Implementation and providers' views of a pharmacist clinician on an inpatient infectious diseases consult service at an academic medical center

2021 ◽  
Author(s):  
Maria Gabriela Cabanilla ◽  
Lisa M. Anselmo ◽  
Nestor R. Sosa ◽  
Keenan L. Ryan
Keyword(s):  
Infectious Diseases ◽  
Medical Center ◽  
Academic Medical Center ◽  
Consult Service ◽  
Academic Medical

scholarly journals Evaluation of an Outpatient Pharmacist Consult Service at a Large Academic Medical Center

2021 ◽  
Vol 12 (2) ◽  
pp. 13
Author(s):  
Melanie Berry ◽  
Amy Gustafson ◽  
Maya Wai ◽  
Alex J. Luli
Keyword(s):  
Medical Record ◽  
Medical Center ◽  
Academic Medical Center ◽  
Cost Savings ◽  
Acceptance Rate ◽  
Demographic Information ◽  
Consult Service ◽  
Descriptive Data ◽  
Academic Medical ◽  
Patient Demographic Information

Objective: To evaluate a novel outpatient pharmacist consult service in a large academic medical center. Setting: Four outpatient pharmacies that are part of a large academic medical center Methods: An outpatient pharmacist consult order was created and embedded in the electronic medical record (EMR). Medical center providers utilized this consult order when identifying patients in need of specific services provided by outpatient pharmacists. Descriptive data about each individual consult was collected including number completed, type of service, and duration. Rate of accepted pharmacy recommendations and patient cost savings were also evaluated. A survey was administered at the completion of the study period to assess provider and pharmacist satisfaction with the service.  Patient demographic information was collected for those who had a documented completed consult. Results: A total of 193 consults were completed: 137 immunizations, 37 care affordability, 15 education, 3 polypharmacy and 1 OTC recommendation. 89% of completed consults took pharmacists 20 minutes or less to complete. Of completed care affordability consults (n=31), 55% of patients saved between $100 - $500 per medication fill. Of providers who completed a survey and utilized the service (n=12), 83.3% were extremely satisfied and 16.7% were satisfied with it. The provider acceptance rate of pharmacist’s recommendations was 74%. Conclusion: Implementation of an outpatient pharmacist consult service provided an alternative method for the utilization of pharmacist provided MTM services in outpatient pharmacies at a large academic medical center. The service was well received by both providers and pharmacists.

scholarly journals Impact of Mandatory Infectious Diseases Consultation on Fungemia Management at a Large Academic Medical Center

2016 ◽  
Vol 3 (suppl_1) ◽  
Author(s):  
Travis Jones ◽  
Dustin Wilson ◽  
Christina Sarubbi ◽  
Deverick J. Anderson ◽  
Richard H. Drew
Keyword(s):  
Infectious Diseases ◽  
Medical Center ◽  
Academic Medical Center ◽  
Academic Medical ◽  
Infectious Diseases Consultation

scholarly journals Learning Experiences Within Infectious Diseases Pharmacy Residency Programs in the United States: A Cross-Sectional Survey

2019 ◽  
Vol 6 (10) ◽  
Author(s):  
Jonathan C Cho ◽  
Matthew P Crotty ◽  
Wesley D Kufel ◽  
Elias B Chahine ◽  
Amelia K Sofjan ◽  
...  
Keyword(s):  
United States ◽  
Infectious Diseases ◽  
Medical Center ◽  
Academic Medical Center ◽  
Travel Medicine ◽  
The United States ◽  
Cross Sectional ◽  
Residency Programs ◽  
Medical Centers ◽  
Academic Medical

Abstract Background Pharmacists with residency training in infectious diseases (ID) optimize antimicrobial therapy outcomes in patients and support antimicrobial stewardship (AS) programs. Although most ID residencies are accredited and assessed by certain standards, the degree to which these programs are similar is not known. Methods A 19-item, cross-sectional, multicentered, electronic survey was distributed via e-mail to pharmacy residency program directors (RPDs) of all 101 second-year postgraduate (PGY-2) ID residency programs in the United States. Results Survey responses were collected from 71 RPDs (70.3%); 64.8% were associated with an academic medical center and 97.2% focused primarily in adult ID. Rotations in the microbiology laboratory, adult AS, and adult ID consult were required in 98.6% of residency programs. Only 28.2% of responding programs required pediatric AS and pediatric ID consult rotations. Programs at academic medical centers were more likely to offer immunocompromised host ID consult (P = .003), pediatric ID consult (P = .006), and hospital epidemiology (P = .047) rotations but less frequently offered outpatient AS (P = .003), viral hepatitis clinics (P = .001), and travel medicine clinics (P = .007) rotations compared to programs at nonacademic medical centers. Residents were frequently involved in AS committees (97.2%), pharmacokinetic dosing of antimicrobials (83.1%), precepting pharmacy trainees (80.3%), and performing research projects (91.5%). Conclusions The PGY-2 ID pharmacy residency programs demonstrated consistency in required adult ID consult, antimicrobial management activities, committee service, and teaching and research opportunities. Pediatric experiences were less common. The PGY-2 ID residency programs prepare pharmacists to become antimicrobial stewards for adult patients.

