Facilitation of Medication Reconciliation Process
|
|
- Eric Booth
- 6 years ago
- Views:
Transcription
1 Facilitation of Medication Reconciliation Process by Gary L. Hamilton, Michael Lim, Mari Pirie-St. Pierre and Diane Tobin Clinical Thinking Course Project Presented on June 1, 2009
2 Introduction Clinical Care Scenario Medication Reconciliation in the outpatient behavioral healthcare setting Patient has numerous healthcare providers Patient has numerous diagnoses Patient is taking numerous medications How to Reduce Medication Discrepancies Best Possible Medication History (BPMH) Paper record (MR) EMR/CPOE eprescibe Suggested Approaches Toward Process Enhancement Metrics Measurement of Success
3 A Clinical Case Study Example Problem List Mrs. Folle, is a 50 year old white female with diagnoses of: Axis I: Paranoid Schizophrenia Anxiety Disorder, NOS Nicotine Dependence Axis II: No Diagnoses Axis III: Type II Diabetes Obesity Hypertension Migraine Headaches Pernicious Anemia Asthma
4 Axis List used by the DSM-IV TR (Diagnostic and Statistical Manual) Axis I Clinical Disorders, including major mental disorders, as well as developmental and learning disorders. Axis II Underlying pervasive or personality conditions, as well as mental retardation. Axis III Acute medical conditions and physical disorders. Axis IV Psychosocial and environmental factors contributing to the disorder.
5 Current Medications (for which conditions) Dr. Freud Psychiatrist Clozaril, 150 mg., twice daily (schizophrenia) Xanax, 0.5 mg, three times daily (anxiety) Dr. House Primary Care Physician Metformin, 850 mg. Once a day (diabetes) Albuterol, 2 puff, every 4-6 hours (asthma) Vitamin B-12 injections, annually (anemia) Furosemide, 40 mg, twice a day (hypertension) Dr. Carter Urgent Care Topomax, 200 mg, twice a day (migraine) Mellaril, 50 mg, three times a day (schizophrenia)
6 Medications (continued) Herbal Supplements Grapefruit Seed, 1 capsule, daily Vitamin B supplement Increase metabolism Over the Counter (OTC) Advil, PRN Headaches Number of medications for a behavioral health patient Average: 9 (According to NYS Office of Mental Health)
7 Quality Concerns Herbal Supplement Grapefruit Certain medications may be activated or deactivated Grapefruit contains furocoumarins Clozaril High risk medication - should be highly scrutinized when being prescribed as it may indicate an increase risk of Metabolic Syndrome (MetS) Polypharmacy Clozaril Mellaril
8 Metabolic Syndrome Impact on Mental Health Consumer The following medications should be highly scrutinized when being prescribed as they indicate an increase risk of MetS. High Risk: Clozaril Zyprexa Moderate Risk: Seroquel Thorazine Mellaril Following conditions in conjunction with antipsychotic meds pose a risk for MetS - Hypertension Any Ischemic Vascular Disease Hyperlipidemia Diabetes Obesity psyckesmedicaid.omh.state.ny.us/common/qualityindicators.aspx
9 Quality Concerns Psychotropic medications are not benign compounds, and polypharmacy has serious potential risks: The possibility of higher than necessary total dosages Increased acute and/or chronic side effect burden Adverse drug-drug interactions or effects (ADEs) Increased rates of non-compliance Higher cost of treatment Difficulties in determining the impact of multiple treatments Higher rates of cardiometabolic disorders compared to the general population Increased risk of mortality
10 Evidence Based Medicine for Reducing Polypharmacy When switching medications, cross taper medications over a period of several months. Combine medications from same drug class after a scenario of failed monotherapy trials. For patients receiving more than one agent from the same class, periodic efforts should be made to streamline the regimen and reduce polypharmacy. Medications should be tapered, slowly over time, patients being monitored closely for early warning signs of relapse. psyckesmedicaid.omh.state.ny.us/common/qualityindicators.aspx
11 Evidence Base Medicine for Reducing Cardiometabolic Risk Developing care management processes that will identify consumers who could benefit from a modified medication regimen. Prescribers, staff,and consumers should be aware of MetS profile, as well as high and moderate risk antipsychotic meds. For those with MetS, consider switching to a low risk antipsychotic med. Provide increase monitoring for metabolic abnormalities. psyckesmedicaid.omh.state.ny.us/common/qualityindicators.aspx
12 What is Medication Reconciliation? The process of comparing what medication the patient is currently taking with what the organization is providing to avoid errors such as conflicts or unintentional omissions. Goal Accurately and completely reconcile medications across the continuum of care Reduce the potential for Adverse Drug Events (ADEs) Eliminate Undocumented intentional discrepancies, and Unintentional discrepancies
13 Out-Patient Medication History (OPMH) An initial medication history taken at time of visit, generally by a physician or nurse. Sources of information may include: patient/family interviews review of medication lists or vials follow up with the community pharmacist or primary care physician
14 Best Possible Medication History (BPMH) A medication history obtained by a clinician which includes a thorough history of all regular medication use (prescribed and non-prescribed). Forms the basis of reconciliation. Sources of information: Patient or caregiver interview Inspection of medication vials and other containers Review of a personal or clinician provided medication list Follow-up with community pharmacist or Primary Care Phy. Review of personal medication list printed by the community pharmacy. *In home medication inspection
15 Medication Reconciliation Process Out-Patient Scenario, Part 1
16 Medication Reconciliation Process Out-Patient Scenario, Part 2
17 Best Possible Medication Plan (Reconciled Medication Orders for Mrs. Folle) Medications What it is Used Dosage Frequency Instructions (Continue / Taken at Home For Discontinue / Change) Clozaril schizophrenia 150mg BID Continue Xanax anxiety 0.5 mg TID Continue Metformin diabetes 500mg QD Change Albuterol asthma 2 Puffs Every 4-6 hrs Continue Vitamin B-12 anemia 1000 mcg Annual Continue injection Topomax migraine 200mg BID Continue Mellaril schizophrenia 50mg TID Discontinue Grapefruit Seed Dietary 1 Capsule QD Discontinue Supplement Advil headaches 200mg Q 4 hrs. PRN Continue
18 Failure Mode & Effects Analysis General Themes Inaccurate, incomplete and/or missing information on patients medication histories No formalized approach for obtaining and documenting medication histories within patients medical records Inconsistencies between histories obtained by various disciplines and documentation throughout patients medical records
19 Failure Mode & Effects Analysis (continued) Accuracy of medication lists relies heavily on patient-shared information In home medication inspection may be more accurate than patients report.
