Four years' experience with a clinical intervention program: Cost avoidance and impact of a clinical coordinator

1990 ◽  
Vol 47 (12) ◽  
pp. 2701-2705
Author(s):  
Harriet F. Catania ◽  
William P. Yee ◽  
Patrick N. Catania
Keyword(s):  
Intervention Program ◽  
Clinical Intervention ◽  
Program Cost ◽  
Cost Avoidance ◽  
Clinical Coordinator

Implementation of a Student Pharmacist-Run Targeted Medication Intervention Program

2016 ◽  
Vol 30 (1) ◽  
pp. 109-114 ◽  
Author(s):  
Karleen T. Melody ◽  
Chintan J. Shah ◽  
Jaydip Patel ◽  
Vincent J. Willey
Keyword(s):  
Intervention Program ◽  
Descriptive Statistics ◽  
Total Revenue ◽  
Cost Avoidance ◽  
Medication Therapy ◽  
Innovative Model ◽  
Acceptance Rates ◽  
Medication Intervention ◽  
Administrative Tasks ◽  
The Impact

Objective: To evaluate the impact of a student pharmacist-run targeted medication intervention (TMI) program. Methods: Student pharmacists in their third professional year resolved TMIs at 5 independent pharmacies under the supervision of a pharmacist. A claims report of completed TMIs from the medication therapy management (MTM) platform, which captured the category and outcome of the TMIs and the estimated cost avoidance (ECA) level, was analyzed using descriptive statistics. Time spent was calculated using an estimation based on each of the tasks required to complete the TMI. Results: Of the 156 TMIs that were billed, 42 (26.9%) were accepted, 24 (15.4%) were rejected, and 90 (57.7%) were unable to be reached. For TMIs where the prescribers or patients were reached, the acceptance rates were 20% and 71%, respectively. Student pharmacists spent a total of 25.2 hours completing TMIs, and the pharmacist spent 2 hours on administrative tasks. Total revenue generated from all TMIs was US$1058, which led to a revenue generation of US$38.90/h. Successfully completing 42 TMIs resulted in a savings to the health care system of approximately US$121 000. Conclusion: This pilot study demonstrates an innovative model for community pharmacies to complete TMIs by utilizing student pharmacists under the supervision of a pharmacist.

Integrated Treatment of Co-Occurring Mental Illness and Addiction: Clinical Intervention, Program, and System Perspectives

CNS Spectrums ◽  
2004 ◽  
Vol 9 (12) ◽  
pp. 892-904,925 ◽  
Author(s):  
Douglas M. Ziedonis
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Addiction Treatment ◽  
Intervention Program ◽  
Clinical Intervention ◽  
Psychosocial Interventions ◽  
Integrated Treatment ◽  
Motivational Enhancement Therapy ◽  
Clinical Interventions ◽  
Increased Risk

AbstractIndividuals with mental illness and addiction comprise at least half of the patients in most mental health treatment systems. This combination results in increased risk for frequent psychiatric relapses, poor medication compliance, violence, suicide, legal problems, and high utilization of the emergency room or inpatient services. Traditional mental health and addiction treatments have not adequately addressed these co-occurring disorders due to clinical interventions, programs, and system flaws that have not addressed the individual's needs. Integrated treatment requires both an understanding of mental illness and addiction and the means to integrate and modify the traditional treatment approaches in both the mental health and addiction treatment fields. There is strong evidence to support the efficacy and effectiveness of integrated treatment in this population. All mental health clinicians should become experienced and skilled in the core psychotherapy approaches to treating substance use disorders, including motivational enhancement therapy, relapse prevention (cognitive-behavioral therapy), and 12-step facilitation. In addition, integrated treatment includes integrating medications for both addiction and mental illness with the behavioral therapies and other psychosocial interventions. This article reviews the clinical intervention, program, and system components of integrated treatment and specific clinical interventions for this population.

