Patient Safety Content in the COP Curriculum

1. Patient Safety Content in the COP Curriculum

2. Medical Chemistry (Medicinal Chemistry Foundations I &II, Nucleotides, Pharmacodynamics (Physiological Basis of Disease I&II, Microbiological Basis for Therapy, Pharmacology, Pharmacological Basis of Therapeutics I&II) Pharmaceutics (Dosage Forms I&II, Dose Optimization I&II, Dosage Forms and Contemporary Practice, Clinical Biochemistry, Herbal Medicines) Pharmaceutical Outcomes and Policy (Quantitative Methods, Introduction to Pharmacy Health Care, Professional Communications, Evidence-based Pharmacy, Legal and Organizational Medicine Use, Pharmacoeconomics) Pharmacy Practice (Practicum I-IV, Drug Therapy Monitoring, Pharmacotherapy I-VI, Pharmaceutical Skills Lab I&II) Total: 146 credits (including 8 elective credits) COP Departments – Teaching Mission

3. Introduction to Pharmacists, Pharmaceuticals and the healthcare System • This course introduces the pharmacy student to the relationships of patients, pharmacists, and other health care professionals with the institutions that control medication use; tools and attitudes necessary to provide patient care; the concepts of health and illness, and patient behavior; legal issues of pharmacy practice; how health care systems, of which pharmacy is a part, seek to meet the goals of equitable access, reasonable cost, and high quality. These areas of knowledge are essential to understanding pharmacy practice, and will guide the student throughout their curriculum towards the goal of becoming a practicing pharmacist. • Delivery: Lectures, Text Book: McCarthy RL & Schafermeyer KW. (2007). Introduction to Health Care Delivery: A Primer for Pharmacists, Cases, Group Discussions • Assessment: Cases (group work, essay); Multiple-choice

4. Legal and Organizational Environment of Medicines Use • This course describes the governmental framework within which pharmacy is practiced. The legal and ethical basis of pharmacy practice is emphasized. Best pharmacy practices and managed care approaches are presented and discussed.

5. Evidence-based Pharmacy –Objectives Methods for evaluation and improvement of drug therapy outcomes including critical appraisal of drug and clinical service literature, and quality assessment and improvement techniques with special focus on patient and medication safety • Find and evaluate published medical literature for clinical decision-making, understand scientific reasoning and the research process • Describe how clinical findings are summarized in evidence reports • Describe current evidence on the assessment and improvement of patient safety, the epidemiology of medication errors & ADEs • Devise ways to assess the quality of pharmacotherapy in pharmacy practice and its effect on patient outcomes and health care cost. • Identify options for change in practice that are feasible and effective • Describe how to design, establish, and evaluate quality improvement programs.

6. EBP –Course Philosophy • IOM report on reinventing the healthcare system: • Consequent application of evidence to healthcare delivery • Full adoption of quality improvement through IT and systems that reward quality • Transition from individual to population-based care • Students don't appreciate patient safety issues • They don't feel responsible • Students love to be smart and to be drug experts

7. Course Structure • 4 campuses, 300+ students • Lectures (online; 3/week) • Discussion groups (6 groups, weekly, 2 hours, with polling tools) • Quizzes (weekly, online or via "clickers") • Midterm (4 hours, article critique) • Final project ( groups of 5, QI project, background paper, formal presentation with external judges)

8. EBP –course content • Critical literature appraisal will address the following issues • Introduction to evidence-based medicine • Retrieval methods for primary medical literature, drug references and other evidence sources • Methods for the critical literature appraisal • Study types and their relevance to study validity and application in practice • Interpretation of epidemiologic measures of frequency and risk • Threats to validity (confounding, bias, random error), hypothesis testing and scientific reasoning • Methods and resources for evidence summaries (meta-analysis, evidence reports, clinical guidelines)

9. EBP –content II • Quality assessment and improvement • Definitions and elements of quality; quality deficits in healthcare • Means to measure quality and current applications; selection of high-priority areas for QI • Methods to explore and explain variation in quality, benchmarking • Selection of QI strategies and plans for implementation & evaluation • Patient and drug safety • Review of drug safety information, methodological issues related to pharmacovigilance and post-marketing studies • Epidemiology of patient safety and medication errors, ascertainment and analysis of medication error data • Examples of medication safety initiatives

10. Interview and Data Entry Form • http://www.cop.ufl.edu/safezone/ned/formgen/5213b.htm • Patient demographics • Diabetes Outcomes (labs, complications, healthcare utilization) • Diabetes care (prevention, drug therapy, monitoring) • Diabetes-related quality of life • Diabetes Knowledge

14. Final Project • Problem statement • Selection of a QI target • Selection of process and outcomes measures • Selection / development of intervention • Study design, statistics • Study significance

15. Thus, there is a great capacity to reduce morbidity and morality with the use of ACE-I. Recall bias is unpredictable because there were 19 countries participating and it is hard to figure out whether there were cases more likely to think harder about whether exposed. The strength of an RCT is that subjects are human. “The control group received a fair fight.” “The authors of the study except of the two associated with Merck were well-positioned and educated.” “Randomization levels the playing field and blinding keeps the game fair.” Efficient use of highlighter Famous Student and Instructor Quotes Study subjects are human and random.” “Attrition was slightly similar.” All the authors appear well-positioned to conduct the study, but they were all from different countries and I wonder how well they were able to communicate with each other. “Attrition bias was minimized by adding more subjects to the study after drop out.” “The causal association is temporarily seen in the study.” “The bias renders the findings reconsiderable.” The dose in the placebo group was not mentioned.

16. almut@cop.ufl.edu