20 Who is responsible for Medication Reconciliation? All providers including: Patient / Care Giver Pharmacist Primary Care Physician Specialists Behavioral Health Professional Nurse
21 How to Reduce Discrepancies? Interoperable EHR Standardized Documentation (Electronic or Paper) Use of medication cards Nurse or software-aided collection of medication lists Letters & phone calls to remind patients to bring all their medication bottles or an updated medication list to their clinic visit Patient education on the importance of using a medication wallet card and bringing their medications to the healthcare visits Verification and correction of the most recent medication list in the EMR by the patient.
22 Challenges in Out-Patient Medication Reconciliation No clear owner No defined process for medication reconciliation. Patients not aware of the necessity for them to know the names of drugs they are taking. (frequency, dosage, side effects) Possible Owners: Pharmacist Primary Care Physician (Medical Home)
23 Tips to remember when interviewing patients for BPMH When asking about all medications, be sure to get the name, dosage form, dosage, dosing schedule, and last dose taken be as specific as possible about prn (as needed) medications. Use open-ended questions (what, how, why, when) and balance with yes/no questions. Use nonbiased questions which do not lead the patient into answering something that may not be true. Ask simple questions, avoid using medical jargon, and always invite the patient to ask questions. Pursue unclear answers until they are clarified. Continued
24 Tips to remember when interviewing patients for BPMH (continued) Educate the patient on the importance of using one central pharmacy/pharmacist. Educate the patient on the importance of using a medication wallet card and bringing their medications to the healthcare facility, physician s office, etc. Prompt the patient to try and remember patches, creams/ointments, eye/ear drops, inhalers, sample medications, shots, herbals, vitamins, and minerals. When discussing allergies, educate the patient on the difference between a side effect and a true allergy e.g., rash, breathing problems, hives. Have patients describe how and when they take their medications, and if they ever have difficulty taking their medications or remembering to take their medications. Vague responses may indicate non-compliance.
25 Steps to take if the patient cannot remember a medication or if clarification is needed Obtain a detailed description of the medication from the patient or a family member dosage form, strength, size, shape, color, markings. Talk to any family members present or contact someone that could possibly bring in the medication or read it over the phone. Call the patient s pharmacy to obtain a list of medications the patient has been regularly filling. Contact the patient s physician(s) to get an accurate listing of their current medications. Obtain previous medical records.
26 Current Best Possible Medication History (BPMH) Current state of medication reconciliation Interoperable Technology Solutions IT IT solutions only as good as the manual processes they were designed to support IT cannot effectively remove inefficiencies or errors in the medication reconciliation process; important to address, Current Best Possible Medication History (BPMH) understand & investigate each component involved in process Paper record (MR) Initial medication history EMR/CPOE Manual process combined with IT component eprescibe Improves drug safety by avoiding drug-drug interactions, drug-disease interactions & other potential drug safety issues.
27 Gaps - Discrepancies in medication reconciliation process Disjointed medical system Discrepancie s Identified Inaccurate histories/lists Use of multiple pharmacies, mail order pharmacies, samples, foreign purchases Rapid introduction of new medications, formulary changes Care team may deliberately focus on other essential tasks & believe that someone else will compile or revise medication list Medication reconciliation is complex and requires multidisciplinary effort
28 Unique Attributes Medication Reconciliation Collaborative Filtering Approach Seeks to detect omissions of medications from a patient s list based on Collaborative Filtering (CF) Collaborative Filtering set of methods for processing information about users in order to make inferences or predictions about the information of other users. CF methods are used to answer the following question: if a patient s medication list is incomplete, what drugs are most likely to be missing?
29 Unique Attributes Medication Reconciliation Narrative compilation Narrative physician notes are a rich but untapped source of medication information Discontinued medications are frequently not removed from EMR medication lists a patient safety risk. Narrative compilation was used to define an algorithm to identify inactive medications using the text of narrative notes in the EMR. This technology could be employed in real-time patient care as well as for research and quality of care monitoring.
30 Unique Attributes NLP using natural language information extraction to obtain medication information for reconciliation processes Medication information may only be available in narrative format and some form of information extraction will be necessary Medication Extraction and Reconciliation Knowledge Instrument (MERKI) Open source tool available at : Tool shows a precision of 94% and recall of 83% in the extraction of medication information
31 Unique Attributes NLP MLP using natural language information extraction or medical language processing to obtain medication information for reconciliation processes Medication information may only be available in narrative format and some form of information extraction will be necessary Natural Language parser that extracts structured medication event information from discharge summaries Next generation parser Built upon the larger project model: Medication Extraction and Reconciliation Knowledge Instrument (MERKI) Open source tool available at : Tool shows a precision of 94% and recall of 83% in the extraction of medication information Gold, S., et al. Extracting Structured Medication Event Information from Discharge Summaries. AMIA Annu Symp Proc. 2008; 2008: Published online PMCID: PMC May = &blobtype=pdf
32 Unique Attributes PHR Personal Health Records MyMedicationList is a prototype application: mml.nlm.nih.gov.ezproxy.galter.northwestern.edu Developed at the National Library of Medicine that assists users in compiling a medication list and makes this record readily available when needed: Free to the general public Adequately protects users personal information Based on standards for terminology and documents (XML export) Independent from any health institutes, organizations or platforms
33 Communicate the Best Possible Medication Plan Patient, Pharmacist, Physician, Alternative care Facilities or Services Communicate the Best Possible Medication Plan Important to address, understand & investigate each component involved in process (Patient, Pharmacist Physician, Alternative care facilities or services) There should be a greater awareness and emphasis that accuracy in medication history is part and parcel of total care. Will likely require a new combination of IT solutions and manual processes
34 Metrics This section is outside of our individual patient example To implement medication reconciliation, you need to do the following steps: Secure Senior Leadership Commitment to begin. Form a Team to implement the process. Define the Problem and Collect Baseline Data to be used. Start with Small Tests of Change & Build Expertise in Reconciling Medications. Evaluate the Improvements Being Made that is, Collect and Submit Data to be analyzed. This is the improvement data. Spread where you work to close the gap between best practice and common practice by using your ideas to implement innovations and new ideas. Two of these activities involve Metrics or Collecting measurable Data the Baseline Data & the Improvement Data.
