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Contribution of Hospital Pharmacy Residents to Resolution of Drug Therapy Problems for Patients: RES-DTP Study. Manish Khullar Richard Slavik Sean Gorman Nicole Bruchet Sarah Murray Brett Hamilton Dawn Dalen Victoria Slavik. Background.
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Contribution of Hospital Pharmacy Residents to Resolution of Drug Therapy Problems for Patients: RES-DTP Study Manish Khullar Richard Slavik Sean Gorman Nicole Bruchet Sarah Murray Brett Hamilton Dawn Dalen Victoria Slavik
Background • Priority disease states account for a significant number of ED visits, hospital admissions, prolonged lengths of stay and increased costs • RCTs have shown that pharmacists providing proactive, evidence-based activities to resolve DTPs for patients with priority disease states can improve the overall quality of drug therapy, and reduce ED visits, readmissions, costs
Background • To promote clinical pharmacist continuous professional development (CPD), disease state education modules (DSEMs) for priority disease states were implemented at IH in 2009 • DSEMs improve the knowledge, skills, abilities, competence, and confidence of pharmacists and improve accepted process of care measures (DTPs, DSEM DTPs and DSEM KPIs)
Background • Pharmacist-resolved DTPs is the primary clinical performance indicator at IH and part of the recommended bundle of Canadian clinical pharmacy key performance indicators (cpKPIs) • From Aug 1/2012 to July 31/2013, IH pharmacists resolved 27, 564 DTPs, of which 10, 911 (40%) were DSEM DTPs, and 7834 (28%) DSEM KPIs
Rationale • Providing evidence-based clinical activities and resolving DTPs is a major goal for professional development during the IH Pharmacy Practice Residency Program • Limited observational data and a systematic review suggest that U.S. entry to practice PharmD students and residents may contribute to “clinical activities” or “clinical interventions” during experiential rotations • There are no data on the contribution of Canadian pharmacy practice residents to clinical activities or resolved DTPs during their experiential rotations
Rationale • At IH, a recently completed study on perceived benefits and barriers to residency precepting identified discordance in the perception of resident contributions to DTP resolution • Current preceptors vs non-preceptors, and staff pharmacists vs managers were more likely to state that pharmacy residents contribute to DTP resolution for patients • There are currently no data on resolution of DTPs by IH pharmacy residents
Purpose and Objectives • Purpose: • To describe the contribution of hospital pharmacy residents to clinical pharmacy care using accepted process of care measures, and capture resident perceptions of DTP tracking • Primary Objective: • To determine the number of DTPs resolved by IH pharmacy residents
Secondary Objectives • To determine the number of DSEM DTPs resolved by IH pharmacy residents • To determine the number of KPIs resolved by IH pharmacy residents • To determine the number of DTPs, DSEM DTPs, and DSEM KPIs resolved by IH pharmacy residents over time • To collect focus group feedback on perceptions of DTP tracking from IH pharmacy residents
Significance • Will help quantify contribution of IH pharmacy residents to evidence-based clinical activities and resolved DTPs, and identify if training procedures need to be modified to promote real world contribution of IH pharmacy residents • Relevance to Canadian hospital pharmacy residency programs
Methods • Design • Prospective, observational, one group study to determine the contribution of hospital pharmacy residents to clinical process of care measures • Setting • Kelowna General Hospital (KGH), Royal Inland Hospital (RIH), Penticton Regional Hospital (PRH), East Kootenay Regional Hospital (EKH) and Kootenay Lake Hospital from July 29, 2013 to June 13, 2014
Methods • Inclusion Criteria • DTP Tracker data collated from all IH hospital pharmacy residents after the completion of the first 4 week patient care rotation (ie. Internal Medicine rotation) will be included • Exclusion Criteria • DTP Tracker data that is un-interpretable due to manipulation of standard pull-down field options, free text options, or incomplete entry of resolved DTPs will be excluded
Methods • Primary Outcomes: • Number of DTPs resolved by IH pharmacy residents • Secondary Outcomes: • Number of DSEM DTPs resolved by IH pharmacy residents • Number of DSEM DTPs and DSEM KPIs resolved by IH pharmacy residents • Number of DTPs, DSEM DTPs, and DSEM KPIs resolved by IH pharmacy residents over time • Focus group feedback on perceptions of DTP tracking from IH pharmacy residents