Gap analysis of emergency department pharmacy services within a multistate, multihospital integrated health system

2021 ◽  
Author(s):  
Riley C J Poe ◽  
Garrett W Fouth ◽  
Ellen N Revak
Keyword(s):  
Emergency Department ◽  
Best Practices ◽  
Health System ◽  
Gap Analysis ◽  
Professional Organizations ◽  
Pharmacy Services ◽  
Gap Closure ◽  
Survey Results ◽  
American Society ◽  
Pharmacy Leaders

Abstract Purpose The purpose of this project was to identify current emergency medicine pharmacist (EMP) practices at each site and create a plan to integrate, align, and optimize pharmacy services across the health system with established American Society of Health-System Pharmacists (ASHP) best practices for EMPs. Summary Initially, a review was performed of the literature and guidelines from professional organizations relating to EMPs. A survey was distributed across the health system to assess EMP services at each site, and survey results were used to conduct a gap analysis, comparing current practices to established ASHP best practices. The survey identified unique components of each site, including the patient population served and EMP coverage and responsibilities. To prioritize, design, and execute the gap closure plan, a systemwide EMP workgroup was created. The workgroup formulated a toolkit to provide pharmacy leaders, pharmacy informatics, and EMPs resources to facilitate alignment on the prioritized areas. Conclusion This project successfully identified gaps in EMP services and alignment with best practices across the health system. Through prioritization of essential EMP responsibilities, workflow standardization, and EHR optimization, a gap closure plan was formulated to align with ASHP best practices.

scholarly journals Improving pediatric pharmacy services in a primarily adult emergency department

2021 ◽  
Author(s):  
Souheila N Hachem ◽  
Julie M Thomson ◽  
Melissa K Heigham ◽  
Nancy C MacDonald
Keyword(s):  
Emergency Department ◽  
Quality Improvement ◽  
Quality Improvement Initiative ◽  
Pharmacy Services ◽  
Compliance Assessment ◽  
Practice Elements ◽  
Full Compliance ◽  
Institutional Review ◽  
Improve Compliance ◽  
American Society

Abstract Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose The American Society of Health-System Pharmacists (ASHP) and Pediatric Pharmacy Advocacy Group (PPAG) guidelines for providing pediatric pharmacy services in hospitals and health systems can be used to improve medication safety wherever pediatric patients receive care, including in the emergency department (ED). The purpose of this initiative was to improve compliance with these guidelines in a primarily adult ED. Methods This quality improvement initiative was conducted in a level 1 trauma center ED between October 2019 and March 2020. The ASHP-PPAG guidelines were used to create practice elements applicable to the ED. An initial compliance assessment defined elements as noncompliant, partially compliant, fully compliant, or not applicable. Investigators identified interventions to improve compliance for noncompliant or partially compliant elements and then reassessed compliance following implementation. Data were expressed using descriptive statistics. This initiative was exempt from institutional review board approval. Results Ninety-three ED practice elements were identified within the 9 standards of the ASHP-PPAG guidelines. At the initial compliance assessment, the majority (59.8%) of practice elements were fully compliant; however, various service gaps were identified in 8 of the standards, and 16 interventions were implemented to improve compliance. At the final compliance assessment, there was a 19.5% increase in full compliance. Barriers to achieving full compliance included technology restrictions, time constraints, financial limitations, and influences external to pharmacy. Conclusion This quality improvement initiative demonstrated that the ASHP-PPAG guidelines can be used to improve ED pediatric pharmacy services in a primarily adult institution. The initiative may serve as an example for other hospitals to improve compliance with the guidelines.

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.