35 Metrics Metrics involves collecting data to measure your implementation and success in Medical Reconciliation. In order to collect your this, data need to be collected and evaluated for both short-term and long-term goals. There are several core measures that need to be worked with in order to do this. The calculation of these can be done through Excel spreadsheets that are then entered into a data base software system including HCIS. Examples of these Excel spreadsheets to do the calculations can be found already set up for use (for example at:
36 Metrics In order to measure the success of medication reconciliation, you need to focus on a consistent set of core measures which represent the minimum measures required to evaluate success of medication reconciliation. (The main source of much of this metrics section: Safer Healthcare Now! Getting Started Kit: Medication Reconciliation Prevention of Adverse Drug Events How-to Guide [ These include the following 3 measures: Intentional Discrepancies Undocumented Intentional Discrepancies Unintentional Discrepancies
37 Metrics To define these three core terms: Intentional Discrepancy is one where the prescriber has made an intentional choice to add, change, or discontinue a medication and their choice is clearly documented. Undocumented Intentional Discrepancy is one where the prescriber has made an intentional choice but it is not clearly documented. Unintentional Discrepancy is one where the physician unintentionally changed, added, or omitted a medication the patient was taking prior to admission. This is important because this is what can lead to ADEs (adverse drug events) which is a major problem and is one reason why you do medication reconciliation.
38 Metrics The first of these is Undocumented Intentional Discrepancies: Mean # of undocumented intentional discrepancies # of undocumented intentional discrepancies # of patients The second of these is Unintentional Discrepancies: Mean # of unintentional discrepancies # of unintentional discrepancies # of patients The third of these is Patients Reconciled at Discharge: # of patients with completed BPMDP Mean # of reconciled at discharge x 100 # of patients discharged in the sample where BPMDP = Best Possible Medication Discharge Plan
39 Metrics There are also several optional measures which can be taken: Mean Number of Discrepancies Resolved which is used to track the number of discrepancies that are being resolved per patient. Time it takes to conduct a BPMH (Best Possible Medication History) Patient and Staff Satisfaction probably through surveys or questionnaires. Time from Admission to Reconciliation measured from charts or HCIS. Number of Med Histories on the chart before medication reconciliation vs. documentation of BPMH first (that is, reduction in duplication) Rate of Potential Harm which is the percentage of patients with one or more intentional discrepancies (a Type 3 Error) The Medication Reconciliation Success Index which refers to the total percentage of good or acceptable errors. With experience and the right tools, the process will lead automatically to fewer unintentional discrepancies and intentional discrepancies.
40 Metrics A quick review of Error Types applicable to metrics: Type I error, also known as an error of the first kind, an αerror, or a false positive : the error of rejecting a null hypothesis when it is actually true. Plainly speaking, it occurs when we are observing a difference when in truth there is none. An example of this would be if a test shows that a woman is pregnant when in reality she is not. A Type I error can be viewed as the error of excessive credulity. Type II error, also known as an error of the second kind, a βerror, or a false negative : the error of failing to reject a null hypothesis when it is in fact not true. In other words, this is the error of failing to observe a difference when in truth there is one. An example of this would be if a test shows that a woman is not pregnant when in reality she is. A Type II error can be viewed as the error of excessive skepticism. Type III error, also known as an error of the third kind, a γerror: the error of correctly rejecting the null hypothesis for the wrong reason. These Error Types are needed for the Mean Number of Discrepancies Resolved optional metrics measurement on the next slide.
41 Metrics Three of these optional metrics measures have the following definitions: Mean Number of Discrepancies Resolved Mean # of Discrepancies Resolved Total # of resolved Type 2 errors + Total # of resolved Type 3 errors # of patients in the sample Rate of Potential Harm (%) # of patients with 1 or more unintentional discrepancies Rate of potential harm (%) x 100 # of patients in the sample The Medication Reconciliation Success Index # of no discrepancies + # of documented intentional discrepancies Medication Reconciliation Success Index x 100 # of patients in the sample
42 Metrics Measurement Tips for collecting metrics: Plot data over time much information about a system and how to improve it can be obtained by plotting data over time and then observing trends and other patterns. Tracking a few key measures over time is the single most powerful tool a team can use and will help them to see the effects of the changes that are being made. This is probably best done by running charts to track the measures over time. (There are several methods to do this.) Seek usefulness, not perfection measurement is not the goal, rather improvement. Measurement should be integrated into the daily routine, and both qualitative and quantitative data should be used. Goals should be set, and then tracked for successful implementation.
43 In Conclusion If Mrs. Folle s medications had been reconciled at each point of care Dr. House: counseled her against the use of Grapefruit seed. Dr. Carter Prescribed Clozaril vs. Mellaril Dr. Freud Switched to a low-risk medication due to MetS
44 Key Elements to take away These lessons are applicable to any practice setting (that is, inpatient and outpatient) & any type of medical record system (that is, electronic, paper-based or both). There is no electronic substitution for a thorough medication interview with patients and/or their caregivers to obtain and verify current medication regimens. Until healthcare information technology with advanced clinical decision support becomes advanced medication reconciliation will remain a manual process.
45 Take away lessons (cont.) Medication reconciliation should be weaved into the culture and practices for safe medication management. Medication reconciliation should be an integral part of handoffs and communication during transitions in care.
46 What are others doing? Medication Reconciliation (a Canadian Pilot Project) $1000 administration fee paid to Pharmacists $50 per annual visit (30 minutes) $25 per follow up visit For example, in Pictou County, N.S., Canada, community pharmacists, healthcare facility pharmacists, nursing staff and preadmission clinic personnel joined forces to create an innovative program where community pharmacists provide medication history information which the nurse in the preadmission clinic discusses and verifies with the patient.