Clinical Intervention: Positive Outcome Based on Improved Communication with Physicians in a Community Hospital

1996 ◽  
Vol 9 (3) ◽  
pp. 188-201 ◽  
Author(s):  
Saifi Vohra ◽  
Joann Fox
Keyword(s):  
Health Care Professionals ◽  
Intervention Program ◽  
Community Hospital ◽  
Cost Savings ◽  
Clinical Intervention ◽  
Positive Outcome ◽  
P Value ◽  
First Year ◽  
Great Cost ◽  
Pharmacy Department

Establishment of a clinical intervention program and standardized drug information system in a community hospital is explained. The establishment of the program increased better communication among pharmacists, medical staff, and other health care professionals. An effective and consistent interaction with the physicians with respect to patient's drug therapy was developed. Medication misadventures are diminished in a positive communications environment. The total number of interventions increased to 4,275 in first year of program in 1992 and 6,700 in 1993. The first six months of 1994 yielded similar improvements with a total of 3,390 interventions. Before 1991, no documentation of interventions existed. This intervention program resulted in a great cost savings to the pharmacy department. An estimated $96,000 cost savings was observed in 1992 and $87,000 in 1993. In the first six months of 1994, a cost savings of $48,000 was observed. This program decreased drug inventory to the lowest level recorded at this institution over this 30 month period. Significant improvement in several intervention categories such as adverse drug reaction (ADR), conversion from parenteral to oral therapy, aminoglycoside and vancomycin monitoring were observed. Statistical analysis showed significant improvement in the intervention program over a three-year period with P value ranging from 0.00 to 0.012.

scholarly journals 2795. Clinical and Economic Impact of a Ribavirin Intervention Program in Hematopoietic Cell and Solid-organ Transplant Recipients with Respiratory Syncytial Virus Infection

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S987-S988
Author(s):  
Emily Leonard ◽  
Rebekah Wrenn ◽  
Jennifer Saullo ◽  
Richard H Drew ◽  
Richard H Drew ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Clinical Outcomes ◽  
Acquisition Cost ◽  
Intervention Program ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Immunocompromised Patients ◽  
Cost Avoidance ◽  
Syncytial Virus

Abstract Background While data are limited, oral ribavirin (RBV) has been shown to be a cost-effective alternative to aerosolized RBV for the treatment of respiratory syncytial virus (RSV) in immunocompromised patients with significant reductions in acquisition and administration costs. We evaluated the clinical and economic impact of an RBV intervention program at a large, academic medical center. Methods This single-center, retrospective cohort study evaluated hematopoietic cell and solid-organ transplant patients admitted to Duke University Hospital (DUH) with documented or suspected RSV receiving aerosolized and/or oral RBV from July 2013 to April 2018. The ID consult service approval requirement was initiated for aerosolized RBV beginning in October 2015. Education was done at this time to promote oral RBV as the preferred therapy for immunocompromised, RSV-infected adults and children. No restrictions or treatment protocols were in place prior to that time for either formulation. Clinical outcomes, adverse effects, and drug acquisition cost were collected. A cost-avoidance analysis was performed using DUH acquisition cost for actual and alternate RBV therapy. Results A total of 118 treatments (115 unique adult and pediatric patients) were included. Demographics were comparable between groups with and median age was 52 years in the Oral RBV and 61 years in the Aerosol RBV group. The predominant transplant type was lung (62.5% in Oral RBV and 55.6% in Aerosol RBV) followed by hematopoietic (16.7% in Oral RBV and 27% in Aerosol RBV). The median (range) duration of therapy was 4 (1–16) days for oral RBV and 5 (1–23) days for aerosolized RBV. The total cost avoidance was $2,522,915 with oral RBV. Clinical outcomes are summarized in Table 1. Conclusion In our large tertiary care center, the use of oral RBV led to substantial cost avoidance with clinical outcomes comparable to aerosolized RBV in immunocompromised patients. Larger prospective trials evaluating oral RBV for RSV treatment are warranted. Disclosures All authors: No reported disclosures.