scholarly journals Analysis of an Infectious Diseases Pharmacist on Call Pager Program to Inform Educational Efforts

2017 ◽  
Vol 33 (4) ◽  
pp. 146-150
Author(s):  
Elise M. Gilbert ◽  
Nathaniel J. Rhodes ◽  
Milena M. McLaughlin ◽  
Jessica M. Cottreau ◽  
Marc H. Scheetz ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Health Care Providers ◽  
Medical Center ◽  
Academic Medical Center ◽  
Temporal Trends ◽  
Question Type ◽  
Care Providers ◽  
Educational Initiatives ◽  
Academic Medical ◽  
Secondary Objective

Background: An on call infectious diseases (ID) pharmacist may be used as a resource for physicians, pharmacists, and other health care providers to help answer questions regarding anti-infective agents. Objective: To assess type, requestor, resources dedicated, and temporal trends of questions received through an ID pharmacist on call pager program. A secondary objective was to gather insight as to how this information was utilized to inform educational initiatives. Methods: This was a retrospective study of questions received by the ID pharmacist on call via pager at a large academic medical center. Question data were documented in a central database and analyzed to assess temporal trends and question type, and qualitatively analyzed to determine areas for targeted educational efforts. Results: The ID pharmacist on call recorded 545 questions during the 1-year study period; questions were composed of various antimicrobial agent–related queries, including antibiotic spectrum and selection (n = 251, 46.1%), dosing of antimicrobials (n = 195, 35.8%), and drug monitoring (n = 26, 4.8%). Targeted educational initiatives secondary to questions received included pharmacist education regarding the use of polymyxin antibiotics and antibiotic dosing protocol updates. Conclusions: An ID pharmacist on call pager program was utilized to inquire about antibiotic spectrum and selection for the majority of questions. Records of questions received may be utilized to direct educational efforts and create or revise targeted resources for pharmacists and other clinicians.

scholarly journals Identifying disincentives to ethics consultation requests among physicians, advance practice providers, and nurses: a quality improvement all staff survey at a tertiary academic medical center

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Lynette Cederquist ◽  
Jamie Nicole LaBuzetta ◽  
Edward Cachay ◽  
Lawrence Friedman ◽  
Cassia Yi ◽  
...  
Keyword(s):  
Online Survey ◽  
Medical Center ◽  
Academic Medical Center ◽  
Scale Up ◽  
Healthcare Providers ◽  
Ethics Consultation ◽  
Consult Service ◽  
Cross Sectional ◽  
Knowing How ◽  
Academic Medical

Abstract Background Ethics consult services are well established, but often remain underutilized. Our aim was to identify the barriers and perceptions of the Ethics consult service for physicians, advance practice providers (APPs), and nurses at our urban academic medical center which might contribute to underutilization. Methods This was a cross-sectional single-health system, anonymous written online survey, which was developed by the UCSD Health Clinical Ethics Committee and distributed by Survey Monkey. We compare responses between physicians, APPs, and nurses using standard parametric and non-parametric statistical methods. Satisfaction with ethics consult and likelihood of calling Ethics service again were assessed using a 0–100 scale using a 5-likert response structured (0 being “not helpful at all” to 100 being “extremely helpful”) and results presented using box plots and interquartile ranges (IQR). Results From January to July 2019, approximately 3800 surveys were sent to all physicians, APPs and nurses with a return rate of 5.5—10%. Although the majority of respondents had encountered an ethical dilemma (85–92.1%) only approximately half had ever requested an Ethics consult. The primary reason for physicians never having requested a consult was that they never felt the need for help (41%). For APPs the primary reasons were not knowing an Ethics consult service was available (33.3%) or not knowing how to contact Ethics (27.8%). For nurses, it was not knowing how to contact the Ethics consult service (30.8%) or not feeling the need for help (26.2%). The median satisfaction score (IQR) for Ethics consult services rated on a 0–100 scale, from physicians was 76 (29), for AAPs 89 (49), and nurses 70 (40) (p = 0.62). The median (IQR) of likelihood of consulting Ethics in the future also on a 0–100 scale was 71 (47) for physicians, 69 (45) for APPs, and 61 (45) for nurses (p = 0.79). APP’s and nurses were significantly more likely than physicians to believe that the team did not act on the Ethics consult’s recommendations. Conclusions Based on the results presented, we were able to identify actionable steps to better engage healthcare providers—and in particular APPs and nurses—and scale up institutional educational efforts to increase awareness of the role of the Ethics consult service at our institution. Actionable steps included implementing a system of ongoing feedback that is critical for the sustainability of the Ethics service role. We hope this project can serve as a blueprint for other hospital-based Ethics consult services to improve the quality of their programs.

scholarly journals Identifying Disincentives to Ethics Consultation Requests Among Physicians, Advance Practice Providers, and Nurses