47 References (Partial List) 1. PSYCKES Medicaid. New York State Office of Mental Health. Accessed: 4/30/ Hert, M., Schreurs, V., Vancampfort D., Van Winkel, R. Metabolic syndrome in people with schizophrenia: a review. World Psychiatry. 2/ Accessed 5/13/ Safer Healthcare Now! (May 2007) Getting Started Kit: Medication Reconciliation Prevention of Adverse Drug Events, How-to Guide V Northwestern Memorial Hospital, The Application of FMEA to a Medication Reconciliation Process retrieved May 16, Varkey, P. & Cunningham & J. Bisping, S. (May 2007) Improving Medication Reconciliation in the Outpatient Setting The Joint Commission Journal on Quality and Patient Safety Volume 33 Number 5 p Breydo, E. et al. Identification of Inactive Medications in Narrative Medical Text. AMIA 2008 Symposium Proceedings. Clinical Informatics Research and Development, Partners HealthCare, Boston, MA, Brigham and Women s Hospital, Boston, MA & Harvard Medical School, Boston, M. 16 May ype=abstract> 12. Hasan, S., and Et al. "AMIA 2008 Symposium Proceedings: Towards a Collaborative Filtering Approach to Medication Reconciliation." The Heinz School, Carnegie Mellon University, Pittsburgh, Pa. 16 May 2009 < 14. Joint Commission Resources, Co-published with the American Society of Health-System Pharmacists (ASHP). "Medication Reconciliation Handbook." Handbook on Medication Reconciliation Joint Commission Resources - Co-published with the American Society of Health-System Pharmacists (ASHP). 16 May 2009 < 18. Schenkel, S. The Unexpected Challenges of Accurate Medication Reconciliation, Annals of Emergency Medicine, Volume 52, Issue 5, November 2008, Pages , ISSN , DOI: /j.annemergmed <
48 Thank You
49 Questions
Who s s on What? Latest Experience with the Framework Challenges and Successes. November 29, Margaret Colquhoun Project Leader ISMP Canada
Who s s on What? Latest Experience with the Framework Challenges and Successes November 29, 2005 Margaret Colquhoun Project Leader ISMP Canada 1 Outline ISMP Canada Partnership with SHN The Canadian Getting
More informationIHA Regional Pharmacy Best Possible Medication History Practice Standard
IHA Regional Pharmacy Best Possible Medication History Practice Standard Section: None Origin Date: June 24, 2009 Number: None Reviewed Date: June 24, 2009 Revised Date: September 24, 2009 PRINTED copies
More informationMedication Reconciliation
Medication Reconciliation The Care Transitions Network National Council for Behavioral Health Montefiore Medical Center Northwell Health New York State Office of Mental Health Netsmart Technologies Today
More informationHow to Fill Out the Admission Best Possible Medication History (BPMH) Tool
How to Fill Out the Admission Best Possible Medication History (BPMH) Tool Medication Reconciliation On Admission Updated: August 21, 2014 Medication Reconciliation on Admission How to Fill Out an admission
More informationMedication Reconciliation: Preventing Errors and Improving Patient Outcomes
Murray State's Digital Commons Scholars Week 2016 - Spring Scholars Week Apr 18th, 12:00 PM - 2:00 PM Medication Reconciliation: Preventing Errors and Improving Patient Outcomes Amanda S. Boren Murray
More informationMedication Reconciliation
Medication Reconciliation Define the term medication. Define medication reconciliation. Describe the potential barriers to obtaining an accurate medication list and resolution strategies to overcome these
More informationLearner Manual. Document Best Possible Medication History (BPMH)
Learner Manual Document Best Possible Medication History (BPMH) Table of Contents Medication safety... 1 Medication errors impact everyone... 1 Who should obtain the BPMH?... 1 When is the BPMH obtained?...
More informationImproving Primary Care Medication Patient Safety: System-level Medication Adherence Issues
Improving Primary Care Medication Patient Safety: System-level Medication Adherence Issues Marie Smith, PharmD Professor and Asst. Dean, Practice and Public Policy Partnerships Meg Mello Moniz, PharmD
More informationReducing Harm Improving Healthcare Protecting Canadians MEDICATION RECONCILIATION IN THE ICU. Change Package.
Reducing Harm Improving Healthcare Protecting Canadians MEDICATION RECONCILIATION IN THE ICU Change Package January 2012 Background The ultimate goal of medication reconciliation is to prevent adverse
More informationUniversity of Wisconsin Hospital and Clinics Medication Reconciliation Education Packet
Medication Reconciliation Education Objectives Purpose: The following learning objectives will be presented and evaluated with regard to the process of medication reconciliation. The goal is to provide
More informationH2H Mind Your Meds "Challenge. Webinar #3- Lessons Learned Wednesday, April 18, :00 pm 3:00 pm ET. Welcome
H2H Mind Your Meds "Challenge Webinar #3- Lessons Learned Wednesday, April 18, 2012 2:00 pm 3:00 pm ET 1 Welcome Take Home Messages Understand how to implement the Mind Your Meds strategies and tools in
More informationPharmacy Medication Reconciliation Workflow Emergency Department
Objectives of the Pharmacy Forum Page To become familiar with EPIC functionalities used in prior to admission (PTA) medication reconciliation (Section 1) 2 7 To understand the pharmacy technicians role
More informationWho Cares About Medication Reconciliation? American Pharmacists Association American Society of Health-system Pharmacists The Joint Commission Agency
The Impact of Medication Reconciliation Jeffrey W. Gower Pharmacy Resident Saint Alphonsus Regional Medical Center Objectives Understand the definition and components of effective medication reconciliation
More informationMedication Reconciliation. Peggy Choye, Pharm.D., BCPS
