Transcript Document

PEARL Rx and WREN Partnership: Parallel
Surveys To Explore Potential Inter-Professional
Collaboration
Betty A. Chewning, PhD., FAPhA
David H. Kreling, RPh, PhD
David Hahn, MD, MS
2013 Wisconsin Health Improvement and Research Partnerships Forum
12 September 2013
Union South, University of Wisconsin - Madison
The current environment for outpatient care includes:
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focus on quality of care and outcomes
increasing time pressures on clinicians
increased complexity and medications in a central role
increased emphasis on inter-professional collaboration
Consequently, physicians and pharmacists are likely
partners for increasingly working together, especially
around patient medication management.
Objective:
To survey members of the Wisconsin Research Education
Network (WREN) and the Pharmacy Practice Enhancement
Action Research Link RX (PEARL Rx) to assess possibilities for
inter-professional collaboration around patient medication
management.
This survey is a product of the collaboration between the WREN
team and the PEARL team and respondents.
Acknowledgements
Lois Sater (PEARL RX)
Erin Leege (WREN)
Roberta Carrier, RPh
Methods:
Design: Parallel surveys for physicians and pharmacists
Samples: WREN and PEARL RX research network members
Administration: Email contacts; Qualtrics online survey platform
Survey:
1. Perceptions about a set of patient-care pharmacist activities
MDs: already have RPhs do, would like RPh to do, not interested
RPhs: already provide, would like to provide, not interested
2. Frequency of direct interaction about patient care
MD → RPh and RPh → MD
3. Preferred method of communicating
MD – “most preferred method”
RPh – “what method works best”
4. Interest in working on a joint project
5. Percent of patients for whom they get up-to-date medication
lists after transition home from hospitalization or NH care
Response Summary
PEARL RX (RPhs):
A total of 41 usable responses from 59 contacted (69.5%)
WREN (MDs):
83 MDs (out of ~300 contacted) accessed the survey;
Usable data for 63 respondents (21%);
Clinician Type: MD: 54, DO: 2, PA: 3, NP: 3, not stated:1
WREN Survey member: 43 yes (68%), 3 no (5%), 16 not sure (27%)
Response Summary – Geographic Dispersion (by County)
PEARL RX - RPh
Dane
12
La Crosse
9
Manitowoc
3
Milwaukee
3
(1) Brown, Dodge, Dunn,
Grant,
Green, Jackson, Rock,
Shawano, Walworth
Washington, Waupaca
Winnebago
WREN - MD
Dane
12
Milwaukee
10
Monroe
5
Juneau
5
Outgamie
3
(2) Barron, Dodge, Fond du Lac,
Rock, Sheboygan, Waukesha,
Wood
(1) Chippewa, Dunn, Eau Claire,
Grant, Kenosha, Marinette
Richland, Sauk, Trempeleau
Winnebago
90%
WREN (MDs)
Perceptions about
Pharmacist Services
80%
70%
60%
50%
40%
30%
20%
10%
0%
Med
Reconcil
Device Ed
Monitor Pt Med Afford
Status
Assist
Yes
Would Like
DailyDose
Orchestr
Optimiz Tx Pt Med ChkDecns
Up
Not Interested
90%
PEARL RX (RPhs)
80%
70%
60%
50%
40%
30%
20%
10%
0%
Med
Reconcil
Device Ed
Monitor Pt Med Afford
Status
Assist
Yes
Would Like
DailyDose
Orchestr
Not Interested
Optimiz Tx Pt Med ChkDecns
Up
40%
Pharmacist Contact Physician
35%
30%
25%
20%
15%
10%
5%
0%
MD
Daily
RPh
Weekly
Monthly
Annually
Never
WREN (MD): how often contact you about patient care issues beyond RX order information?
PEARL RX (RPh): not including to obtain RX orders, how often interact about care for their patients?
Physician Contact Pharmacist
50%
45%
40%
35%
30%
25%
20%
15%
10%
5%
0%
MD
Daily
RPh
Weekly
Monthly
Annually
Never
WREN (MD): how often interact for input and experience relevant to patients you care for?
PEARL RX (RPh): other than to provide RX info, how often contact you about their patients?
Preferred Method for Communicating
80%
70%
60%
50%
40%
30%
20%
10%
0%
FAX
Phone
Email
MD
Shared Elec
Face/In person
RPh
WREN (MD): most preferred method for communicating with pharmacists
PEARL RX (RPh): What methods work best for you to communicate (check all)
Interest in a Joint Project?
80%
70%
60%
50%
40%
30%
20%
10%
0%
Yes
No
MD
Possibly
RPh
Would you be interested at some point in working with physicians/pharmacists in your region
on a joint project?
Up-to-date Medication Lists after Transition Home from
Hospital or NH Care
40%
35%
30%
25%
20%
15%
10%
5%
0%
0%
<= 20%
21 - 40%
41 - 60%
MD
61 - 80%
81 - 99%
100%
RPh
For about what percent of your patients do you get up-to-date medication lists following a
transition home from hospitalization or nursing home care?
Conclusions
• Considerable interest was present from both groups for many
of the pharmacist services.
• Pharmacists more often reported daily or weekly interactions
about patient care issues – around half for both directions of
contact.
• ‘Traditional’ means of communicating (phone and FAX)
remain common; shared electronic records also used by
~25+% of both groups.
• A high proportion of both groups expressed interest in
potentially working on a joint project.
Implications – Moving Forward
• Interest in the services and in potentially working on a joint
project suggests doors may be open for enhanced
collaboration. However, for some, the extent of interaction
was low - an area for development and growth.
• Next steps?
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Begin exploring mutual studies. Key in on RFA opportunities,
identify prospect(s) for project idea or interventions involving
both groups (keying in on enhancing patient care, quality, and
outcomes).
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Explore geographic overlap for possible projects
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Devise means for growing network memberships in areas for
critical masses, perhaps via collaborative recruiting (WREN
clinics approach the pharmacists they work with to join Pearl-Rx
and vice versa)
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Others???
Questions/Suggestions/Ideas?