A framework to increase prescription capture from health-system clinics

2020 ◽  
Vol 77 (8) ◽  
pp. 658-662
Author(s):  
Eric Chmielewski ◽  
Joseph L Cesarz
Keyword(s):  
Health System ◽  
Process Improvement ◽  
Capture Rate ◽  
Pharmacy Services ◽  
Medical Assistant ◽  
Design Strategies ◽  
Percentage Points ◽  
Key Drivers ◽  
Interdisciplinary Process ◽  
Improvement Effort

Abstract Purpose To develop and implement an interprofessional framework to increase the capture of health system–generated prescriptions within health system–owned pharmacies. Summary Low prescription capture rates within a health system’s internal pharmacies led to an interdisciplinary process improvement effort. A framework was developed to assess the baseline prescription capture rate, select clinics for improvement, understand clinic workflows and key drivers of pharmacy selection, design strategies to increase prescription capture, implement targeted efforts, and measure the effectiveness of the intervention(s). Employing this framework provided revised workflows for nursing and medical assistant staff scripting and for referral of patients to internal pharmacies. These workflows were pilot tested at 3 system clinics. Results indicated that overall prescription capture increased by 2.9 to 4.1 percentage points (range, 10 to 86 prescriptions per month) and specialty prescription capture increased by 11.6 to 26.7 percentage points (range, 4 to 26 prescriptions per month) for each clinic within the first 2 months. A total of 99 new patients were referred to internal pharmacies within the first month. Conclusion Development and implementation of a framework to increase prescription capture from health system clinics helped increase capture, enhanced clinic engagement and knowledge about pharmacy services, and supported positive clinic-pharmacy relationships.

Pharmacy workload benchmarking: Establishing a health-system outpatient infusion productivity metric

2017 ◽  
Vol 25 (1) ◽  
pp. 172-178
Author(s):  
Jeffrey S Reichard ◽  
David M Garbarz ◽  
Amanda L Teachey ◽  
Jonathan Allgood ◽  
M Jay Brown
Keyword(s):  
Health System ◽  
Clinical Review ◽  
Medical Record ◽  
Pharmacy Services ◽  
Current Procedural Terminology ◽  
Batch Preparation ◽  
Key Drivers ◽  
Clinical Workload ◽  
Productivity Assessment

Background and objectives Current productivity assessment models lack the ability to measure the quality of pharmacy services through workload validation. The goal of our efforts was to create a model to more accurately assess workload at multiple outpatient infusion centers. Method Current procedural terminology codes were identified as representative of the key drivers of pharmacy workload. Fourteen current procedural terminology codes representing medication orders were selected and categorized into eight distinctive groups associated with varying amounts of pharmacy workload. A three-month average of current procedural terminology volumes were calculated and used to create a workload baseline. Results Our study found a usable productivity assessment and coefficient to compare relevant clinical workload across outpatient oncology sites. The current procedural terminology codes were readily retrievable from our system electronic medical record. By assigning activities, e.g. clinical review, verification, barcoding, batch preparation, we were able to compute a workload and then adjust staffing to achieve a median coefficient across sites. Discussion This study evaluated the use of administration current procedural terminology codes for an outpatient oncology productivity model. Based upon our analysis, it can be successfully used to determine workload for pharmacists and technicians across variable locations. We believe it is the first study to demonstrate a productivity model for this setting.

scholarly journals Responding to unforeseen disasters in a large health system

2020 ◽  
Author(s):  
Ryan J Hannan ◽  
Margaret K Lundholm ◽  
Dennis Brierton ◽  
Noelle R M Chapman
Keyword(s):  
Supply Chain ◽  
Health System ◽  
Disaster Response ◽  
Well Being ◽  
Lessons Learned ◽  
Strategic Decision ◽  
Pharmacy Services ◽  
Efficient System ◽  
Team Members

Abstract Purpose To describe how health systems may respond to sudden changes in operations by leveraging existing resources and to share one organization’s experience responding to the coronavirus disease (COVID-19) pandemic. Summary In a health system based in Illinois and Wisconsin, pharmacy services are provided by a single, integrated department responsible for all aspects of pharmaceutical care within the organization. Hospital, retail, ambulatory care, and population health services are all managed under one leadership team. All pertinent ancillary services are also managed within the department, including informatics, supply chain, and drug policy. During the COVID-19 pandemic, the pharmacy services leadership has successfully managed volume and capacity challenges by redirecting resources to where they are needed. A disaster response framework based on Federal Emergency Management Agency guidance was put in place, and change management principles were used to rapidly operationalize change. Components of the nimble response have included quickly increasing capacity, thoughtful and timely communication to all team members, strategic decision making with available data, creating an agile pool of labor, and maintaining an efficient system supply chain. Well-being and resilience are emphasized alongside reflection on lessons learned. Some changes made in the urgent response to the pandemic are being considered for long-term implementation. Conclusion Organizations have the potential to respond to almost any situation if they are integrated and teams work together to build flexibility. The keys to success are thoughtful maximization of existing resources and strong communication.