2020 ◽  
Author(s):  
Lynette Carol Cederquist ◽  
Jamie LaBuzetta ◽  
Edward Cachay ◽  
Lawrence Friedman ◽  
Cassia Yi ◽  
...  
Keyword(s):  
Online Survey ◽  
Medical Center ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Ethics Consultation ◽  
Consult Service ◽  
Consultation Process ◽  
Cross Sectional ◽  
Improvement Project ◽  
Academic Medical

Abstract Background: Ethics consult services are well established, but often remain underutilized. Our aim was to identify the barriers and perceptions of the Ethics consult service at our urban academic medical center which might contribute to underutilization.Methods: This was a cross-sectional single-center, anonymous written online survey, developed by the UCSD Ethics committee, distributed by Survey Monkey, in January 2019, to a total of 3,800 clinicians at a tertiary care academic medical center. This was a quality improvement project, so IRB approval was waived. Results: Approximately 3,800 surveys were sent to physicians, advance practice providers (APPs) and nurses with a return rate of 5.5 - 10%. The majority of respondents had encountered an ethical dilemma although only half had ever requested an ethics consult. We found that there were 4 general reasons people did not consult Ethics: 1.) unawareness of the existence of or means of contacting the Ethics service. 2.) a priori perceptions that an Ethics consult would not be helpful or might slow down decision making. 3.) experiencing a poor quality consult in the past, including variability in knowledge and ability among various consultants, 4) a consult did not improve the situation, or lacked specific guidance from the consultant.Conclusions: Based on our survey results, we proposed the following methods of reducing barriers to use of an Ethics consult service: 1) Consults need to offer specific recommendations 2) set expectations for the consultation process and outcome; 3) ensure that Ethics consultants have strong training; 4) more actively engage nursing staff, and 5) better inform clinicians about the availability of the Ethics consult service.

scholarly journals 1949. Putting Out Fires: Assessing Burnout within an Infectious Diseases Fellowship at an Academic Medical Center

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S58-S59
Author(s):  
Leslie-Ann Alexander ◽  
Barbra M Blair ◽  
Wendy Stead
Keyword(s):  
Infectious Diseases ◽  
Needs Assessment ◽  
Medical Center ◽  
Academic Medical Center ◽  
Maslach Burnout Inventory ◽  
Personal Accomplishment ◽  
Medical Community ◽  
Personal Factors ◽  
Academic Medical ◽  
Participant Understanding

Abstract Background Burnout, “a psychological syndrome of emotional exhaustion (EE), depersonalization (DP), and reduced personal accomplishment (PA),” is a well-described problem in the medical community. National surveys report 45% of practicing physicians and 60% of residents and fellows are burnt out. A longitudinal study of medical students and residents reported 45% burnout, as well as career choice regret in 14% of trainees. There are little data about burnout in Infectious Diseases (ID) physicians, including fellows. We sought to measure burnout prevalence in an academic ID Division, identify factors that modified the risk of burnout, and assess knowledge and attitudes about fellow and faculty burnout in the division. Methods The study population included 33 ID physicians (10 fellows, 23 faculties). Level of burnout was assessed via the Maslach Burnout Inventory (MBI), a validated 22-item tool. An additional survey was distributed as a needs assessment to determine participant understanding of “burnout” and “wellness,” ability to recognize burnout in colleagues, attitudes about the scope of the problem, and specific programmatic and personal factors felt to contribute to burnout. Results The MBI was completed by 10 fellows and 16 faculties (76%). A high score in ≥ 1 domain of burnout was reported in 50% of respondents, and 19% received a high score in both EE and DP. Fellows had moderate to high levels of EE (90%) and DP (70%), though all fellows reported at least a moderate sense of PA. The survey needs assessment was completed by 9 fellows and 17 faculties (79%). In a hypothetical case, 100% and 58% of participants correctly identified elements of DP and EE, respectively. Respondents identified several factors contributing to burnout risk, most commonly being lack of schedule autonomy (100%), increasing patient load (96%), and inability to attend teaching conferences (88%). Fellows felt burnt out when seeing ≥ 4 new consults per day and/or carrying a census of 10–11 patients. Conclusion ID fellows at an academic medical center recognize burnout and report levels on par with national data. Fellows and faculty can identify personal and programmatic factors that increase and decrease their risk of burnout. These data can guide programmatic and divisional interventions to improve trainee wellness. Disclosures All Authors: No reported Disclosures.

Impact of automatic infectious diseases consultation on the management of fungemia at a large academic medical center

2017 ◽  
Vol 74 (23) ◽  
pp. 1997-2003 ◽  
Author(s):  
Travis M. Jones ◽  
Richard H. Drew ◽  
Dustin T. Wilson ◽  
Christina Sarubbi ◽  
Deverick J. Anderson
Keyword(s):  
Infectious Diseases ◽  
Medical Center ◽  
Academic Medical Center ◽  
Academic Medical ◽  
Infectious Diseases Consultation
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