Transcript Bringing it Home - UWHC Perspective

Reflections on the PPMI Summit
and Using the Results to Drive Change
at UW Health
Steve Rough, RPh, MS
Director of Pharmacy
University of Wisconsin Hospital and Clinics
Summit Burning Platform Issues
 Pharmacists must move closer to patients
 We must embrace and expand the role of
pharmacy technicians
– Sterile products compounding can be delegated to well
trained technicians with well-documented procedures
 …and technology
 We must be accountable for patient outcomes
– Accountability versus Responsibility?
• Drug therapy management services for all patients
• Can’t provide “some services for some patients”
• Requirements of being accountable don’t mesh well with
the scheduling expectations of new practitioners and
many pharmacists with advanced residency training
Summit Burning Platform Issues
 Improving operational efficiency is paramount
 So is improving our financial acumen and
accountability
 Integration is key
– Need to define where pharmacists with specialized
training provide maximal value, but assure all
pharmacists provide a high level of care
 Must be more patient-focused, and less
physician- and pharmacist-focused
 Training, education and credentialing of our
workforce is very important
Overcoming Our Great Divides
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Clinical vs. Distributive
Practice vs. Academia
Leadership vs. Clinicians
Hospital vs. Community?
Perhaps we should get
the words “clinical” and
“specialist” out of our
vocabulary?
Pharmacy Practice Models
Model 1
(Drug-distribution
centered model)
Model 2
(Clinical pharmacist-centered model)
Model 3
(Patient-centered integrated model)
Model 4
(Comprehensive pharmacy services model)
Adopted from Pedersen CA, Schneider PJ, Scheckelhoff DJ. Survey of pharmacy practice in
hospital settings: Dispensing and administration-2008. Am J Health Syst Pharm. 2009;66:926-46.
What does this Mean for UW Hospital?
 We are doing a great job, high performing in
many areas
 But…change must continue to occur
 We likely won’t get more resources, so we must
learn to use existing staff and technology more
efficiently
Pharmacy Practice Model Summit
at UW Health
Focus of our May, 2011 Department
Strategic Planning Retreat
UW Health PPMI Retreat
 Pre-retreat:
– Education, awareness, engagement
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Pre-ASHP Summit letter from Director to staff
Inservice for staff after summit (invited my boss)
Pre-summit materials shared with staff and boss
Recommendations of summit shared with staff
 Made coordination/leadership of retreat a
resident class project
UW Health PPMI Retreat
 Retreat Preparation
– Electronic survey distributed to all pharmacists
• Input to prioritize opportunities to grow practice
• Elicited nominations for retreat participants
– Gap analysis: ASHP PPMI Recommendations
• Small group of managers and staff convened
• Assessed and analyzed for each recommendation:
– Extent of current implementation
– Importance to advancing our practice
– Participants announced
– Background readings will be distributed to all
participants
UW Health PPMI Retreat
 Day-long retreat on Friday, May 6th
– Currently planning the agenda
– At the new Union South, food and drinks throughout the
day, happy hour, etc
 Retreat Goal:
– To establish a 2015 UW Health vision for pharmacy
practice
– Discussion about mostly strategy, but some tactics
 Attendees
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11 pharmacy department managers
6 pharmacy department coordinators
15 frontline pharmacists
14 pharmacy residents
A few technicians
UW Health PPMI Retreat
 Anticipated retreat agenda/activities
– A motivating futuristic speaker?
– Overview of ASHP PPMI Summit
recommendations
– Review of our survey and gap analysis
findings
UW Health PPMI Retreat
 Anticipated retreat agenda/activities
– Series of breakout sessions and pearls
presentations
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Discussion of recommendations, gap analysis results
Pharmacist practice and role
Pharmacist education, training, and credentialing
Pharmacist publications, presentations, and research
Technician role, training, and credentialing
Resident practice, role, numbers and types
Automation and information technology
Areas with increased need of pharmacy services
Role of managers, supervisors, and coordinators and
those with specialized training
Steve’s Audacious PPMI Goals
for UW Health
 Advance our integrated pharmacist practice
model, while developing and maximizing
pharmacists’ competency and knowledge in areas
of specialty practice
 Better document the outcomes of pharmacist care
 Maximize decision support and prescriptive
authority
 Use technicians greater than ever before,
especially at transitions
 Ambulatory practice in clinics and procedure
areas is equal priority with inpatient practice
Steve’s Audacious PPMI Goals
for UW Health
 Resources to assist pharmacists with “how to”
advance research, education and project ideas
 When patients leave UW Hospital, they should be
talking about how the pharmacist (by name) made
a difference in their care
 Expand pharmacist skill in targeted specialty and
chronic disease therapeutic areas and become a
full service specialty pharmacy
 Develop programs to evaluate and improve the
skills of pharmacists in core areas: drug therapy
monitoring, enforcing guidelines, participating in
patient care rounds and patient teaching