A state affiliate’s utilization of ASHP’s Practice Advancement Initiative 2030 to identify current state of practice and a process to prioritize goal achievement

2021 ◽  
Author(s):  
Tyler A Vest ◽  
Lorna F Doucette ◽  
Stephen F Eckel
Keyword(s):  
North Carolina ◽  
Health System ◽  
Pharmacy Practice ◽  
Self Assessment ◽  
The North ◽  
Current State ◽  
Innovative Program ◽  
State Affiliate ◽  
American Society ◽  
Pharmacy Leaders

Abstract Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose The American Society of Health-System Pharmacists (ASHP) has been a long-standing supporter of advancing pharmacy practice, specifically in the area of pharmacy practice models. In 2019, ASHP began the planning to launch PAI (Practice Advancement Initiative) 2030. PAI 2030 describes and details a bold vision for patient care, medication use, and pharmacy practice over the next decade. This work represents an ambitious goal to continue to advance the profession of pharmacy for the betterment of our patients. While much has been accomplished with the PAI, there is little literature on PAI 2030 (the authors are unaware of any published examples). Summary The purpose of the article is to explain a novel state affiliate’s prioritization of ASHP’s PAI 2030 recommendations. In the spring of 2020, the North Carolina Association of Pharmacists (NCAP), the North Carolina state affiliate of ASHP, began discussions around PAI 2030. In the fall of 2020, prior to the NCAP Annual Convention, health-system pharmacy leaders within NCAP developed a questionnaire to serve as a PAI 2030 self-assessment. This approach allowed a state affiliate to implement an innovative program to act on the recommendations from PAI 2030. After the prioritization, health-system pharmacy leaders engaged in discussion to comment on what recommendations have been identified. The goal of this discussion was to provide NCAP a direction to pursue focused efforts to support recommendations of PAI 2030. Ultimately, NCAP seeks that this statewide approach would help advance pharmacy practice, and improve pharmacy practice across the state of North Carolina in collaboration with NCAP. Conclusion This discussion illustrates how a state affiliate has pursued implementing PAI 2030. This approach provides a strategy for state affiliates in addressing the recommendations within PAI 2030. A novel statewide approach can help marshal resources to advance practice when health systems partner with a state affiliate.

scholarly journals Best Practices for Reducing Unplanned Acute Care for Patients With Cancer

2018 ◽  
Vol 14 (5) ◽  
pp. 306-313 ◽  
Author(s):  
Nathan R. Handley ◽  
Lynn M. Schuchter ◽  
Justin E. Bekelman
Keyword(s):  
Emergency Department ◽  
Best Practices ◽  
Acute Care ◽  
Clinical Pathways ◽  
Optimal Strategies ◽  
Emergency Department Visits ◽  
Professional Organizations ◽  
Early Palliative Care ◽  
Patients With Cancer ◽  
Unplanned Admissions

Variation and cost in oncology care represent a large and growing burden for the US health care system, and acute hospital care is one of the single largest drivers. Reduction of unplanned acute care is a major priority for clinical transformation in oncology; proposed changes to Medicare reimbursement for patients with cancer who suffer unplanned admissions while receiving chemotherapy heighten the need. We conducted a review of best practices to reduce unplanned acute care for patients with cancer. We searched PubMed for articles published between 2000 and 2017 and reviewed guidelines published by professional organizations. We identified five strategies to reduce unplanned acute care for patients with cancer: (1) identify patients at high risk for unplanned acute care; (2) enhance access and care coordination; (3) standardize clinical pathways for symptom management; (4) develop new loci for urgent cancer care; and (5) use early palliative care. We assessed each strategy on the basis of specific outcomes: reduction in emergency department visits, reduction in hospitalizations, and reduction in rehospitalizations within 30 days. For each, we define gaps in knowledge and identify areas for future effort. These five strategies can be implemented separately or, with possibly more success, as an integrated program to reduce unplanned acute care for patients with cancer. Because of the large investment required and the limited data on effectiveness, there should be further research and evaluation to identify the optimal strategies to reduce emergency department visits, hospitalizations, and rehospitalizations. Proposed reimbursement changes amplify the need for cancer programs to focus on this issue.

scholarly journals Optimizing your undergraduate teaching as you would an experiment: developing the next generation of cell biologists

2019 ◽  
Vol 30 (19) ◽  
pp. 2439-2440
Author(s):  
Verónica A. Segarra ◽  
Melanie L. Styers ◽  
Erin L. Dolan
Keyword(s):  
Best Practices ◽  
Undergraduate Education ◽  
Cell Biology ◽  
Biology Education ◽  
Professional Organizations ◽  
Undergraduate Teaching ◽  
Underrepresented Minorities ◽  
Next Generation ◽  
American Society ◽  
Scientific Workforce

