Leading Change, Critical Access Hospital Pharmacy Residency Project

Transcription

1 Leading Change, Critical Access Hospital Pharmacy Residency Project Rhonda Wiering, RN Patient Care Coordinator, Tyler Healthcare Center Todd D. Sorensen, Pharm.D. Associate Professor, University of Minnesota

2 Tyler, Minnesota

3 Wind Towers of Southwest Minnesota These wind towers stretch for miles across the Buffalo Ridge, near Tyler.

4 Æbleskiver Days A Danish Heritage event Tyler's Aebleskiver Days is an annual tradition that promises fun, food, and a great time for the entire family! There are games for the kids, crafts and entertainment for the adults, and of course, good food everywhere, including our famous Danish sandwiches, and the Aebleskiver - a tennis ball shaped Danish pancake.

5 Back 2 Back State Champs!!! RTR Knights are the Class A State Champions for 2004 & 2005!

6 Tyler Healthcare Center A.L. Vadheim Hospital Sunrise Manor Nursing Home Tyler Medical Clinic Tyler Home Care & Ridgeview Hospice

7 Tyler Healthcare Center Demographics 21-bed CAH hospital in Tyler, MN Service area: 30 mile radius of Tyler in SW MN 20% of patients >65 years old Nursing home, hospice/home health services 2 MDs, 1 PA-C

8 CAH Definition Medicare program Cost-Based Reimbursement vs. DRG Rural community outside of metro area <25 beds, where <15 are for acute care Average length of stay <96 hours

9 Pharmacy Services in CAH prior to Pharmacy Project Local Pharmacist onsite ½-2 hours/day for hospital inpatient dispensing. Nursing department responsible for inventory management/ ordering. Primary pharmacy function was dispensing and managing controlled drugs. Used all manual functions including limited use of unit dose packaging. 2003: Community identified as at risk of losing lone retail/hospital pharmacist to retirement.

10 Pharmacy Project Need CAH Rules-C-0276-Effective July 1, 2004 All prescribers medication orders (except in emergency situations) should be reviewed for appropriateness by a pharmacist before the first dose is dispensed. Pharmacy maintains control over drugs in all locations Appropriate monitoring of med therapy Compound sterile products

11 More Reasons for Pharmacy Project CAH National Patient Safety Goals: 2005 Healthy People 2010 Professional Satisfaction for HC providers

12 A Tool for Practice Development: Pharmacy Residency Education Prepare pharmacists for patientcentered practice. Influence the practice of pharmacy in Minnesota and beyond. Facilitate the growth of model advanced practice sites for the College of Pharmacy.

13 A Foundation for Partnerships College of Pharmacy Framework for residency education/accreditation Expertise in practice development Administrative support Comprehensive, coordinated marketing effort Assist in acquiring seed money Practice Sites Patients who have a need for pharmaceutical care Enthusiasm for practice development Funding for residents Commitment to teaching residents AND students Serve as a model for additional opportunities for collaboration

14 Program Emphasis Program focus is ambulatory care Urban and Rural Partners Three unique areas of emphasis Community Health Rural Health Professional Leadership

15 Our Partners Community Health UMP, Fairview, Westside CHC, St. Cloud VAMC Rural Health Tyler HC Center, Paynesville Area HCS, St. Elizabeth s Hospital/Mayo Clinic (Wabasha) Professional Leadership UM COP, UMP, Fremont CHC

16 Outcomes of Collaboration Addressing community/organization specific problems Creating a broader view of the role of pharmacy in an organization Expansion of the role of pharmacists Increased availability of pharmacists with advanced training Allowing for win-win between UM and health care organizations

17 Pharmacy Project 2004: Rural Hospital Planning and Transition Grant received Community-based needs assessment initiated Pharmacy resident on hospital staff- July 2004

18 First Year Pharmacy Project Activities Collaborative practice agreement in anticoagulation Committees: Medication Errors, P&T, Infection control,cqi, Pain CQI Implemented unit dose dispensing Nursing education programs Inventory control-preferred PPI and quinolones Policy/procedure update/implementation

19 Results : Pharmacy services expanded to include direct patient care mgmt at Tyler Medical Clinic 2005: Resident recruited to serve as full-time pharmacist Resident pharmacy program continues Awarded Capital Improvement Grant to purchase Pyxis or other automated computer dispensing system to begin in June, 05.

20 Professional Satisfaction and Financial Benefits Nurses decreased time spent dispensing/mixing IVs Dr. interaction/collaboration Implement pharmaceutical care Inventory control Collaborative practice agreements

21 CAH National Patient Safety Goals 2005 Medication related to 5 of 7 goals Medication specific: -Improve the safety of using medications. -Accurately and completely reconcile medications across the continuum of care. Source:

22 Healthy People 2010 Objective 17: Medical Product Safety -Increase proportion of people who review with patients >65yo all new or OTC meds -Increase proportion of patients who receive verbal counseling