Showing posts with label Practice. Show all posts
Showing posts with label Practice. Show all posts

Development of an inpatient operational pharmacy productivity model Society Logo Skip to main page content

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Development of an inpatient operational pharmacy productivity model Ryan W. Naseman?, Ben R. Lopez, Ryan A. Forrey, Robert J. Weber and Kris M. Kipp
Ryan W. Naseman, Pharm.D., M.S., is Assistant Director of Pharmacy and Infusion; Ben R. Lopez, Pharm.D., M.S., M.H.A., is Assistant Director of Pharmacy and Infusion; and Ryan A. Forrey, Pharm.D., M.S., is Associate Director of Pharmacy and Infusion, The Ohio State University (OSU) James Cancer Center and Solove Research Institute, Columbus. Robert J. Weber, Pharm.D., M.S., is Administrator, Pharmacy Services, OSU Wexner Medical Center, and Assistant Dean, OSU College of Pharmacy, Columbus. Kris M. Kipp, M.S.N., is Executive Director, Patient Services, and Chief Nursing Officer, OSU James Cancer Hospital and Solove Research Institute. Address correspondence to Dr. Naseman (ryan.naseman{at}osumc.edu). Abstract Purpose An innovative model for measuring the operational productivity of medication order management in inpatient settings is described.

Methods Order verification within a computerized prescriber order-entry system was chosen as the pharmacy workload driver. To account for inherent variability in the tasks involved in processing different types of orders, pharmaceutical products were grouped by class, and each class was assigned a time standard, or “medication complexity weight” reflecting the intensity of pharmacist and technician activities (verification of drug indication, verification of appropriate dosing, adverse-event prevention and monitoring, medication preparation, product checking, product delivery, returns processing, nurse/provider education, and problem-order resolution). The resulting “weighted verifications” (WV) model allows productivity monitoring by job function (pharmacist versus technician) to guide hiring and staffing decisions. A 9-month historical sample of verified medication orders was analyzed using the WV model, and the calculations were compared with values derived from two established models—one based on the Case Mix Index (CMI) and the other based on the proprietary Pharmacy Intensity Score (PIS).

Results Evaluation of Pearson correlation coefficients indicated that values calculated using the WV model were highly correlated with those derived from the CMI-and PIS-based models (r = 0.845 and 0.886, respectively). Relative to the comparator models, the WV model offered the advantage of less period-to-period variability.

Conclusion The WV model yielded productivity data that correlated closely with values calculated using two validated workload management models. The model may be used as an alternative measure of pharmacy operational productivity.

Copyright ? 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved. Add to CiteULikeCiteULike Add to DeliciousDelicious Add to DiggDigg Add to FacebookFacebook Add to Google+Google+ Add to RedditReddit Add to TwitterTwitter What's this?

? Previous | Next Article ? Table of Contents This Article doi: 10.2146/ajhp130803 American Journal of Health-System Pharmacy February 1, 2015 vol. 72 no. 3 206-211 ? Abstract Full Text Full Text (PDF) Classifications Print Content Practice Report Services Email this article to a colleague Alert me when this article is cited Alert me if a correction is posted Alert me when eLetters are published Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Download to citation manager eLetters Submit an eLetter No eLetters published Citing Articles Load citing article information Google Scholar Articles by Naseman, R. W. Articles by Kipp, K. M. PubMed PubMed citation Articles by Naseman, R. W. Articles by Kipp, K. M. Related Content Load related web page information Social Bookmarking Add to CiteULikeCiteULike Add to DeliciousDelicious Add to DiggDigg Add to FacebookFacebook Add to Google+Google+ Add to RedditReddit Add to TwitterTwitter What's this?

Current Issue February 15, 2015, 72 (4) Current Issue Alert me to new issues of American Journal of Health-System Pharmacy From the Cover RhOD immune globulin products for prevention of alloimmunization during pregnancy Sublingual tacrolimus as an alternative to oral administration for solid organ transplant recipients Economic burden of recurrent venous thromboembolism: Analysis from a U.S. hospital perspective Comparative analytics of infusion pump data across multiple hospital systems ABOUT AJHP SUBSCRIPTIONS FOR AUTHORS/REVIEWERS PERMISSION REQUESTS ADVERTISING EMAIL ALERTS (FREE) Email Alerts (Free) RSS FEEDS (FREE) RSS Feeds (Free) HELP CONTACT US/FEEDBACK American Society of Health System Pharmacists Learning Center (CE) Store Meetings & Conferences ASHP Foundation MOST READ ARTICLES (Last 30 Days) Clinical practice guidelines for antimicrobial prophylaxis in surgery Therapeutic monitoring of vancomycin in adult patients: A consensus review of the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, and the Society of Infectious Diseases Pharmacists How to write a patient case report Treatment of poisoning caused by {beta}-adrenergic and calcium-channel blockers ? View all Most Read articles Advertisement ? 2015 by the American Society of Health-System Pharmacists. Terms of Use | Copyright Online ISSN: 1535-2900 Print ISSN: 1079-2082

