Considerations for SB • Bleeding
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Presentation Outline ICHP Annual Meeting September 13-15

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