The American Society for Cell Biology (ASCB) is a community dedicated to helping prepare the next generation of scientists to advance our understanding of the cell to an unprecedented level of sophistication and detail. Its Education Committee fosters this process by creating educational and professional development opportunities around best practices in science pedagogy, while its Minorities Affairs Committee aims to strengthen the scientific workforce by broadening participation of and support for underrepresented minorities in cell biology. To act upon these complementary priorities, the ASCB has developed a Declaration on Effective and Inclusive Biology Education. Its purpose is to outline practical actions for stakeholders in undergraduate education at the levels of faculty, departments, institutions, professional organizations, and funding agencies. Its recommendations are rooted in evidence-based best practices to support the success of diverse and heterogeneous undergraduate demographics and are designed to be highly adaptable to the existing strengths and needs of individual practitioners, student populations, and institutions. We acknowledge the ever-evolving nature of best practices in undergraduate education and hope that the dissemination of this declaration will play a role in this iterative process.

Commentary on Chaplain-Physician Interactions From the Chaplain’s Perspective: A Mixed Method Analysis

2021 ◽  
pp. 104990912110030
Author(s):  
Rev George Handzo ◽  
Rev Brian Hughes
Keyword(s):  
Best Practices ◽  
Health System ◽  
Patient Care ◽  
Health Systems ◽  
Mixed Method ◽  
Effective Strategies ◽  
Optimal Patient Care ◽  
Relationship Of ◽  
The Relationship ◽  
Method Analysis

Gomez and her colleagues have presented a helpful study of the relationship of the chaplains in her health system to physicians which highlights several barriers to a well-integrated relationship and thus to more optimal patient care. We have seen these same barriers as we have consulted with health systems nationally and have also identified many best practices that mediate or even eliminate many of these barriers. This commentary describes some of what we have seen as chaplain-generated causes of those barriers and effective strategies that have been employed to overcome them. We also provide some resources for chaplains who wish to institute some of these best practices themselves.

627 Strategies for Reducing Emergency Department Lengths of Stay for Admitted Pediatric Burn Patients

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S169-S169
Author(s):  
Lisa M Shostrand ◽  
Brett C Hartman ◽  
Belinda Frazee ◽  
Dawn Daniels ◽  
Madeline Zieger
Keyword(s):  
Emergency Department ◽  
Gap Analysis ◽  
Burn Patients ◽  
Improvement Project ◽  
Burn Trauma ◽  
Charge Nurse ◽  
Lengths Of Stay ◽  
Burn Unit ◽  
Set Up ◽  
Trauma Activation

Abstract Introduction Various strategies to reduce emergency department (ED) lengths of stay (LOS) for admitted pediatric burn patients may be employed as a quality improvement project. Decreasing ED LOS may promote patient outcomes and reduce morbidity. Initial discussions were brought forth during trauma and burn multidisciplinary peer review rounds in March 2019 and have persisted to present day. Methods Several strategies, such as preparation of the burn unit staff within one hour of patient arrival in ED, notification to the burn unit by the burn attending of an incoming pediatric burn patient, allowing the PICU charge nurses or advisors to assist with room set up and admissions, and creating a checklist to assist PICU nurses and advisors in helping prepare for anticipating inpatient admissions. These strategies were designed and enforced in March/April 2019. In addition to these action plans, trauma activation alerts were added in December 2019 to the burn charge nurse phone for pediatric burn trauma one and trauma alerts for more expedient notifications. Finally, communication efforts between ED and burn leadership teams were conducted in June 2020 to help with additional mitigating of ED LOS, such as discussing the appropriateness of specialty consults while in the ED. Results Initial ED LOS was reduced from 209 minutes in March 1019 to 150 minutes in June 2019. Increased trends were noted in early 2020, with a peak at 244 minutes in July 2020. Additional interventions, such as trauma activation alerts and ED/Burn team communications, did not provide sustainable long-term reductions. Conclusions Recent strategies to reduce overall ED LOS trends have been beneficial, but not consistent, in sustaining downward trends. Action to perform a gap analysis to discover persistent barriers and to introduce additional structure, such as a burn trauma one algorithm, may provide stability to this metric.

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