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Building an outpatient cancer center pharmacy program across a tristate region Society Logo Skip to main page content

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Building an outpatient cancer center pharmacy program across a tristate region Susan J. Skledar?, Andrew Doedyns and Bryan Yourich
Susan J. Skledar, B.S., M.P.H., is Clinical Pharmacy Specialist, University of Pittsburgh Medical Center (UPMC), and Associate Professor, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA. Andrew Doedyns, B.S., M.B.A., is Pharmacy Manager, UPMC CancerCenter, Pittsburgh. Bryan Yourich, Pharm.D., is Regional Director of Pharmacy Operations, Department of Pharmacy, UPMC Shadyside, Pittsburgh. Address correspondence to Ms. Skledar (skledarsj{at}upmc.edu). Abstract Purpose The transition to a hybrid model of oncology pharmacy services including remote order verification across a regional network of cancer centers is described.

Summary Five years ago the University of Pittsburgh Medical Center (UPMC) began a major expansion of its cancer care services, gradually integrating 19 community-based physician practice sites into its tristate oncology network as affiliated hospital-based clinics (HBCs). The network expansion was achieved through a stepwise process including (1) development of oncology medication protocols, (2) interdisciplinary efforts to modify oncology care workflows, (3) implementation of a hybrid practice model to optimize the use of clinical pharmacy resources, and (4) focused staff training programs. Under the hybrid practice model, first checks of antineoplastic medication orders, premedication orders, and laboratory values are performed by either onsite or remote pharmacists, with all second checks performed remotely. In 2013, network pharmacists implemented large numbers of medication therapy interventions to improve chemotherapy and biological response modifier dosing (n = 641) and nonchemotherapy medication use (n = 1082); other documented interventions included patient counseling to help optimize the use of erythropoietin-stimulating agents and other medications (n = 441) and anticoagulation-related dosing adjustments and patient education (n = 102).

Conclusion Nineteen ambulatory care centers were successfully integrated into the UPMC oncology network as affiliated HBCs through a stepwise process that included workflow modifications, staff training, and a hybrid pharmacy services model that ensures a two-pharmacist check of antineoplastic orders in accordance with regulatory and quality standards.

Copyright ? 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved. Add to CiteULikeCiteULike Add to DeliciousDelicious Add to DiggDigg Add to FacebookFacebook Add to Google+Google+ Add to RedditReddit Add to TwitterTwitter What's this?

? Previous | Next Article ? Table of Contents This Article doi: 10.2146/ajhp140233 American Journal of Health-System Pharmacy January 15, 2015 vol. 72 no. 2 127-132 ? Abstract Full Text Full Text (PDF) Classifications Print Content Practice Reports Services Email this article to a colleague Alert me when this article is cited Alert me if a correction is posted Alert me when eLetters are published Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Download to citation manager eLetters Submit an eLetter No eLetters published Citing Articles Load citing article information Google Scholar Articles by Skledar, S. J. Articles by Yourich, B. PubMed PubMed citation Articles by Skledar, S. J. Articles by Yourich, B. Related Content Load related web page information Social Bookmarking Add to CiteULikeCiteULike Add to DeliciousDelicious Add to DiggDigg Add to FacebookFacebook Add to Google+Google+ Add to RedditReddit Add to TwitterTwitter What's this?

Current Issue February 15, 2015, 72 (4) Current Issue Alert me to new issues of American Journal of Health-System Pharmacy From the Cover RhOD immune globulin products for prevention of alloimmunization during pregnancy Sublingual tacrolimus as an alternative to oral administration for solid organ transplant recipients Economic burden of recurrent venous thromboembolism: Analysis from a U.S. hospital perspective Comparative analytics of infusion pump data across multiple hospital systems ABOUT AJHP SUBSCRIPTIONS FOR AUTHORS/REVIEWERS PERMISSION REQUESTS ADVERTISING EMAIL ALERTS (FREE) Email Alerts (Free) RSS FEEDS (FREE) RSS Feeds (Free) HELP CONTACT US/FEEDBACK American Society of Health System Pharmacists Learning Center (CE) Store Meetings & Conferences ASHP Foundation MOST READ ARTICLES (Last 30 Days) Clinical practice guidelines for antimicrobial prophylaxis in surgery Therapeutic monitoring of vancomycin in adult patients: A consensus review of the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, and the Society of Infectious Diseases Pharmacists How to write a patient case report Treatment of poisoning caused by {beta}-adrenergic and calcium-channel blockers ? View all Most Read articles Advertisement ? 2015 by the American Society of Health-System Pharmacists. Terms of Use | Copyright Online ISSN: 1535-2900 Print ISSN: 1079-2082

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Economic burden of recurrent venous thromboembolism: Analysis from a U.S. hospital perspective Society Logo Skip to main page content