Medication Reconciliation Peggy Choye, Pharm.D., BCPS What is it? Medication reconciliation The process of identifying the most accurate list of all medications that a patient is taking including name,
More informationCOMPUTERIZED PHYSICIAN ORDER ENTRY (CPOE)
COMPUTERIZED PHYSICIAN ORDER ENTRY (CPOE) Ahmed Albarrak 301 Medical Informatics albarrak@ksu.edu.sa 1 Outline Definition and context Why CPOE? Advantages of CPOE Disadvantages of CPOE Outcome measures
More informationMedicine Reconciliation FREQUENTLY ASKED QUESTIONS NATIONAL MEDICATION SAFETY PROGRAMME
Medicine Reconciliation FREQUENTLY ASKED QUESTIONS NATIONAL MEDICATION SAFETY PROGRAMME The Process What is medicine reconciliation? Medicine reconciliation is an evidence-based process, which has been
More informationMEDICINES RECONCILIATION GUIDELINE Document Reference
MEDICINES RECONCILIATION GUIDELINE Document Reference G358 Version Number 1.01 Author/Lead Job Title Jackie Stark Principle Pharmacist Clinical Services Date last reviewed, (this version) 29 November 2012
More informationMEDICATION THERAPY MANAGEMENT. MemberChoice FORMULARY MANAGEMENT MEDICATION THERAPY MANAGEMENT (MTM) SPECIALTY DRUG MANAGEMENT
MemberChoice FORMULARY MANAGEMENT MEDICATION THERAPY MANAGEMENT (MTM) SPECIALTY DRUG MANAGEMENT MEDICATION THERAPY MANAGEMENT Medication Therapy Management 1 $ 290 Billion Wasted in avoidable costs due
More informationRole of Clinical Pharmacist in Primary Care Clinic HYOJIN SUNG, PHARM.D SALEM HEALTH MEDICAL GROUP OSMA ANNUAL CONFERENCE APRIL 14, 2018
Role of Clinical Pharmacist in Primary Care Clinic HYOJIN SUNG, PHARM.D SALEM HEALTH MEDICAL GROUP OSMA ANNUAL CONFERENCE APRIL 14, 2018 Objectives Understand the scope of practice for pharmacist and role
More informationMeasure #130 (NQF 0419): Documentation of Current Medications in the Medical Record National Quality Strategy Domain: Patient Safety
Measure #130 (NQF 0419): Documentation of Current Medications in the Medical Record National Quality Strategy Domain: Patient Safety 2017 OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS ONLY MEASURE TYPE: Process
More informationJHQ 177 Medication Reconciliation: A Necessity in Promoting a Safe Hospital Discharge
JHQ 177 Medication Reconciliation: A Necessity in Promoting a Safe Hospital Discharge Donna L. Poole, Juliane N. Chainakul, Mary Pearson, LeAnn Graham Keywords: Discharge, Information technology, Medication
More informationAPPENDIX 2 NCQA PCMH 2011 AND CMS STAGE 1 MEANINGFUL USE REQUIREMENTS
Appendix 2 NCQA PCMH 2011 and CMS Stage 1 Meaningful Use Requirements 2-1 APPENDIX 2 NCQA PCMH 2011 AND CMS STAGE 1 MEANINGFUL USE REQUIREMENTS CMS Meaningful Use Requirements* All Providers Must Meet
More informationClinical Training: Medication Reconciliation. VNAA Best Practice for Home Health
Clinical Training: Medication Reconciliation VNAA Best Practice for Home Health Learning Objectives To understand why medication reconciliation is important to providing quality care To understand the
More informationMedicines Reconciliation: Standard Operating Procedure
Clinical Medicines Reconciliation: Standard Operating Procedure Document Control Summary Status: Version: Author/Owner/Title: Approved by: Ratified: Related Trust Strategy and/or Strategic Aims Implementation
More information4/28/2017. Medication Management for Improved Compliance & Home Care Satisfaction PREPARED FOR NEHCC Presenter. Overview
Medication Management for Improved Compliance & Home Care Satisfaction PREPARED FOR NEHCC 2017 Presenter Debra Demar, MS is the Community Liaison for White Cross Pharmacy, serving RI, MA and CT. She has
More informationQuality ID #46 (NQF 0097): Medication Reconciliation Post-Discharge National Quality Strategy Domain: Communication and Care Coordination
Quality ID #46 (NQF 0097): Medication Reconciliation Post-Discharge National Quality Strategy Domain: Communication and Care Coordination 2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY MEASURE TYPE:
More informationMEDS TO BEDS AND CARE MANAGEMENT MEDICATION ASSESSMENT TOOLKIT: FOR HOSPITAL TEAM AND PHARMACISTS
MEDS TO BEDS AND CARE MANAGEMENT MEDICATION ASSESSMENT TOOLKIT: FOR HOSPITAL TEAM AND PHARMACISTS Implementation Toolkit Last Updated: 02/2018 OneCity Health Services 199 Water Street, 31st Floor, New
More informationGuidance for Use of SNOMED CT in Transitions of Care Documentation. July 18, 2016
Guidance for Use of SNOMED CT in Transitions of Care Documentation July 18, 2016 Table of Contents 1. PURPOSE...3 2. OVERVIEW...3 3. DISCUSSION...5 3.1. STEPS FOR TRANSITION OF CARE...5 3.2. CODES USED
More informationSt. Michael s Hospital Medication Reconciliation Learning Package
St. Michael s Hospital Medication Reconciliation Learning Package What is Medication Reconciliation? A formal process which begins with obtaining a complete and accurate list of each patient s home medications
More informationNOTE: The first appearance of terms in bold in the body of this document (except titles) are defined terms please refer to the Definitions section.
TITLE MEDICATION ORDERS SCOPE Provincial APPROVAL AUTHORITY Clinical Operations Executive Committee SPONSOR Provincial Medication Management Committee PARENT DOCUMENT TITLE, TYPE AND NUMBER Not applicable
More informationPharmacological Therapy Practice Guidance Note Medicine Reconciliation on Admission to Hospital for Adults in all Clinical Areas within NTW V02
Pharmacological Therapy Practice Guidance Note Medicine Reconciliation on Admission to Hospital for Adults in all Clinical Areas within NTW V02 V02 issued Issue 1 May 11 Issue 2 Dec 11 Planned review May
More informationGetting Started Kit MEDICATION RECONCILIATION IN ACUTE CARE. Version 4. Reducing Harm Improving Healthcare Protecting Canadians.
