ASHP PAI Self Assessment in Action Kimber Boothe, PharmD, MHA - - PowerPoint PPT Presentation
ASHP PAI Self Assessment in Action Kimber Boothe, PharmD, MHA System Director Pharmacy Marilin Castle, PharmD, BCPS PGY2-HSPA Resident March 23, 2019 CONFIDENTIAL FOR INTERNAL USE ONLY Outline PAI Strategy PAI Self Assessment
Kimber Boothe, PharmD, MHA System Director Pharmacy Marilin Castle, PharmD, BCPS PGY2-HSPA Resident March 23, 2019
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Measure
Threshold Target Max
2016 2017 Patient (ADC): RPh Ratio - (Avg, ICU, Floor) Weekday 43:1
35:1 50:1
30:1
25:1 35:1
25:1
18:1 30:1
Evening/Weekend Orders Verified/RPh/Hr Weekday 50 40 30 Evening/Weekend 60 50 40 Decentralized RPh Coverage % Units Covered 50% 75% 100% % Units Rounding/Team 25% 50% 75% ASHP PAI Metrics PAI Self Assessment Score 65% 75% 85% % RPh w/ Residency 25% 50% 75% % RPh Board Certified TBD TBD TBD
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10 20 30 40 50 60 70 80
Pharmacists Current Pharmacists Goal Physicians Respiratory Therapist Nurses
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Category Edgew ood Florence
OVERALL 7 3 % 7 3 % 7 3 % OPTIMAL PHARMACY PRACTICE CHARACTERISTICS - PART 1 83% 83% 84% OPTIMAL PHARMACY PRACTICE CHARACTERISTICS - PART II 62% 63% 63% ADVANCING THE APPLICATION OF INFORMATION TECHNOLOGY IN THE MEDICATION USE PROCESS 92% 92% 92% ADVANCING THE USE OF PHARMACY TECHNICIANS 41% 40% 41% SUCCESSFULL IMPLEMENTATION OF NEW PHARMACY PRACTICE INITIATIVES 82% 80% 80%
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Assessment Question Actionable Item - EDG Actionable Item - FLO Actionable Item - FTT
Are pharmacists involved in development of a patient care plan? [B23a] X X Do pharmacists review medication orders before initial dose is administered? [B23b] X X X Are drug therapy management services prioritized for inpatients based on patient medication complexity? [B8] X X X Does the pharmacy department at your hospital identify problem-prone (e.g. high-alert) and high-risk therapies using pre-established criteria? [B24k] X X X Are medication preparation and distribution tasks assigned to pharmacy technicians, to the extent possible, to allow redeployment of pharmacists’ time to drug therapy management activities at your hospital? [D2] X X X 17
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Assessment Question Actionable Item - EDG Actionable Item - FLO Actionable Item - FTT
If permitted by law, is the accuracy of medication dispensing by pharmacy technicians checked by other technicians (i.e. “tech-check-tech”) who have appropriate education and training at your hospital? [D3c] X X X Are all distributive functions that do not require a pharmacist’s clinical judgement assigned to pharmacy technicians at your hospital? [D9] X X X Do pharmacists participate on your hospital’s rapid response teams? [B23n] X Do pharmacists provide discharge education to patients at your hospital? [B23m] X X X Is medication reconciliation performed by the pharmacy staff at your hospital? [B23k] X X X 18
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Assessment Question Actionable Item - EDG Actionable Item - FLO Actionable Item - FTT
Based on the genetic characteristics of the patient, do pharmacists have a role in adjusting dosing or changing therapy of selective medications? [B23f] X X X Are all patients’ medication profiles reviewed for appropriateness at least daily by a pharmacists? [B23c] X X X Do pharmacists facilitate medication-related continuity of care? [B20] X X X Does the pharmacy department at your hospital manage prospective medication-use evaluation programs to improve prescribing? [B24i] X X X Do automated systems at your hospital notify pharmacists when medication serum concentrations or other clinically important laboratory values fall outside of a therapeutic or normal range? [C2i] X X X 19
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Assessment Question Actionable Item - EDG Actionable Item - FLO Actionable Item - FTT
If you employ pharmacy student interns, are their duties different from traditional pharmacy technician duties? [B24c] X X X Does a lack of pharmacy staff impede development of an optimal pharmacy practice model at your hospital? [B6c] X X X Initiation of a medication reconciliation, including obtaining and documenting patients’ medication information for pharmacists’ review, should be done at every transition of care in which new medications are
X X X Is the management of controlled substance systems assigned to pharmacy technicians who have appropriate education and training at your hospital? [D3j] X X X Are components of quality improvement programs conducted by pharmacy technicians who have appropriate education and training at your hospital? [D3l] X X X 20
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Assessment Question Actionable Item - EDG Actionable Item - FLO Actionable Item - FTT
Have pharmacy technician responsibilities been expanded to the extent possible based on education and training at your hospital? [E4e] X Are pharmacists assigned/deployed to patient-care units at your hospital? [E4d] X X 21
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100 100 100 18.37 79.59 2.04 EXISTS IN ALL AREAS (100%) EXISTS IN MOST AREAS (50-99%) EXISTS ONLY IN SOME AREAS (1-49%) DOES NOT EXIST (0%)
SELECTION (%) ANSWER CHOICES EDG FLO FTT PEER 22
Peer group: N=49; bed size 400-599; community hospital; all metropolitan statistical area; all regions; Yes – medical residency program; Yes – pharmacy residency program; Yes – takes 6 or more pharmacy students per year
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100 100 100 4.08 28.57 32.65 34.69 THROUGHOUT ALL AREAS IN SOME AREAS PARTIALLY PERFORMED IN SOME OR ALL AREAS NOT PERFORMED BY PHARMACY STAFF
SELECTION (%) ANSWER CHOICES EDG FLO FTT PEER 23
Peer group: N=49; bed size 400-599; community hospital; all metropolitan statistical area; all regions; Yes – medical residency program; Yes – pharmacy residency program; Yes – takes 6 or more pharmacy students per year
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100 100 100 8.16 4.08 12.24 30.61 44.9 EXISTS IN ALL AREAS (100%) EXISTS IN MOST AREAS (50-99%) EXISTS IN ONLY SOME AREAS (1- 49%) DOES NOT EXIST (0%) NOT PERMITTED BY LAW
SELECTION (%) ANSWER CHOICES EDG FLO FTT PEER 24
Peer group: N=49; bed size 400-599; community hospital; all metropolitan statistical area; all regions; Yes – medical residency program; Yes – pharmacy residency program; Yes – takes 6 or more pharmacy students per year
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OBJECTIVES Tactics
Clinical Practice Standardization
Service Line Support/Expansion
Medication Reconciliation
Residency Expansion
Students
Precision Medicine
Patient Experience
Operations PAI
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86% 22% 16% 12% 12% 6% 4% 4% 3% 2% 1% 1% 0% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% All clinical tasks Clinical review (exclude rounding) Documentation of intervention Order verification Professional communication Medication Review Walking Rounding Providing drug/health information to patients/caregivers Meetings Technologies Looking for something Discharge dispensing
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i.
ii.
iii.
1) Work flow prioritization 2) Practicing at the top of your license 3) Practice model 4) Scheduling
1. Epic Decision Support
2. Workflow Prioritization
3. Education
4. Scheduling
Ratio
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