scholarly journals Optimization of REMS Program Compliance in a Large Academic Health System

2021 ◽  
Vol 12 (2) ◽  
pp. 18
Author(s):  
Audrey B Kostrzewa
Keyword(s):  
Health System ◽  
Health Systems ◽  
Risk Evaluation ◽  
Medication Use ◽  
Lessons Learned ◽  
Mitigation Strategies ◽  
Program Optimization ◽  
Academic Health ◽  
The Past ◽  
Program Compliance

Ensuring compliance with all applicable Risk Evaluation and Mitigation Strategies (REMS) programs within a health system is challenging. These FDA-mandated programs are numerous, unique, and ever-changing. Actions require several stakeholders and moving parts. In addition, the effectiveness and impact of these programs has been challenged and is not always clear, which hampers buy-in and therefore compliance. F&MCW is a health network in southeastern Wisconsin that includes five hospitals and almost 40 clinics. Since 2014, several system-wide approaches to medication use, including formulary alignment and REMS program optimization, have taken place with an over-arching goal of providing efficient, safe, and consistent care for the patients and populations served. This manuscript describes the steps that took place over the past six years or so related to REMS program optimization. It also offers practical tips for other health systems based on lessons learned through this one institution’s experiences.

scholarly journals 22.F. Workshop: What makes for resilient health systems? Evidence from the State of Health in the EU country profiles

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Health System ◽  
Health Systems ◽  
Building Blocks ◽  
The State ◽  
Lessons Learned ◽  
Three Dimensions ◽  
Health System Strengthening ◽  
New Work ◽  
State Of Health ◽  
The Eu

Abstract The European Commission's State of Health in the EU (SoHEU) initiative aims to provide factual, comparative data and insights into health and health systems in EU countries. The resulting Country Health Profiles, published every two years (current editions: November 2019) are the joint work of the European Observatory on Health Systems and Policies and the OECD, in cooperation with the European Commission. They are designed to support the efforts of Member States in their evidence-based policy making and to contribute to health care systems' strengthening. In addition to short syntheses of population health status, determinants of health and the organisation of the health system, the Country Profiles provide an assessment of the health system, looking at its effectiveness, accessibility and resilience. The idea of resilient health systems has been gaining traction among policy makers. The framework developed for the Country Profiles template sets out three dimensions and associated policy strategies and indicators as building blocks for assessing resilience. The framework adopts a broader definition of resilience, covering the ability to respond to extreme shocks as well as measures to address more predictable and chronic health system strains, such as population ageing or multimorbidity. However, the current framework predates the onset of the novel coronavirus pandemic as well as new work on resilience being done by the SoHEU project partners. This workshop aims to present resilience-enhancing strategies and challenges to a wide audience and to explore how using the evidence from the Country Profiles can contribute to strengthening health systems and improving their performance. A brief introduction on the SoHEU initiative will be followed by the main presentation on the analytical framework on resilience used for the Country Profiles. Along with country examples, we will present the wider results of an audit of the most common health system resilience strategies and challenges emerging from the 30 Country Profiles in 2019. A roundtable discussion will follow, incorporating audience contributions online. The Panel will discuss the results on resilience actions from the 2019 Country Profiles evidence, including: Why is resilience important as a practical objective and how is it related to health system strengthening and performance? How can countries use their resilience-related findings to steer national reform efforts? In addition, panellists will outline how lessons learned from country responses to the Covid-19 pandemic and new work on resilience by the Observatory (resilience policy briefs), OECD (2020 Health at a Glance) and the EC (Expert Group on Health Systems Performance Assessment (HSPA) Report on Resilience) can feed in and improve the resilience framework that will be used in the 2021 Country Profiles. Key messages Knowing what makes health systems resilient can improve their performance and ability to meet the current and future needs of their populations. The State of Health in the EU country profiles generate EU-wide evidence on the common resilience challenges facing countries’ health systems and the strategies being employed to address them.

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.

scholarly journals Early prescribing outcomes after exporting the EQUIPPED medication safety improvement programme

2021 ◽  
Vol 10 (4) ◽  
pp. e001369
Author(s):  
Camille P Vaughan ◽  
Ula Hwang ◽  
Ann E Vandenberg ◽  
Traci Leong ◽  
Daniel Wu ◽  
...  
Keyword(s):  
Older Adults ◽  
Health System ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Health Systems ◽  
Medication Safety ◽  
Potentially Inappropriate Medications ◽  
Health Administration ◽  
Academic Health ◽  
The Impact