Reducing Harm Improving Healthcare Protecting Canadians MEDICATION RECONCILIATION IN ACUTE CARE Getting Started Kit Version 4 Marc h 2017 w w w.patientsafetyinstitute.c a This Getting Started Kit has been
More informationCOMPASS Phase II Incident Analysis Report Prepared by ISMP CANADA February 2016
COMPASS Phase II Incident Analysis Report Prepared by ISMP CANADA February 2016 INTRODUCTION Incidents as part of COMPASS (Community Pharmacists Advancing Safety in Saskatchewan) Phase II reported by 87
More informationA Pharmacist Network for Integrated Medication Management in the Medical Home
A Pharmacist Network for Integrated Medication Management in the Medical Home Marie Smith, PharmD UConn School of Pharmacy Professor/Dept. Head Pharmacy Practice Asst. Dean, Practice and Public Policy
More informationMeasure #46 (NQF 0097): Medication Reconciliation Post-Discharge National Quality Strategy Domain: Communication and Care Coordination
Measure #46 (NQF 0097): Medication Reconciliation Post-Discharge National Quality Strategy Domain: Communication and Care Coordination 2017 OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS ONLY MEASURE TYPE: Process
More informationMedication Reconciliation with Pharmacy Technicians
Technician Education Day March 29, 2014 Jacksonville, FL Outline with Pharmacy Technicians Roma Merrick RPhT., CPhT. Pharmacy Technician Coordinator St. Vincent s Medical Center Southside Jacksonville,
More informationSafe Medication Assistance and Administration Policy
Safe Medication Assistance and Administration Policy It is the policy of New Challenges Inc. to provide safe medication setup, assistance and administration: When assigned responsibility in the person
More informationUniversity of Michigan Health System Program and Operations Analysis. Analysis of Problem Summary List and Medication Reconciliation Final Report
University of Michigan Health System Program and Operations Analysis Analysis of Problem Summary List and Medication Reconciliation Final Report To: John Clark, PharmD, MS, University of Michigan Health
More informationIMPROVING MEDICATION RECONCILIATION WITH STANDARDS
Presented by NCPDP and HIMSS for the Pharmacy Informatics Community IMPROVING MEDICATION RECONCILIATION WITH STANDARDS December 13, 2012 Keith Shuster, Manager, Acute Pharmacy Services, Norwalk Hospital
More informationThe Impact of CPOE and CDS on the Medication Use Process and Pharmacist Workflow
The Impact of CPOE and CDS on the Medication Use Process and Pharmacist Workflow Conflict of Interest Disclosure The speaker has no real or apparent conflicts of interest to report. Anne M. Bobb, R.Ph.,
More informationMedication Reconciliation for Older Adults Transitioning from. Long-Term Care to Home. Allison (Leverett) Kackman
Medication Reconciliation for Older Adults Transitioning from Long-Term Care to Home By Allison (Leverett) Kackman Washington State University Spokane. Riverpoint campus Ubrary P.O. Box 1495 Spokane, WA
More informationGuidelines for Psychotropic Medication Use in Children and Adolescents
Guidelines for Psychotropic Medication Use in Children and Adolescents Psychotropic Medication Advisory Committee Department of Children and Families State of Connecticut June 2014 1 Guidelines for Psychotropic
More informationMedication Reconciliation Review
The Medication Reconciliation Review tool provides step-by-step instructions for conducting a review of closed patient records to identify errors related to unreconciled medications. Organizations that
More informationNational Jewish Health Best Practices for Medication Reconciliation in a Respiratory Academic Medical Center
National Jewish Health Best Practices for Medication Reconciliation in a Respiratory Academic Medical Center Introduction/Background/History: Please include any relevant information that may be helpful
More informationMeasure #46 (NQF 0097): Medication Reconciliation Post-Discharge National Quality Strategy Domain: Communication and Care Coordination
Measure #46 (NQF 0097): Medication Reconciliation Post-Discharge National Quality Strategy Domain: Communication and Care Coordination 2017 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY MEASURE TYPE:
More informationGo! Guide: Medication Administration
Go! Guide: Medication Administration Introduction Medication administration is one of the most important aspects of safe patient care. The EHR assists health care professionals with safety by providing
More informationMedication Therapy Management
Medication Therapy Management Presented by Sylvia Saade, PharmD Ghada Khoury, Pharm D, BCACP Objectives Describe the components of medication therapy management (MTM) programs Discuss the needs of MTM
More informationObtaining the Best Possible Medication History (BPMH)
Obtaining the Best Possible Medication History (BPMH) What is a BPMH? A Best Possible Medication History is: A thorough comprehensive medication history, using a combination of sources to obtain and validate
More informationGetting Started Kit MEDICATION RECONCILIATION IN LONG-TERM CARE. Reducing Harm Improving Healthcare Protecting Canadians
Reducing Harm Improving Healthcare Protecting Canadians MEDICATION RECONCILIATION IN LONG-TERM CARE Getting Started Kit March 2012 www.saferhealthcarenow.ca Safer Healthcare Now! We invite you to join
More informationPolicy Statement Medication Order Legibility Medication orders will be written in a manner that provides a clearly legible prescription.
POLICY POLICY PURPOSE: The purpose of this policy is to provide a foundation for safe communication of medication and nutritional orders in-scope, thereby reducing the potential for preventable medication
More informationAvoiding Errors During Transitions of Care: Medication Reconciliation
in in Practice Avoiding Errors During Transitions of Care: Medication Reconciliation When medication errors occur, they often are the result of discrepancies in medication information during transitions
More informationUNIVERSITY OF WISCONSIN HOSPITAL AND CLINICS DEPARTMENT OF PHARMACY SCOPE OF PATIENT CARE SERVICES FY 2017 October 1 st, 2016
UNIVERSITY OF WISCONSIN HOSPITAL AND CLINICS DEPARTMENT OF PHARMACY SCOPE OF PATIENT CARE SERVICES FY 2017 October 1 st, 2016 Department Name: Department of Pharmacy Department Director: Steve Rough, MS,
More informationPatient-Centered Connected Care 2015 Recognition Program Overview. All materials 2016, National Committee for Quality Assurance
Patient-Centered Connected Care 2015 Recognition Program Overview All materials 2016, National Committee for Quality Assurance Learning Objectives Introduction to Patient-Centered Connected Care and Eligibility
More informationSafetyFirst Alert. Improving Prescription/Order Writing. Illegible handwriting
SafetyFirst Alert Massachusetts Coalition for the Prevention of Medical Errors January 2000 This issue of Safety First Alert is a publication of the Massachusetts Coalition for the Prevention of Medical
More informationIdentifying Errors: A Case for Medication Reconciliation Technicians
Organization: Solution Title: Calvert Memorial Hospital Identifying Errors: A Case for Medication Reconciliation Technicians Program/Project Description and Goals: What was the problem to be solved? To
More informationProviderReport. Managing complex care. Supporting member health.
