Clinical Oncology Pharmacy Technician: Impact of a New Role on Pharmacy and Patient Metrics at a Large Academic Cancer Center.

PURPOSE: To describe the impact of an inpatient clinical oncology pharmacy technician program. METHODS: A retrospective study was conducted to observe outcomes in patients discharged from the hematology/oncology or bone marrow transplant (BMT) units at Indiana University Health in the year before (April 1, 2016-March 31, 2017) compared with the year after (April 1, 2018-March 31, 2019) the implementation of expanded technician services. The technician performed admission medication histories and ensured access to discharge medications. RESULTS: There were 1,169 and 1,112 encounters included in the pre- and post-technician cohorts. The median age was lower (54 v 61 years; P < .001), and there was a higher percentage of male patients (62% v 52.3%; P < .001) in the pre- compared with post-technician cohort. There were a higher percentage of oncology (36.4% v 31%; P = .007) and no difference in hematology (37.4% v 40.2%; P = .17) nor BMT encounters (26.3% v 28.8%; P = .18) in the pre- compared with post-technician cohort. The discharge prescription capture rate increased (42.7% v 78.5%; P < .001) from the pre- to post-technician cohort, resulting in a 34.2% increase ($314,639.46 in US dollars [USD]-$422,129.20 USD) in retail pharmacy revenue. More admission medication histories were completed by pharmacy staff (64.4% v 91.9%; P < .001), and there was an increase in the Hospital Consumer Assessment of Healthcare Providers and Systems-derived patient satisfaction results for both hematology/oncology (79% v 88%; P < .001) and BMT units (77% v 84%; P = .02) in the pre- compared with post-technician cohort. There was no difference in rates of unplanned readmissions (16.4% v 18.2%; P = .69) in the pre- compared with post-technician cohort. CONCLUSION: The overall capture rate of discharge prescriptions, revenue for the retail pharmacy, and patient satisfaction scores significantly increased after the implementation of expanded, inpatient clinical pharmacy technician services.

Supporting COVID-19 Vaccine Rollout before Charter Class Arrives: The University of California, Irvine Experience.

Despite numerous challenges in relation to being a recently established school, the University of California, Irvine (UCI) School of Pharmacy and Pharmaceutical Sciences (SPPS), similar to many schools of pharmacy in the United States, was highly committed to supporting the rollout of COVID-19 vaccines. UCI SPPS and our affiliated UCI Medical Center (UCIMC) Pharmacy Department partnered to spearhead the pharmacy element of a large-scale COVID-19 vaccination clinic on campus for both employees and the community. Three key initiatives were established in order to overcome the obstacles we faced in the large-scale roll out of COVID-19 vaccines: (1) forging new collaborations within the pharmacy team, (2) leveraging interprofessional education and practice, and (3) raising awareness of the pharmacists' role. Our response to the COVID-19 vaccines at UCI was a tangible, visible model that demonstrated that, while we continue to embrace our role in team-based, patient-centered care, it is also important for us to step up and lead the profession. Additionally, this vaccine rollout experience is a teachable moment for our communities and our health professional partners as we continue to march forward as one voice to serve the American public.

Assurance of Myeloid Growth Factor Administration in an Infusion Center: Pilot Quality Improvement Initiative.

PURPOSE: Four incident reports involving missed doses of myeloid growth factors (MGFs) triggered the need for an outcome-driven initiative. From March 1, 2015, to February 29, 2016, at University of California Irvine Health Chao Infusion Center, 116 of 3,300 MGF doses were missed (3.52%), including pegfilgrastim, filgrastim, and sargramostim. We hypothesized that with the application of Lean Six Sigma methodology, we would achieve our primary objective of reducing the number of missed MGF doses to < 0.5%. METHODS: This quality improvement initiative was conducted at Chao Infusion Center as part of a Lean Six Sigma Green Belt Certification Program. Therefore, Lean Six Sigma principles and tools were used throughout each phase of the project. Retrospective and prospective medical record reviews and data analyses were performed to evaluate the extent of the identified problem and impact of the process changes. Improvements included systems applications, practice changes, process modifications, and safety-net procedures. RESULTS: Preintervention, 24 missed doses (20.7%) required patient supportive care measures, resulting in increased hospital costs and decreased quality of care. Postintervention, from June 8, 2016, to August 7, 2016, zero of 489 MGF doses were missed after 2 months of intervention ( P < .001). Chao Infusion Center reduced missed doses from 3.52% to 0%, reaching the goal of < 0.5%. CONCLUSION: The establishment of simplified and standardized processes with safety checks for error prevention increased quality of care. Lean Six Sigma methodology can be applied by other institutions to produce positive outcomes and implement similar practice changes.