Enhancing quality of prescribing practices for older adults discharged from the Emergency Department (EQUIPPED) aims to reduce the monthly proportion of potentially inappropriate medications (PIMs) prescribed to older adults discharged from the ED to 5% or less. We describe prescribing outcomes at three academic health systems adapting and sequentially implementing the EQUIPPED medication safety programme.EQUIPPED was adapted from a model developed in the Veterans Health Administration (VA) and sequentially implemented in one academic health system per year over a 3-year period. The monthly proportion of PIMs, as defined by the 2015 American Geriatrics Beers Criteria, of all medications prescribed to adults aged 65 years and older at discharge was assessed for 6 months preimplementation until 12 months postimplementation using a generalised linear time series model with a Poisson distribution.The EQUIPPED programme was translated from the VA health system and its electronic medical record into three health systems each using a version of the Epic electronic medical record. Adaptation occurred through local modification of order sets and in the generation and delivery of provider prescribing reports by local champions. Baseline monthly PIM proportions 6 months prior to implementation at the three sites were 5.6% (95% CI 5.0% to 6.3%), 5.8% (95% CI 5.0% to 6.6%) and 7.3% (95% CI 6.4% to 9.2%), respectively. Evaluation of monthly prescribing including the twelve months post-EQUIPPED implementation demonstrated significant reduction in PIMs at one of the three sites. In exploratory analyses, the proportion of benzodiazepine prescriptions decreased across all sites from approximately 17% of PIMs at baseline to 9.5%–12% postimplementation, although not all reached statistical significance.EQUIPPED is feasible to implement outside the VA system. While the impact of the EQUIPPED model may vary across different health systems, results from this initial translation suggest significant reduction in specific high-risk drug classes may be an appropriate target for improvement at sites with relatively low baseline PIM prescribing rates.

scholarly journals Resilience to dealing with COVID-19: university perspective in a low-income health Brazilian region

2021 ◽  
Vol 29 (111) ◽  
pp. 525-542
Author(s):  
Bruno Bastos Godoi ◽  
Delba Fonseca Santos
Keyword(s):  
Health System ◽  
Health Systems ◽  
Low Income ◽  
Universal Access ◽  
Lessons Learned ◽  
World Health ◽  
The People ◽  
Innovative Products ◽  
Quality Health ◽  
Health Organization

Abstract The COVID-19 pandemic draws into focus the need to rebuild resilient health systems with increased access to quality health services. Reaction ability to changing demand is crucial. Resilience is relevant because all countries have vulnerable communities. One could push the argument further, using as an example the resilience particularly present on the agenda of meetings of the World Health Organization. More critical than ever, it is to take stock of the lessons learned. The stakeholders need to work together to accelerate progress towards universal access to essential health information through resilience. Regarding major societal challenges, which have a local dimension, universities have a key role to play in the knowledge creation of innovative products and services. The need for timely, accurate, and reliable data about the Vale do Jequitinhonha in the health system is unarguably overdue for a real-time, technology-driven, surveillance and reporting infrastructure to respond effectively to public health emergencies. Health system resilience is one of the focuses in low-income region framework and it is an indispensable university strategy for managing the health risks of older adults, and chronic disease patients. COVID-19 can cause disruption in health systems. Disruptions to health service infrastructure can result in loss of life, negative economic impact, and harm to communities. Focused actions include investing in Primary Health Care (PHC) and this encompasses basic preventive, promotive, and curative health cares for enhancing the health status of the people by reducing morbidity and mortality rates. Given the key role of such information for health, the university located in a low-income health region has a fundamental role. The reflections and shreds of evidence showed during this essay can serve as a framework for health policies in post-pandemic reality and university acting in the population.

scholarly journals GWEP Successes and Lessons Learned From Making Communities Age Friendly

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 496-496
Author(s):  
Katherine Thompson ◽  
Jennifer Ouellet
Keyword(s):  
Older Adults ◽  
Health System ◽  
Health Systems ◽  
Clinical Decision Making ◽  
Health Resources ◽  
Clinical Decision ◽  
Lessons Learned ◽  
Community Based ◽  
Wide Range ◽  
What Matters

Abstract Geriatrics Workforce Enhancement Programs (GWEPs), funded by the Health Resources and Services Administration have a strong focus on age friendly care and community engagement. With a wide range of populations, locales, and health systems served, GWEPs have significant experience working with a wide variety of communities to implement age friendly care. In this symposium, we present successes and lessons learned from GWEP projects representing diverse populations and approaches to achieving age friendly communities. For instance, one GWEP is utilizing Patient Priorities Care to lay the framework for What Matters in clinical decision-making. Another GWEP is focusing on What Matters by uniquely embedding Area Agencies on Aging care coordinators within primary care settings to invite the participation of aging patients in advance care planning, among other health interventions. A third GWEP is using the 4Ms to educate patients and caregivers in geriatric psychiatry clinics in a population of veterans. Another GWEP is pairing Age Friendly Health System efforts within a health system with community-based efforts to become an age friendly and dementia friendly city. A final GWEP is using multiple educational modalities to create Age-Friendly Communities and assure that health systems, community-based organizations, and older adults and families are educated about the 4Ms. By exploring successes and lessons learned in making communities age friendly, we can improve existing and future programs centered on age friendly care for older adults.