A Therapeutic Milieu for Establishing and Expanding Communicative Behaviors in Psychotic Children

1976 ◽  
Vol 41 (1) ◽  
pp. 70-92
Author(s):  
Carol Melnick Ratusnik ◽  
David L. Ratusnik
Keyword(s):  
Language Development ◽  
Intervention Program ◽  
Expressive Language ◽  
Substantial Reduction ◽  
Clinical Intervention ◽  
Substantial Improvement ◽  
Communicative Behaviors ◽  
Therapeutic Milieu ◽  
Diagnostic Measures ◽  
Expressive Language Development

This study describes a clinical intervention program that was used to facilitate development of receptive and expressive language skills in a group of four psychotic children. A group format utilizing an interactive language development teaching procedure combined with a therapeutic milieu was shown to be effective in establishing and expanding communicative behaviors in psychotic children. Nine diagnostic measures were utilized to assess children’s performance prior to therapy and at the end of three-month and six-month intervals. Results indicated substantial reduction of delayed and immediate echolalia, jargon, inappropriate stress, pitch, and intonation. Substantial improvement was noted in expressive syntactic and morphological functioning and in the children’s ability to generate novel utterances about day-to-day experiences, family, and toys. Increases in children’s concept of body image and ego functioning paralleled their improvement in receptive and expressive language development.

Analysis of Clinical Intervention Documentation by Dispensing Pharmacists in a Teaching Hospital

2003 ◽  
Vol 38 (4) ◽  
pp. 346-350 ◽  
Author(s):  
Liya Davydov ◽  
Gina C. Caliendo ◽  
Lawrence G. Smith ◽  
Bernard Mehl
Keyword(s):  
Intervention Program ◽  
Clinical Intervention ◽  
Mount Sinai Hospital ◽  
Pharmacist Intervention ◽  
Prescribing Errors ◽  
Prescribing Error ◽  
Clinical Interventions ◽  
Pharmacist Interventions ◽  
Physician Order Entry ◽  
Valuable Role

Decentralized pharmacists have a valuable role in preventing medication errors. At Mount Sinai Hospital, each pharmacist's contact with a prescriber to correct or clarify a possible prescribing error is documented on the original order. Our pharmacists are also encouraged to document interventions as part of the pharmacist intervention program. The authors undertook a blinded observational study to determine the percentage of prescriber contacts documented as pharmacist clinical interventions. This 2-month study was conducted in two nursing units with computerized physician order entry. All orders from these units were collected and evaluated for possible prescribing errors and documentation of a pharmacist's contact with a prescriber. Additionally, all pharmacist interventions documented in these units during the study period were collected and entered into the pharmacist intervention database. The percentage of all pharmacist interventions vs the number of documented prescriber contacts on original orders was then calculated. A total of 14 pharmacists were involved in the provision of pharmaceutical care to patients in the study units. During the 2-month study period, a total of 221 orders required pharmacists to contact prescribers regarding potential prescribing errors. However, only 109 (49.3%) of these were documented as clinical interventions. The findings indicate a need for improved documentation of clinical services (eg, interventions) performed by pharmacists.

Posttraumatic Stress Disorder: A Case Study of an Elite Rifle Shooter

2011 ◽  
Vol 5 (2) ◽  
pp. 134-147 ◽  
Author(s):  
David A. Shearer ◽  
Stephen D. Mellalieu ◽  
Catherine R. Shearer
Keyword(s):  
Posttraumatic Stress Disorder ◽  
General Population ◽  
Posttraumatic Stress ◽  
Sport Psychology ◽  
Intervention Program ◽  
Stress Disorder ◽  
Clinical Intervention ◽  
Bicycle Accident ◽  
Recommendations For Practice

While posttraumatic stress disorder (PTSD) is most commonly associated with survivors of traumatic events (e.g., combat), PTSD can occur after any situation in which victims perceive that their life or safety is threatened. In sport, athletes often place themselves in dangerous situations and are also exposed to the same lifestyle dangers as the general population. The literature on PTSD among athletes is sparse, and consequently, it is possible that many (non-clinical) sport psychologists would fail to recognize the symptoms and may subsequently fail to refer the athlete to the appropriate professional for clinical assistance. In the following case study, we present an example of an athlete suffering from PTSD following a serious bicycle accident in which she sustained head and facial injuries. We briefly detail the nature of PTSD and discuss how sport psychology services can be implemented alongside a parallel clinical intervention program. Finally, we offer recommendations for practice when working with athletes with PTSD.

