ABSTRACT
OBJECTIVE: To challenge the standard of practice by evaluating the identification of medication discrepancies found depending on type of access to an electronic health record (EHR). In other words, is there a difference in the number of discrepancies between a pharmacist with only access to the postacute long-term care (PALTC) EHR (ie, single-access pharmacist [SAP]) compared with a pharmacist with access to both the PALTC and hospital EHRs (ie, dual-access pharmacist DAP) In October 2018, the Improving Medicare PostAcute Care Transformation (IMPACT) Act mandated admission drug review (DRR) upon admission to a postacute, long-term care (PALTC) facility.
SUMMARY:This was a prospective study investigating the occurrence of medication therapy problems (MTP) identified by two different DRR processes; SAP versus DAP. Data were collected in a community hospital and a stand-alone PALTC facility. It was found that the DAP identified more safety-related medication needs and medication omissions than an SAP. There was a significant association between the type of access and whether a MTP (ie, yes or no) was discovered, the type of medication-related need, and MTP category.
CONCLUSION: These results strongly suggest that current standard of practice should change to require access to both hospital and PALTC EHR systems for a pharmacist completing the medication reconciliation. Until the gap in EHR interoperability is closed, the potential breakdown in communication associated with SAP places patients transitioning from hospital to PALTC facilities at increased risk for medication problems and accompanying adverse medication events.
Subject(s)
Electronic Health Records , Pharmaceutical Preparations , Humans , Medicare , Medication Reconciliation , Prospective Studies , United StatesABSTRACT
INTRODUCTION: The American Society of Health-System Pharmacists' Postgraduate Year 1 and Year 2 Residency Accreditation Standards require that residents demonstrate effective teaching skills. The College of Psychiatric and Neurologic Pharmacists' survey of pharmacy program curricula assessed resident teaching in psychiatry and neurology, however, results were not published. The objective of this article is to describe resident teaching in psychiatry and neurology curricula as reported by responses to the college's survey. METHODS: An electronic survey was sent to a curricular representative from each of 133 US pharmacy programs accredited as of July 2015. Programs were asked to report on psychiatry and neurology curricular content, faculty credentials, and types of teaching activities, including resident teaching. RESULTS: Fifty-six percent (75/133) of programs responded to the survey. Fifty out of 75 (67%) distinct pharmacy programs reported utilizing residents for teaching topics in psychiatry and neurology. Residents were twice as likely to teach didactic topics in psychiatry (n = 44) compared to neurology (n = 22). Three times as many residents were involved in precepting psychiatric Advanced Pharmacy Practice Experiences (n = 37) compared to neurology Advanced Pharmacy Practice Experiences (n = 12). DISCUSSION: Residents are involved in both didactic and experiential teaching with more residents teaching psychiatry content compared to neurology content. Authors recommend utilizing the American Society of Health-System Pharmacists' electronic resident assessment tool, PharmAcademic®, to capture the quantity and quality of resident teaching across accredited programs.