scholarly journals Accelerating implementation of research in Learning Health Systems: Lessons learned from VA Health Services Research and NCATS Clinical Science Translation Award programs

2020 ◽  
Vol 4 (3) ◽  
pp. 195-200
Author(s):  
Amy M. Kilbourne ◽  
Patricia L. Jones ◽  
David Atkins
Keyword(s):  
Health Services Research ◽  
Health Services ◽  
Health System ◽  
Health Systems ◽  
Real World ◽  
Veterans Affairs ◽  
Lessons Learned ◽  
Services Research ◽  
Community Based Research ◽  
Learning Health System

AbstractTranslation of research to practice is challenging. In addition to the scientific challenges, there are additional hurdles in navigating the rapidly changing US health care system. There is a need for innovative health interventions that can be adopted in “real-world” settings. Barriers to translation involve misaligned timing of research funding and health system decision-making, lack of research questions aligned with health system and community priorities, and limited incentives in academia for health system and community-based research. We describe new programs from the US Department of Veterans Affairs Health Services Research and Development (HSR&D) and the National Center for Advancing Translational Sciences (NCATS) Clinical and Translational Science Award (CTSA) Programs that are building capacity for Learning Health System research. These programs help to incentivize adopting and adapting Learning Health System principles to ensure that, primarily in implementation science within academic/veterans affairs health systems, there is alignment of the research with the health system and community needs. Both HSR&D and NCATS CTSA Program encourage researchers to develop problem-focused research innovations in partnership with health systems and communities to ultimately facilitate design treatments that are feasible in “real-world” practice.

scholarly journals The Privatization of the Italian National Health System and its Impact on Health Emergency Preparedness and Response: The COVID-19 Case

2021 ◽  
pp. 002073142110249
Author(s):  
Maria Luisa Buzelli ◽  
Tammy Boyce
Keyword(s):  
Health System ◽  
Health Systems ◽  
National Health ◽  
Emergency Preparedness ◽  
Critical Role ◽  
Health Sector ◽  
National Health System ◽  
Lessons Learned ◽  
Future Health ◽  
The Public

Hospitals play a critical role in providing essential care during emergencies; however, this essential care can overwhelm the functional capacity of health systems. In Italy, substantial cuts in funding have drastically reduced the resources of the National Health Service (NHS) and contributed to the expansion of the private health sector which, unlike the public health system, does not have the capacity to deal with a health emergency such as coronavirus disease 2019 (COVID-19). The purpose of this article is to show how the privatization of the NHS contributed to making Italy more vulnerable and unprepared to tackle the COVID-19 pandemic. The available capacity and resources in the public and private emergency services systems in Italy are compared, including a focus on the numbers of hospital staff, hospitals, and hospital beds. The reduced funding and subsequent shortfalls in services in the NHS are reasons why extreme measures were needed to increase these resources during the COVID-19 pandemic. A public NHS in Italy would be better prepared for future health emergencies. The lessons learned from the COVID-19 pandemic can help to inform future health systems strategies, to halt the current financial decline and performance loss of national health systems, and to enable better preparation for future health emergencies.

scholarly journals Building Individual and Institutional Capacity of an Urban Academic Health System to Serve Local Sex Trafficking Victims

JCSCORE ◽  
2019 ◽  
Vol 3 (2) ◽  
pp. 62-96
Author(s):  
John Murray-Garcia ◽  
Kupiri W. Ackerman-Barger ◽  
Ellen Goldstein ◽  
Jerry John Nutor
Keyword(s):  
Health System ◽  
Health Systems ◽  
Health Care Providers ◽  
Sex Trafficking ◽  
The United States ◽  
Institutional Capacity ◽  
Care Providers ◽  
Academic Health ◽  
Hidden Population ◽  
Public Health Training

Every day, there are unrecognized sex trafficked victims visiting urban academic health systems in the United State, victims who are perhaps hoping against hope that a frontline provider, student, or staff member would ask that one question that would identify them as enslaved or otherwise trapped in an unthinkable situation. Health care providers’ lack of awareness of the relatively hidden population of sex trafficked victims causes missed opportunities to improve public health. Training healthcare providers to recognize and serve sex trafficked victims is critical, but such training will likely be less effective without addressing the institutional capacity of urban academic health systems. Indeed, local sex trafficking industries can thrive in the shadow of urban health systems, many associated with world class universities. This exploratory study aimed to assess and enhance the institutional capacity of an urban academic health system in the United States, and that of its employees, to appropriately serve victims of sex trafficking.

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