A Cognitive-Linguistic Intervention Program: Basic Concept Formation Level

1977 ◽  
Vol 8 (1) ◽  
pp. 23-32
Author(s):  
Gerald E. Chappell
Keyword(s):  
Basic Concept ◽  
Concept Formation ◽  
Intervention Program ◽  
Cognitive Linguistic ◽  
Basic Concepts ◽  
Linguistic Skills ◽  
Linguistic Intervention

Test-teach questioning is a strategy that can be used to help children develop basic concepts. It fosters the use of multisensory exploration and discovery in learning which leads to the development of cognitive-linguistic skills. This article outlines some of the theoretical bases for this approach and indicates possibilities for their applications in child-clinician transactions.

Developing an Early Intervention Preservice Specialization in Speech-Language Pathology

1995 ◽  
Vol 4 (2) ◽  
pp. 31-36 ◽  
Author(s):  
Joanne E. Roberts ◽  
Elizabeth Crais ◽  
Thomas Layton ◽  
Linda Watson ◽  
Debbie Reinhartsen
Keyword(s):  
Early Childhood ◽  
Early Intervention ◽  
Intervention Program ◽  
Graduate Program ◽  
Master's Level ◽  
Clinical Experiences ◽  
Speech Language Pathology ◽  
Early Intervention Program ◽  
Language Pathology ◽  
Family Centered

This article describes an early intervention program designed for speech-language pathologists enrolled in a master's-level program. The program provided students with courses and clinical experiences that prepared them to work with birth to 5-year-old children and their families in a family-centered, interdisciplinary, and ecologically valid manner. The effectiveness of the program was documented by pre- and post-training measures and supported the feasibility of instituting an early childhood specialization within a traditional graduate program in speech-language pathology.

The Effect of Vocabulary Intervention on Text Comprehension: Who Benefits?

2019 ◽  
Vol 50 (4) ◽  
pp. 562-578 ◽  
Author(s):  
Dawna Duff
Keyword(s):  
Middle School ◽  
Reading Comprehension ◽  
Text Comprehension ◽  
Classroom Instruction ◽  
Vocabulary Instruction ◽  
Clinical Intervention ◽  
Vocabulary Knowledge ◽  
Vocabulary Intervention ◽  
The Mean ◽  
The Difference

Purpose Vocabulary intervention can improve comprehension of texts containing taught words, but it is unclear if all middle school readers get this benefit. This study tests 2 hypotheses about variables that predict response to vocabulary treatment on text comprehension: gains in vocabulary knowledge due to treatment and pretreatment reading comprehension scores. Method Students in Grade 6 ( N = 23) completed a 5-session intervention based on robust vocabulary instruction (RVI). Knowledge of the semantics of taught words was measured pre- and posttreatment. Participants then read 2 matched texts, 1 containing taught words (treated) and 1 not (untreated). Treated texts and taught word lists were counterbalanced across participants. The difference between text comprehension scores in treated and untreated conditions was taken as a measure of the effect of RVI on text comprehension. Results RVI resulted in significant gains in knowledge of taught words ( d RM = 2.26) and text comprehension ( d RM = 0.31). The extent of gains in vocabulary knowledge after vocabulary treatment did not predict the effect of RVI on comprehension of texts. However, untreated reading comprehension scores moderated the effect of the vocabulary treatment on text comprehension: Lower reading comprehension was associated with greater gains in text comprehension. Readers with comprehension scores below the mean experienced large gains in comprehension, but those with average/above average reading comprehension scores did not. Conclusion Vocabulary instruction had a larger effect on text comprehension for readers in Grade 6 who had lower untreated reading comprehension scores. In contrast, the amount that children learned about taught vocabulary did not predict the effect of vocabulary instruction on text comprehension. This has implications for the identification of 6th-grade students who would benefit from classroom instruction or clinical intervention targeting vocabulary knowledge.

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