ProviderReport Supporting member health Managing complex care Do you have patients whose conditions need complex, coordinated care they may not be able to facilitate on their own? A care manager may be
More informationPharmacy Technicians and Interns: Charting New Territory
Pharmacy Technicians and Interns: Charting New Territory Peter Dippel Pharm.D, BCPS Clinical Pharmacist II Baptist Health Medical Center NLR Objectives Understand what Pharmacist Extenders are and why
More informationAdopting Accountable Care An Implementation Guide for Physician Practices
Adopting Accountable Care An Implementation Guide for Physician Practices EXECUTIVE SUMMARY November 2014 A resource developed by the ACO Learning Network www.acolearningnetwork.org Executive Summary Our
More informationMedication Reconciliation
Medication Reconciliation Where are we now? Angie Powell, PharmD Director of Pharmacy Baxter Regional Medical Center Disclosures I, Angie Powell, have no relevant financial relationships to disclose. Learning
More informationSHRI GURU RAM RAI INSTITUTE OF TECHNOLOGY AND SCIENCE MEDICATION ERRORS
MEDICATION ERRORS Patients depend on health systems and health professionals to help them stay healthy. As a result, frequently patients receive drug therapy with the belief that these medications will
More informationPharmaceutical Services Report to Joint Conference Committee September 2010
Pharmaceutical Services Report to Joint Conference Committee September 21 Background: Pharmaceutical Services staffing has increased by 31 FTE from 26 due to program changes and to comply with regulatory
More informationAdmission Medication History and Reconciliation Documentation. Froedtert Hospital, Milwaukee WI
Overview of Medication History and Reconciliation Process 2 Overview of Icons Used in the Medication History 2 and Reconciliation Process The Admission Navigator 3 SureScripts Medication Reconciliation
More informationDisclosure. SwedishAmerican Hospital A Division of UW Health. Learning Objectives. Medication History. Medication History 2/2/2017
Disclosure Pharmacy Technician- Acquired Medication Histories in the ED: A Path to Higher Quality of Care David Huhtelin, PharmD Emergency Medicine Clinical Pharmacist SwedishAmerican Hospital A Division
More informationNURSING HOME MODULE THE ABACUS NURSING HOME MODULE IS CAPABLE OF PERFORMING MANY FUNCTIONS PERTINENT TO NURSING HOME APPLICATIONS.
NURSING HOME MODULE THE ABACUS NURSING HOME MODULE IS CAPABLE OF PERFORMING MANY FUNCTIONS PERTINENT TO NURSING HOME APPLICATIONS. For instance, you have the ability to produce a forwarded physician s
More informationMeaningful Use Hello Health v7 Guide for Eligible Professionals. Stage 2
Meaningful Use Hello Health v7 Guide for Eligible Professionals Stage 2 Table of Contents Introduction 3 Meaningful Use 3 Terminology 4 Computerized Provider Order Entry (CPOE) for Medication, Laboratory
More informationUnintentional Medication Discrepancies Technical Assistance Webinar October 16 17, 2017
Unintentional Medication Discrepancies Technical Assistance Webinar October 16 17, 2017 Jeffrey L. Schnipper, MD, MPH, FHM Director of Clinical Research, BWH Hospitalist Service Associate Physician, Division
More informationTopic 3B: Documentation Prep for NCQA Recognition Focus on Standards 3, 4, and 1F
Topic 3B: Documentation Prep for NCQA Recognition Focus on Standards 3, 4, and 1F Diane Altman Dautoff, MSW, EdD, Senior Consultant Heather Russo, Consultant January 2013 Welcome Introductions and Housekeeping
More informationHealth Home Flow Hypothetical Patient Scenario
Health Home Flow Hypothetical Patient Scenario Client Background: Soozie SoonerCare Soozie is a single female, age 42, 5'6" tall 215 pounds. She smokes 2 packs of cigarettes a day. At age 24, Soozie was
More informationMedication Reconciliation in Transitions of Care
Medication Reconciliation in Transitions of Care Jeff West, RN MPH June 18th, 2015 Adverse Drug Events & Readmissions For every 1,000 hospital admissions, medication reconciliation could prevent 14 adverse
More informationA Discussion of Medication Error Reduction Strategies
A Discussion of Medication Error Reduction Strategies By: Donald L. Sullivan, R.Ph., Ph.D. Program Number: 071067-011-01-H05 C.E.U.s: 0.1 Contact Hours: 1 hour Release Date: 4/1/11 Expiration Date: 4/1/14
More informationTips for PCMH Application Submission
Tips for PCMH Application Submission Remain calm. The certification process is not as complicated as it looks. You will probably find you are already doing many of the required processes, and these are
More informationPartnering with Pharmacists to Enhance Medication Management
Partnering with Pharmacists to Enhance Medication Management Tamara Ravn PharmD BCACP Staff Pharmacist Clinical Cancer Pharmacy Froedtert & The Medical College of Wisconsin April 6, 2016 Objectives Describe
More informationVNAA Blueprint for Excellence PATHWAY TO BEST PRACTICES
VNAA Blueprint for Excellence PATHWAY TO BEST PRACTICES Patient Safety: Medication Reconciliation and Management VNAA Best Practice for Hospice and Palliative Care Medication Reconciliation and Adherence
More informationMedication Reconciliation as a Patient Safety Practice During Transitions of Care
Medication Reconciliation as a Patient Safety Practice During Transitions of Care Janice L. Kwan, MD, MPH, FRCPC Division of General Internal Medicine Mount Sinai Hospital, University of Toronto Recorded
More informationMedication Safety Action Bundle Adverse Drug Events (ADE) All High-Risk Medication Safety
Medication Safety Action Bundle Adverse Drug Events (ADE) All High-Risk Medication Safety Background The Institute of medicine (IOM) estimates that 1.5 million preventable Adverse Drug Events (ADE) occur
More informationGetting Started with Medication Reconciliation in Long Term Care. SHN! MedRec Teleconference September 14, EST
Getting Started with Medication Reconciliation in Long Term Care SHN! MedRec Teleconference September 14, 2010 1200-1300 EST 1 Welcome! By the end of this teleconference, participants will: Understand
More informationMental Health Care and OpenVista
Medsphere Systems Corporation Mental and OpenVista Version 2.0 The OpenVista Platform: Integrated Support for Mental Designed by clinicians from all healthcare disciplines, OpenVista is guided by the principle
More informationMental Health Care and OpenVista
Medsphere Systems Corporation Mental and OpenVista Version 2.0 The OpenVista Platform: Integrated Support for Mental Designed by clinicians from all healthcare disciplines, OpenVista is guided by the principle