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Economic burden of recurrent venous thromboembolism: Analysis from a U.S. hospital perspective Julian P. Casciano?, Zenobia Dotiwala, Robert Kemp, Chenghui Li, Jennifer Cai and Ronald Preblick
Julian P. Casciano, B.S., is President and CEO; and Zenobia Dotiwala, M.S., is Manager, eMAX Health Systems, LLC, White Plains, NY. Robert Kemp, Ph.D., is Associate Professor, School of Pharmacy, University of Louisiana, Monroe. Chenghui Li, Ph.D., is Associate Professor, Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences, Little Rock. Jennifer Cai, M.S., M.P.H., is Associate Director, Health Economics & Outcomes Research; and Ronald Preblick, Pharm.D., M.P.H., is Director, Health Economics & Outcomes Research, Daiichi Sankyo, Inc., Parsippany, NJ. Address correspondence to Mr. Casciano (juliancasciano{at}emaxhealth.net). Abstract Purpose An analysis of resource utilization and hospital costs associated with recurrent venous thromboembolism (VTE) is presented.

Methods A retrospective cohort analysis was conducted using a large U.S. hospital database. Patients with VTE-related hospitalization events during the period January–December 2010 were identified; data collection extended for up to 12 months after the index event. Postdischarge hospital resource use and total costs were compared in cohorts of patients with and without recurrent VTE. Regression analysis was performed to compare hospital costs and length of stay (LOS) during initial and subsequent VTE encounters.

Results Among the study population of 43,734 patients, 4% had postdischarge VTE-related events during the data collection period. The median and mean ? S.D. times to VTE recurrence were 48 days and 98 ? 106 days, respectively. Patients with recurrent VTE had more all-cause hospitalizations than those without recurrent VTE (mean ? S.D., 1.07 ? 0.96 versus 0.15 ? 0.53; p < 0.0001), more all-cause emergency room visits (mean ? S.D., 0.31 ? 0.66 versus 0.05 ? 0.31; p < 0.0001), and greater total costs (mean ? S.D., $28,353 ? $39,624 versus $17,712 ? $33,461; p < 0.0001). Relative to initial VTE admissions, admissions for recurrent VTE were, on average, associated with a 14% longer LOS (p = 0.0002) and a 22% higher total cost (p < 0.001).

Conclusion Patients with recurrent VTE used more hospital resources than those without recurrent VTE. Readmissions for VTE were significantly longer and more costly than index encounters.

Copyright ? 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved. Add to CiteULikeCiteULike Add to DeliciousDelicious Add to DiggDigg Add to FacebookFacebook Add to Google+Google+ Add to RedditReddit Add to TwitterTwitter What's this?

? Previous | Next Article ? Table of Contents This Article doi: 10.2146/ajhp140204 American Journal of Health-System Pharmacy February 15, 2015 vol. 72 no. 4 291-300 ? Abstract Full Text Full Text (PDF) Classifications Print Content Practice Report Services Email this article to a colleague Alert me when this article is cited Alert me if a correction is posted Alert me when eLetters are published Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Download to citation manager eLetters Submit an eLetter No eLetters published Citing Articles Load citing article information Google Scholar Articles by Casciano, J. P. Articles by Preblick, R. PubMed PubMed citation Articles by Casciano, J. P. Articles by Preblick, R. Related Content Load related web page information Social Bookmarking Add to CiteULikeCiteULike Add to DeliciousDelicious Add to DiggDigg Add to FacebookFacebook Add to Google+Google+ Add to RedditReddit Add to TwitterTwitter What's this?

Current Issue February 15, 2015, 72 (4) Current Issue Alert me to new issues of American Journal of Health-System Pharmacy From the Cover RhOD immune globulin products for prevention of alloimmunization during pregnancy Sublingual tacrolimus as an alternative to oral administration for solid organ transplant recipients Economic burden of recurrent venous thromboembolism: Analysis from a U.S. hospital perspective Comparative analytics of infusion pump data across multiple hospital systems ABOUT AJHP SUBSCRIPTIONS FOR AUTHORS/REVIEWERS PERMISSION REQUESTS ADVERTISING EMAIL ALERTS (FREE) Email Alerts (Free) RSS FEEDS (FREE) RSS Feeds (Free) HELP CONTACT US/FEEDBACK American Society of Health System Pharmacists Learning Center (CE) Store Meetings & Conferences ASHP Foundation MOST READ ARTICLES (Last 30 Days) Clinical practice guidelines for antimicrobial prophylaxis in surgery Therapeutic monitoring of vancomycin in adult patients: A consensus review of the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, and the Society of Infectious Diseases Pharmacists How to write a patient case report Treatment of poisoning caused by {beta}-adrenergic and calcium-channel blockers ? View all Most Read articles Advertisement ? 2015 by the American Society of Health-System Pharmacists. Terms of Use | Copyright Online ISSN: 1535-2900 Print ISSN: 1079-2082

View the original article here