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Safety, Quality, and the Pharmacy Practice Model Initiative: Aligning for Success. Scott Knoer, M.S., Pharm.D. Chief Pharmacy Officer Cleveland Clinic. Objectives.
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Safety, Quality, and the Pharmacy Practice Model Initiative: Aligning for Success Scott Knoer, M.S., Pharm.D. Chief Pharmacy Officer Cleveland Clinic
Objectives • Describe metrics and a process that can be used to measure the quality of change that occurred and ensure that a positive change has taken place • Describe how organizations have implemented safety and quality principles in daily practice
A Case Study at the Cleveland Clinic • Impacting metrics that count • HCAHPS medication scores • HF readmission reduction
Insured Payor Mix Exchange % Note: Based on gross charges. Excludes strategic projects in forecasted period. Detail
Projected Impact of Healthcare Reform $ Millions Detail
HCAHPS Scores • Hospital Consumer Assessment of Healthcare Providers & Systems • Measures patients’ perceptions of their hospital experience • Tied to hospital reimbursement
Why Do HCAHPS Scores Count? • Publically reported measures • Beginning this year, government reimbursement is directly tied into HCAHPS Scores • Underperformers will get less money
Medication Domain Questions • Purpose of new medications explained • Side effects described • Medication Communication • Composite score based on the percent of patients responding ‘Always’
HF Readmissions • Unplanned readmissions cost Medicare $17.4 billion a year, and HF is the most frequent reason for rehospitalizations (Jencks et al., 2009). • Reducing readmission rates has the potential to lead to significant cost savings • You get paid less if you have high readmissions http://www.medscape.com/viewarticle/722234
Ask 3, Teach 3 • Ask 3 • Patients will be encouraged to "Ask 3" so they understand the name, purpose and possible side effects of their medications
Ask 3, Teach 3 • Teach 3: System wide pharmacy competency • The name of the medication • Describe the purpose of the medication • Explain possible side effects (Note: It’s important to use the words possible side effects in the conversation)
Pharmacy HF Education • Every Cleveland Clinic patient discharges with a primary diagnosis for HF receives discharge education from a pharmacist • System competency
Bedside Delivery of Medications • Bedside delivery option for discharge Rx for all HF patients • Tech driven literacy survey • iPad education pilots
Summary of Projects • Patient Experience • Bedside discharge delivery • HF education • Ask 3, teach 3 education
Future • Expand discharge delivery option to all patients • Leverage technology • iPads • Portable credit card readers • Expand RPh education to selected groups • Manage the continuum
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