Design strategies for oxy-combustion power plant captured CO2 purification

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Ikenna J. Okeke ◽  
Tia Ghantous ◽  
Thomas A. Adams
Keyword(s):  
Power Plant ◽  
Flue Gas ◽  
Capture Rate ◽  
Ghg Emissions ◽  
Oxygen Removal ◽  
Water Removal ◽  
Design Strategies ◽  
Technoeconomic Analysis ◽  
Trade Offs ◽  
End Use

Abstract This study presents a novel design and techno-economic analysis of processes for the purification of captured CO2 from the flue gas of an oxy-combustion power plant fueled by petroleum coke. Four candidate process designs were analyzed in terms of GHG emissions, thermal efficiency, pipeline CO2 purity, CO2 capture rate, levelized costs of electricity, and cost of CO2 avoided. The candidates were a classic process with flue-gas water removal via condensation, flue-gas water removal via condensation followed by flue-gas oxygen removal through cryogenic distillation, flue-gas water removal followed by catalytic conversion of oxygen in the flue gas to water via reaction with hydrogen, and oxy-combustion in a slightly oxygen-deprived environment with flue-gas water removal and no need for flue gas oxygen removal. The former two were studied in prior works and the latter two concepts are new to this work. The eco-technoeconomic analysis results indicated trade-offs between the four options in terms of cost, efficiency, lifecycle greenhouse gas emissions, costs of CO2 avoided, technical readiness, and captured CO2 quality. The slightly oxygen-deprived process has the lowest costs of CO2 avoided, but requires tolerance of a small amount of H2, CO, and light hydrocarbons in the captured CO2 which may or may not be feasible depending on the CO2 end use. If infeasible, the catalytic de-oxygenation process is the next best choice. Overall, this work is the first study to perform eco-technoeconomic analyses of different techniques for O2 removal from CO2 captured from an oxy-combustion power plant.

scholarly journals Integration of an Academic Medical Center and a Large Health System: Implications for Pharmacy

2019 ◽  
Vol 54 (3) ◽  
pp. 170-174
Author(s):  
Brian L. Erstad ◽  
Tina Aramaki ◽  
Kurt Weibel
Keyword(s):  
Health System ◽  
Health Systems ◽  
Integration Method ◽  
Medical Center ◽  
Academic Medical Center ◽  
Lessons Learned ◽  
Faculty Members ◽  
Pharmacy Services ◽  
Academic Medical ◽  
High Level

Objective: To provide lessons learned for colleges of pharmacy and large health systems that are contemplating or in the process of undergoing integration. Method: This report describes the merger of an academic medical center and large health system with a focus on the implications of the merger for pharmacy from the perspectives of both a college of pharmacy and a health system’s pharmacy services. Results: Overarching pharmacy issues to consider include having an administrator from the college of pharmacy directly involved in the merger negotiation discussions, having at least one high-level administrator from the college of pharmacy and one high-level pharmacy administrator from the health system involved in ongoing discussions about implications of the merger and changes that are likely to affect teaching, research, and clinical service activities, having focused discussions between college and health system pharmacy administrators on the implications of the merger on experiential and research-related activities, and anticipating concerns by clinical faculty members affected by the merger. Conclusion: The integration of a college of pharmacy and a large health system during the acquisition of an academic medical center can be challenging for both organizations, but appropriate pre- and post-merger discussions between college and health system pharmacy administrators that include a strategic planning component can assuage concerns and problems that are likely to arise, increasing the likelihood of a mutually beneficial collaboration.

Expanding pharmacy services in a health system through partnership with a college of pharmacy

2007 ◽  
Vol 64 (9) ◽  
pp. 925-926 ◽  
Author(s):  
Patrick Skeffington ◽  
Monica Akus ◽  
Jessica Goren
Keyword(s):  
Health System ◽  
Pharmacy Services

scholarly journals Nontraditional Career Opportunities for Pharmacists

2016 ◽  
Vol 51 (11) ◽  
pp. 944-949 ◽  
Author(s):  
Sandra Bai ◽  
John B. Hertig ◽  
Robert J. Weber
Keyword(s):  
Health Care ◽  
Health System ◽  
Scope Of Practice ◽  
Pharmacy Services ◽  
Patient Centered ◽  
High Performing ◽  
Nontraditional Career ◽  
Career Opportunities ◽  
Career Options ◽  
Pharmacy Leaders

The changing landscape of health care mirrors that of health-system pharmacy, with pharmacists' scope of practice and provider status being the most significant changes. This creates new roles and opportunities; many of these roles are considered to be nontraditional in today's practice. This article reviews some new roles for pharmacy leaders that provide different career options and pathways. Nontraditional career opportunities discussed include expanded consulting roles in pricing analytics and drug pricing programs (contracting, 340B programs), pharmacogenomics patient consult services and clinics, specialty drug pharmacies, and compounding pharmacy services. To continue to develop high-performing pharmacy departments, pharmacy directors should recognize these roles and ensure they are clearly defined and managed. With the advent of these nontraditional opportunities, pharmacy departments can further expand their ability to provide advanced patient-centered pharmacy services.

