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1.
Am J Health Syst Pharm ; 77(Supplement_1): S2-S7, 2020 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-31950136

RESUMO

PURPOSE: To describe the development, design, and implementation of a pilot preceptor development bootcamp and feedback related to its feasibility and impact on operational pharmacy preceptors. SUMMARY: The University of Texas MD Anderson Cancer Center designed and implemented a pilot preceptor development bootcamp for operational staff pharmacists serving as residency preceptors for longitudinal weekend staffing experiences. A systematic, multipronged approach was taken to identify preceptor development gaps and design a full-day bootcamp curriculum. The resultant curriculum was comprised of content in major functional areas including using the 4 preceptor roles, documenting performance, giving and receiving feedback, and dealing with difficult situations or learners. The impact of the pilot preceptor development bootcamp was assessed using survey methodology and qualitative feedback from debrief discussions. CONCLUSION: Implementation of a pilot preceptor bootcamp program addressing major areas of precepting skill was well received, resulted in positive feedback from operational pharmacy preceptors, and was feasible to implement at a large academic medical center.


Assuntos
Farmacêuticos/organização & administração , Residências em Farmácia/organização & administração , Preceptoria/normas , Desenvolvimento de Programas/métodos , Centros Médicos Acadêmicos , Currículo , Humanos , Assistência Farmacêutica/organização & administração , Projetos Piloto , Avaliação de Programas e Projetos de Saúde , Inquéritos e Questionários
2.
Am J Health Syst Pharm ; 75(18): 1386-1393, 2018 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-30065061

RESUMO

PURPOSE: Results of a study comparing readmission rates and medication adherence measures before and after implementation of a pharmacy-led transitions-of-care (TOC) program are reported. METHODS: A quasi-experimental case-control study was conducted to assess the impact of a TOC program including medication history-taking and reconciliation services, inpatient and discharge education, and 72-hour and 30-day postdischarge phone follow-up. Hospital and emergency room (ER) readmission rates were compared in cohorts of oncology patients admitted to a large teaching hospital during specified periods before TOC program implementation (the standard-of-care [SOC] group) or after program implementation (the TOC group). The primary outcome was unplanned hospital or ER readmission within 30 days after initial discharge. The secondary endpoint was first-fill medication adherence. Benefits associated with specific TOC interventions were assessed in subgroup analyses. RESULTS: After propensity score matching, both study groups consisted of 323 patients. The SOC group had 76 patients (23.5%) and the TOC group had 74 patients (22.9%) who were readmitted to the hospital or ER within 30 days, with a significant reduction in hospital readmissions in 1 subgroup of TOC patients versus SOC controls (absolute difference, -7.6%; p = 0.0159). CONCLUSION: While there were no significant overall differences in readmission rates between the TOC and SOC groups, hospital readmissions were reduced in the subgroup of TOC patients who received both medication history-taking and reconciliation services and phone follow-up as TOC interventions.


Assuntos
Institutos de Câncer/organização & administração , Aceitação pelo Paciente de Cuidados de Saúde , Alta do Paciente , Transferência de Pacientes/organização & administração , Serviço de Farmácia Hospitalar/organização & administração , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Serviços Médicos de Emergência/estatística & dados numéricos , Determinação de Ponto Final , Feminino , Humanos , Masculino , Anamnese , Adesão à Medicação , Reconciliação de Medicamentos , Pessoa de Meia-Idade , Readmissão do Paciente/estatística & dados numéricos , Pontuação de Propensão
3.
Am J Health Syst Pharm ; 72(14): 1204-8, 2015 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-26150570

RESUMO

PURPOSE: The effects of dispensing inhalers to patients with chronic obstructive pulmonary disease (COPD) on hospital discharge were evaluated. METHODS: Data were collected in 2011-12 for patients with COPD who had hospital orders for the study inhalers (preintervention group) and after implementation of the multidose medication dispensing on discharge (MMDD) service (2013-14) (postintervention group). The primary objective of this study was to assess inhaler adherence and readmission rates before and after MMDD implementation. Adherence was defined as filling the discharge prescription for the multidose inhaler at a Harris Health pharmacy within three days of discharge or having at least seven days of medication left in an inhaler from a previous prescription that was filled or refilled before hospital admission. All patients in the postintervention group were considered adherent, since every patient was given the remainder of his or her multidose inhaler when discharged. RESULTS: Data from 620 patients (412 in the preintervention group, 208 in the postintervention group) were collected. During the preintervention time period, 88 of 412 patients were readmitted within 30 days compared with 18 of 208 patients during the postintervention period (p < 0.001). The intervention was associated with a significant reduction in 30-day readmissions (p = 0.0016) and 60-day readmissions (p = 0.0056). CONCLUSION: A targeted pharmacy program to provide COPD patients being discharged from the hospital with the multidose inhalers they had used during hospitalization was associated with improved medication adherence, as measured by prescription filling behavior, and reduced rates of 30- and 60-day hospital readmissions.


Assuntos
Prescrições de Medicamentos , Adesão à Medicação , Nebulizadores e Vaporizadores/tendências , Alta do Paciente/tendências , Readmissão do Paciente/tendências , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Idoso , Broncodilatadores/administração & dosagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/epidemiologia
4.
Am J Health Syst Pharm ; 72(7): 568-72, 2015 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-25788511

RESUMO

PURPOSE: The expansion of clinical pharmacy services through increased use of outpatient pharmacists for anticoagulation services is described. SUMMARY: Due to the high demand for clinical pharmacist services by patients and medical staff at Harris Health System in Houston, Texas, and the strict budgetary restrictions to improve the quality of care through cost-neutral services, a new telephone anticoagulation monitoring service, provided by clinical pharmacists, was established at four of the busiest anticoagulation ambulatory care centers within the system. One clinical staff pharmacist was trained in each of the four clinics by a clinical pharmacy specialist. Each pharmacist received roughly two weeks of training to provide this service. Implementation of the new anticoagulation monitoring service occurred on April 1, 2013. Data collected between October 2011 and April 2014 revealed significantly more visits per month for the clinical pharmacy service after the implementation of the telephone anticoagulation monitoring service (p=0.011). Redistribution of workflow resulted in a 16% increase in clinical pharmacy patient volume at the ambulatory care clinics (p=0.011). The percentage of International Normalized Ratio values in the therapeutic range, the proportion of hospitalizations due to thromboembolic or bleeding events, work hours per prescription volume, project completion rates, and the number of students precepted did not significantly differ between groups. CONCLUSION: The implementation of a clinical pharmacy telephone service for patients receiving anticoagulation at an outpatient center resulted in increased patient clinic visits without adversely affecting patient outcomes or increasing personnel or costs.


Assuntos
Assistência Ambulatorial/organização & administração , Anticoagulantes/uso terapêutico , Farmacêuticos , Serviço de Farmácia Hospitalar/organização & administração , Adulto , Prescrições de Medicamentos/estatística & dados numéricos , Feminino , Humanos , Coeficiente Internacional Normatizado , Masculino , Pacientes Ambulatoriais , Estudantes de Farmácia/estatística & dados numéricos , Telefone , Texas , Tromboembolia/epidemiologia
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