Transcript No Slide Title

S afe
M edication
Practice
Unit
State-wide adoption
of
a
Competency
Presentation title
Framework for Pharmaceutical
Review
Presenter
Coombes I, Coombes
J, Cardiff L,name
Bettenay K, Chuan F,
Stowasser D
Safe Medication Practice Unit, Queensland Health
“Welcome to the
hospital”,
“You have been
allocated the
general surgical
ward,
Off you go then !!!!!
Pharmaceutical Review Definition
[Health Ministers commitment 04/04]
A minimum standard of systematic appraisal of all
aspects of patients’ medication management within an
institution
Conducted (or supervised) by a qualified and suitably
trained health professional (ideally a pharmacist)
acting as part of a multidisciplinary team.
It includes objective review of medication prescribing,
dispensing, distribution, administration, monitoring of
outcomes and documentation of medication related
information in order to optimise the Quality Use of
Medicines.
Rate of pharmacy review - Site Comparison
N = Number of patients audited
How well
do your pharmacists perform?
Target = 100%
(Percentage patients “reviewed”)
100%
80%
60%
40%
20%
0%
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
Sites
Why develop and implement a
competency framework?
• Optimising individual practice and systems of
care
• Identify areas of unknown behaviour,
knowledge or skill to assist practitioner
development
• Identify training requirement’s for the workforce
• Put into operation national standards and
deliverables
Mapping Standards to Actions
APAC
Guidelines
Cont QUM
•Guiding
principle –
linked to
Pharmaceutical reform
QH Service
Capability
Framework
for
Pharmacy
Services
•ADRs
•History
•Review
•Evaluation
SHPA Clinical
Pharmacy
Standards
•8 Activities/
procedures
link to MAP
PSA/ Guild/
SHPA
Competency
Standards
•History
•Review
•Plan
•Provide
information
QH
Pharmaceutical
review Activities
Individual
behaviors –
combined to
competencies
•Patient
selection to
discharge
•Patient Care
•Problem
solving
•Professional
competencies
Competency Matrix for General Level
Clinical Practice
PERSONAL
Organisation,
Team working,
Communication,
Professionalism
Assertiveness
Initiative
Confidentiality
DELIVERY
OF
PATIENT
CARE
Drug
use
process
Drug history taking
Interaction identification
Patient counselling
PROBLEM
MANAGEMENT
Gathers information
Knowledge
Analyses Information
Provides information
Follows up and reflects
Assesses information
Provides - Accurate
relevant, Timely
20 in June 2007 now 27 sites utilise GLF, proposal for National GLF
Alw ays
Usually
Sometimes
Never
Missing
QH General Level Framew ork Baseline (n=165)
Pharmacists (165)
Patient History Consolidated scores
180
160
140
120
100
80
60
40
20
0
109
95
83
66
55
55
47
35
17
2 2
Opening
Consultation
Introduction
26
22
19
3
Opening
Consultation
Agenda
86
9
0
Questioning
Competency
3329
4 4
Patient
Consent
15
0
9
Allergy/ADR
Review
QH General Level Framew ork Baseline (n=165)
Alw ays
Communication Consolidated Scores
Usually
Pharmacists (165)
Sometimes
Never
180
160
140
120
100
80
60
40
20
0
Missing
85
84
83
72
61
59
55
55
52
45
34
20
1 0
Clear / Precise /
Appropriate
29
21
4
Involves Patient in
M ed M anagement
9
0
Prescribers
Competency
21
5
0
Nursing Staff
27
3 0
Other Health
Care Professionals
QH General Level Framew ork baseline (n=165)
Alw ays
Medicines Information and Patient Education
Usually
Pharmacists (165)
Sometimes
180
160
140
120
100
80
60
40
20
0
Never
Missing
101
75
72
63
46
55
49 45
33
26
14
4
Need Identified
8
4
0
Cultural / Social
Background
29
26
1
Accurate Information
Retrieved
Competency
7 2
Oral / Written
Information
Pharmacist feedback
n =154
(median score)
Fair
7
6
5
s
3
2
1 Unfair
Positive experience
7
6
5
4
3
2
1 Negative experience
Non-Taxing
7
6
5
4
3
2
1 Taxing
Was helpful to me
7
6
5
4
3
2
1 Was unhelpful
Fair reflection of what
7
I usually “do”
6
5
4
3
2
1 Unfair reflection
Useful
7
6
5
4
3
2
1 Useless
Evaluated my skills
7
6
5
4
3
2
1 Did not evaluate skills
Evaluated my
knowledge
7
6
5
4
3
2
1
Did not evaluate
knowledge
Evaluated my
attitudes
7
6
5
4
3
2
1
Did not evaluate
attitudes
Practical
7
6
5
4
3
2
1 Theoretical
Inspiring
7
6
5
4
3
2
1 Crushing
3
2
8
2
8
15
18
8
7
32
5
7
17 1
1
2
1
7
2
5
8
7
12
Conclusion
•
•
•
•
Acceptance
Practitioner development
Reflection of service delivery
Sustainability
• Progression