Transcript Document

Optimal Prescribing Update and
Support (OPUS)
Prototype Session 2
March 7, 2012
Session Opening
Dr. Keith White, MD
OPUS takes off and flies
Agenda
 Session Opening (15 min)
 Report out by Practices (75 min)
 Break (15 min)
 Feedback on Materials (30 min)
 Facilitation Skills (60 min)
 Lunch (60 min)
 Break out: Presentations Skills, MOA (60 min)
 Break (30 min)
 Training Video Discussion (30 min)
 Engagement Strategy (30 min)
 Evaluation (15 min)
 Closing Remarks (15 min)
3
Action Period Report Results
 “What’s In It For Me?” (WIIFM) ––> What was “it” for you?
4
Report Out by Practices
Out of 8 physicians who reported…
How Many Patients were Identified?
906 patients were identified
Statins
PPIs
Patient Lists
63
137
EMR
334
372
Total
397
509
7
# Patients on PPIs Identified
# Patients on Statins Identified
160
120
140
100
120
80
100
80
60
60
40
40
20
20
0
0
3
1
6
4
2
7
8
5
9
7
2
5
8
8
Action Period Activities
5 GPs reviewed patient charts before visit
4 GPs called in patients to discuss medications
4 GPs flagged charts to identify patients who
required medication reviews on next visit
Over half of patients were caught at their next
regular visit
9
What happened?
GPs had discussions about medication changes with 181 patients
PPIs
Statins
156
125
GPs changed medication in over 54 patients
PPIs
Statins
35+
19
GPs succeeded in tapering or stopping medications in over 45
patients
PPIs
Statins
26+
19
10
PPIs
100%
90%
80%
70%
2
60%
1
50%
7
40%
6
30%
5
20%
10%
0%
% who agreed to the change meds
after discussion w GP
% who where successful in tapering or
stopping
Statins
100%
90%
80%
70%
2
60%
6
50%
7
40%
5
30%
20%
10%
0%
% who Agreed to the Change
meds after Discussion w GP
% of Pts who Where Successful in
Tapering or Stopping
11
Table Discussions
 Give a brief overview of what you did in the action period:
› What went well?
› What did not?
› How did MOAs help?
› Suggestions for improvements for your colleagues?
 Summary Reports from tables:
› Top 2-3 highlights of the action period.
› Top 2-3 barriers.
› Most common MOA supporting roles.
› Suggestions for future action periods.
12
BREAK
(15 minutes)
Feedback on Materials
Discussion questions
 What worked well?
 What didn't work at all?
 What needs to be revised? How should it be revised?
 What is missing or what would make things make things run more
smoothly?
15
Facilitation Skills
Helen Roberts, Clippe Communications
[email protected]
604 788 9886
Purpose
 To help you feel comfortable as a facilitator
 To clarify the role of the pharmacy support
17
Principle #1: Engage them
 The earlier the better
 WIIFM - What's In It For Me
 Open ended questions
 Teaching attitude is different than teaching a skill !
18
Your Brain on Questions
19
Agenda
 Engage them with questions
 Review purpose and agenda
 Your role: Share your story – what you liked
 What’s in it for them
 Recap
20
Principle #2
 Tell them what you are going to tell them
 Then tell them
 Then tell them what you told them
21
Principle #3: You never need to have all the
answers
 Put questions back to the group
 Lean into your partner for help
22
Principle #4 and 5
 7 + 2 Chunk your information
 Attitudes are contagious
23
Break out sessions
 Presentation Skills – plenary
 MOAs – Beijing Room, Second Floor
24
LUNCH
(60 minutes)
BREAK
(15 minutes)
Training Video Discussion
Malcolm Maclure and Alan Cassels
http://www.web.uvic.ca/~studies/
Uses of Videos
 Recruit GPs
 Rehearse your presentation
 Replace or supplement Academic Detailer
 Reminders for Action Periods
 Additional drugs classes. e4PROS project.
29
Engagement Strategy
 “What’s In It For Me?”