scholarly journals Real-World Integration of a Sepsis Deep Learning Technology Into Routine Clinical Care: Implementation Study

10.2196/15182 ◽  
2020 ◽  
Vol 8 (7) ◽  
pp. e15182 ◽  
Author(s):  
Mark P Sendak ◽  
William Ratliff ◽  
Dina Sarro ◽  
Elizabeth Alderton ◽  
Joseph Futoma ◽  
...  
Keyword(s):  
Machine Learning ◽  
Quality Improvement ◽  
Deep Learning ◽  
Health System ◽  
Clinical Decision Making ◽  
Clinical Care ◽  
Quality Improvement Effort ◽  
Management Platform ◽  
Routine Clinical Care ◽  
Improvement Effort

Background Successful integrations of machine learning into routine clinical care are exceedingly rare, and barriers to its adoption are poorly characterized in the literature. Objective This study aims to report a quality improvement effort to integrate a deep learning sepsis detection and management platform, Sepsis Watch, into routine clinical care. Methods In 2016, a multidisciplinary team consisting of statisticians, data scientists, data engineers, and clinicians was assembled by the leadership of an academic health system to radically improve the detection and treatment of sepsis. This report of the quality improvement effort follows the learning health system framework to describe the problem assessment, design, development, implementation, and evaluation plan of Sepsis Watch. Results Sepsis Watch was successfully integrated into routine clinical care and reshaped how local machine learning projects are executed. Frontline clinical staff were highly engaged in the design and development of the workflow, machine learning model, and application. Novel machine learning methods were developed to detect sepsis early, and implementation of the model required robust infrastructure. Significant investment was required to align stakeholders, develop trusting relationships, define roles and responsibilities, and to train frontline staff, leading to the establishment of 3 partnerships with internal and external research groups to evaluate Sepsis Watch. Conclusions Machine learning models are commonly developed to enhance clinical decision making, but successful integrations of machine learning into routine clinical care are rare. Although there is no playbook for integrating deep learning into clinical care, learnings from the Sepsis Watch integration can inform efforts to develop machine learning technologies at other health care delivery systems.

scholarly journals Specialty Pharmacy Services: Preparing for a New Era in Health-System Pharmacy

2015 ◽  
Vol 50 (9) ◽  
pp. 834-839 ◽  
Author(s):  
Blake Shay ◽  
Les Louden ◽  
Bonnie Kirschenbaum
Keyword(s):  
Health System ◽  
Pharmacy Services ◽  
New Era ◽  
Specialty Pharmacy

PP22 How Do Health System Leaders Use Evidence To Inform Action?

2018 ◽  
Vol 34 (S1) ◽  
pp. 74-75
Author(s):  
Matthew D Mitchell ◽  
C Michael White ◽  
Jeanne-Marie Guise ◽  
Lionel Bañez ◽  
Craig Umscheid ◽  
...  
Keyword(s):  
Health System ◽  
Health Systems ◽  
Process Improvement ◽  
Systematic Reviews ◽  
Predictive Analytics ◽  
Structured Interview ◽  
Healthcare Research ◽  
System Quality ◽  
Study Results ◽  
System Leaders

Introduction:The US Agency for Healthcare Research and Quality (AHRQ) Evidence-based Practice Center (EPC) program sponsors the development of systematic reviews to inform clinical policy and practice. The EPC program sought to better understand how health systems identify and use this evidence.Methods:Representatives from eleven EPCs, the EPC Scientific Resource Center, and AHRQ developed a semi-structured interview script to query a diverse group of nine Key Informants (KIs) involved in health system quality, safety and process improvement about how they identify and use evidence. Interviews were transcribed and qualitatively summarized into key themes.Results:All KIs reported that their organizations have either centralized quality, safety, and process improvement functions within their system, or they have partnerships with other organizations to conduct this work. There was variation in how evidence was identified, with larger health systems having medical librarians and central bureaus to gather and disseminate information and smaller systems having local chief medical officers or individual clinicians do this work. KIs generally prefer guidelines, especially those with treatment algorithms, because they are actionable. They like systematic reviews because they efficiently condense study results and reconcile conflicting data. They prefer information from systematic reviews to be presented as short digestible summaries with the full report available on demand. KIs preferred systematic reviews from reputable entities and those without commercial bias. Some of the challenges KIs reported include how to resolve conflicting evidence, the generalizability of evidence to local needs, determining whether the evidence is up-to-date, and the length of time required to generate reviews. The topics of greatest interest included predictive analytics, high-value care, advance care planning, and care coordination. To increase awareness of AHRQ EPC reviews, KIs suggest alerting people at multiple levels in a health-system when new evidence reports are available and making reports easier to find in common search engines.Conclusions:Systematic reviews are valued by health system leaders. To be most useful they should be easy to locate and available in different formats targeted to the needs of different audiences.

Sign in / Sign up

Export Citation Format

Share Document