More informationMedication Management of Chronic Diseases in a Medical Home Model: CMS Medicaid Transformation Project
Medication Management of Chronic Diseases in a Medical Home Model: CMS Medicaid Transformation Project Marie Smith, PharmD University of Connecticut School of Pharmacy Marghie Giuliano, RPh, CAE CT Pharmacists
More informationMedication Adherence: Strategies for Improving Outcomes
Medication Adherence: Strategies for Improving Outcomes Thursday, June 16, 2016, 12:00 p.m. to 1:00 p.m. Andrea H. Williams, RPh, MBA President, RX CONSULTANTS LLC, Wilmington, DE EDUCATIONAL OBJECTIVES
More informationMedicines Reconciliation Policy
Medicines Reconciliation Policy Lead executive Medical Director Authors details Senior Clinical Pharmacy Technician - 01244 39 7494 Document level: Trustwide (TW) Code: MP19 Issue number: 3 Type of document
More informationHome Medication History in Horizon Health Summary (HHS)
Home Medication History in Horizon Health Summary (HHS) Medication history is longitudinal data which means it - Is retrievable (comes back) with each admission. Medications must be verified and confirmed,
More informationPharmacy Services. Division of Nursing Homes
Pharmacy Services Division of Nursing Homes 1 483.45 Pharmacy Services Overview The Pharmacy Services section of Appendix PP contains all Pharmacy Services requirements and interpretive guidelines (IG)
More informationMeaningful Use Hello Health v7 Guide for Eligible Professionals. Stage 1
Meaningful Use Hello Health v7 Guide for Eligible Professionals Stage 1 Table of Contents Introduction 3 Meaningful Use 3 Terminology 5 Computerized Provider Order Entry (CPOE) for Medication Orders [Core]
More informationMedication Reconciliation: Using Pharmacy Technicians to Improve Care. Becky Johnson, CPhT Megan Ohrlund, PharmD Steve Finch, RPh
Medication Reconciliation: Using Pharmacy Technicians to Improve Care Becky Johnson, CPhT Megan Ohrlund, PharmD Steve Finch, RPh Objectives Evaluate the medication reconciliation process and evidence for
More informationMedication Reconciliation: Using Pharmacy Technicians to Improve Care. Objectives THE BASICS AND USING TECHNICIANS 3/22/2017
Medication Reconciliation: Using Pharmacy Technicians to Improve Care Becky Johnson, CPhT Megan Ohrlund, PharmD Steve Finch, RPh Objectives Evaluate the medication reconciliation process and evidence for
More information2011 Electronic Prescribing Incentive Program
2011 Electronic Prescribing Incentive Program Hardship Codes In 2012, the physician fee schedule amount for covered professional services furnished by an eligible professional who is not a successful electronic
More informationGetting Started Kit MEDICATION RECONCILIATION IN LONG-TERM CARE. Version 3. Reducing Harm Improving Healthcare Protecting Canadians.
Reducing Harm Improving Healthcare Protecting Canadians MEDICATION RECONCILIATION IN LONG-TERM CARE Getting Started Kit Version 3 Marc h 2017 w w w.patientsafetyinstitute.c a This Getting Started Kit has
More informationBy: Jacqueline Kayler DeBrew, MSN, RN, CS, Beth E. Barba, PhD, RN, and Anita S. Tesh, EdD, RN
Assessing Medication Knowledge and Practices of Older Adults By: Jacqueline Kayler DeBrew, MSN, RN, CS, Beth E. Barba, PhD, RN, and Anita S. Tesh, EdD, RN DeBrew, J., Barba, B. E., & Tesh, A. S. (1998).
More informationMedication Control and Distribution. Minor/technical revision of existing policy. ± Major revision of existing policy Reaffirmation of existing policy
Name of Policy: Policy Number: 3364-133-17 Department: Pharmacy Approvingofficer: Chief Executive Officer THE unrversity OF TOLEDO MEDICAL CERITER Responsible Agent: Scope: Director of Pharmacy University
More informationEvaluation of Pharmacy Delivery Models
Evaluation of Pharmacy Delivery Models As Required By House Bill 1, 84th Legislature, Regular Session, 2015 (Article II, Health and Human Services Commission, Rider 83) Health and Human Services Commission
More informationPosition Statement. Enhanced Authorit y for the Pharmacist. Prescribe. Collaborative Practice Environments. September 2008
Saskatchewan College of Pharmacists Position Statement On Enhanced Authorit y for the Pharmacist To Prescribe Drugs In Collaborative Practice Environments September 2008 Executive Summary: The Saskatchewan
More informationUPDATE ON MEANINGFUL USE. HITECH Stimulus Act of 2009: CSC Point of View
HITECH Stimulus Act of 2009: CSC Point of View UPDATE ON MEANINGFUL USE Introduction The HITECH provisions of the American Recovery and Reinvestment Act of 2009 provide a commanding $36 billion dollars
More informationMedication Related Changes Phase 1&2
Medication Related Changes Phase 1&2 Medicare and Medicaid Programs Reform of Requirements for Long-Term Care Facilities Published January 23, 2017 Medication- Related Changes* Changes will be implemented
More informationSouth Staffordshire and Shropshire Healthcare NHS Foundation Trust
South Staffordshire and Shropshire Healthcare NHS Foundation Trust Document Version Control Document Type and Title: Authorised Document Folder: Policy for Medicines Reconciliation on Admission and on
More informationED Transfer Communication
ED Transfer Communication USING DATA TO DRIVE IMPROVEMENT! EDTC-4: Medication information June 16 th 2016 Presented By: Shanelle Van Dyke Agenda EDTC 4 Measure Overview Review of Data Results Discussion
More informationIMPROVING TRANSITIONS OF CARE IN POPULATION HEALTH
IMPROVING TRANSITIONS OF CARE IN POPULATION HEALTH TABLE OF CONTENTS 1. The Transitions Challenge 2. Impact of Care Transitions 3. Patient Insights from Project Boost 4. Identifying Patients 5. Improving
More informationAll Wales Multidisciplinary Medicines Reconciliation Policy
All Wales Multidisciplinary Medicines Reconciliation Policy June 2017 This document has been prepared by the Quality and Patient Safety Delivery Group of the All Wales Chief Pharmacists Group, with support
More informationAdvanced Practice Provider (APP): Nurse Practitioner (NP) or Physician s Assistant (PA).
GEORGIA DEPARTMENT OF JUVENILE JUSTICE Applicability: { } All DJJ Staff { } Administration { } Community Services {x} Secure Facilities (RYDC and YDC) Transmittal # 17-15 Policy # 11.26 Related Standards
More informationImproving Transitions to Home & Community- Based Care Settings
This presenter has nothing to disclose. Improving Transitions to Home & Community- Based Care Settings Eric Coleman September 29, 2015 Session Objectives Participants will be able to: Describe the role
More information