 Special Authority Pre-Approval: other drug class?
 Other motivators to engage GPs
 e4PROS project: e-Education for Prescribing Review
 Enabling remote GPs to participate
 Option to extend OPUS to other drug classes
30
Evaluation
Marcus Hollander, PhD &
Helena Kadlec, PhD
March 7, 2012
Hollander Analytical Services Ltd.
308 -895 Fort Street
Victoria, BC V8W 1H7
Tel: (250) 384-2776
Fax: (250) 389-0105
E-Mail:
[email protected]
[email protected]
Our Evaluation Approach
(Adapted to the Quarterly Learning Session model)
Prototyping a PSP Learning Module
Session #1 Action Period
Everyone in
attendance:
Session #1 Survey
Session #2
Finalize
Module
Content
Everyone in
attendance:
Session #2 Survey
** TODAY **
Report to PSP
Report to PSP
Regional
Roll-out
Findings from Session 1
• Prototype Session 1 (Nov 2011)
 23 participants who completed the survey (11 GPs, 3 MOAs, 6
Academic Detailers, 3 PSP RSTs)
 response rate = 87%
• Make-up session (Jan 2012)
 8 participants completed the survey (7 GPs and 1 Pharmacist)
Number and Percentage of Participants Rating their
Understanding of Each Topic as “Very Good” or “Good”
Topic
Prototype
Session 1
Make-up
session
N
%
N
%
The overall aims of the OPUS learning session.
12/13
92.3
7/8
87.5
Information contained in an EQIP report.
12/13
92.3
4/6
66.7
Special Authority Pre-approval Agreement.
9/13
69.3
2/6
33.3
The model for improvement employed by PSP.
12/13
92.3
7/8
87.5
Your role in the OPUS initiative.
10/13
76.9
4/7
57.1
Your goals and expectations for the action period.
10/13
76.9
5/8
62.5
Your plans for change during the action period.
9/11
81.8
4/7
57.1
How to engage the local community pharmacist in patients’
care.
3/13
23.1
2/8
25.0
How the new information/handouts will be used in the GP’s
practice.
6/12
50.0
5/7
71.4
How you will self-audit charts during the action period.
9/13
69.2
4/7
57.1
How you will monitor changes during the action period.
11/13
84.6
4/8
50.0
Overall level of preparedness for the action period.
9/12
75.0
5/8
62.5
Number and % of GPs who Agreed or Strongly Agreed
Session 1
Make-up
(Nov 2011)
(Jan 2012)
8 (100%)
5 (62.5%)
1 (12.5%)
3 (100%)
1 (33.3%)
0
The discussion of the data limitation (as influenced by a GP’s
approach to MSP coding) was helpful to me.
9 (90.0%)
3 (75.0%)
My understanding of my prescribing patterns was improved by
attending the session.
7 (70.0%)
4 (80.0%)
After attending the session, I understand how I can improve my
patient lists
7 (70.0%)
4 (57.1%)
After attending the session, I feel more comfortable with collaborating with the community pharmacist in caring for my patients.
2 (20.0%)
1 (14.3%)
9 (90.0%)
10 (100%)
10 (100%)
4 (44.4%)
-7 (100%)
7 (100%)
--
The review of my personal EQIP portrait prior to the learning
session, was:
helpful to me. . . . . . . . . . . . . . . . . . . . .
surprising to me. . . . . . . . . . . . . . . . . .
uncomfortable for me . . . . . . . . . . . . . .
After attending the session, I feel more comfortable discussing
changes in prescriptions with my patients, with regard to:
a) Antihypertensives
b) Statins
c) Proton Pump Inhibitors
d) Anticoagulants
The Evaluation Today
• Please complete the survey at the
end of today’s session
• We appreciate your time and input
into this process
Closing Comments
Dr. Keith White, MD
38
Next Steps
 Presentation to GPSC of OPUS prototype results
 Data strategy approval
 e-Education for Prescribing Review & Online Support (e4PROS)
 Additional drugs classes may be explored
 Evaluation of the provincial OPUS
39