Sean Patrick Nordt, MD, PharmD will discuss some of the newer specific therapies for the acutely poisoned patient. There will be case discussions followed by brief review of pharmacology and targeted antidotal therapies.
6/6/12
Drug Diversion: A Collaborative Process-Driven Approach
Steve Carlson, RPh, MHA and Andrew Corsaro will help attendees understand the prevalence of drug abuse in healthcare. They will review developing a drug diversion program and detecting drug diversion. They will provide helpful interviewing methodology and give an understanding of reporting requirements.
6/20/12
Outbreaks Associated with Unsafe Injection and Medication Practices -- and How We Can Prevent Them
Since 2007, multiple outbreaks associated with improper injection and medication handling practices have occurred in the United States. These breaches have resulted in the transmission of a variety of bacterial and viral pathogens and in patients developing viral hepatitis, meningitis, bloodstream infections, skin abscesses, and skin, soft tissue and joint infections. They have also resulted in the notification of tens of thousands of patients that they were possibly exposed to bloodborne pathogens, and the screening of thousands of patients for infection with hepatitis B and C viruses and HIV.
Although these events are preventable, why do they continue to occur? Kathleen Arias, MS, MT(ASCP), CIC will answer this question by identifying the unsafe injection and medication handling practices associated with disease transmission in these outbreaks; discuss recommendations for safe injection and medication handling practices developed by a variety of organizations; and identify resources that can be used to promote adherence to proper infection prevention protocols in our healthcare organizations.
5/16/12 -
NEW
Parenteral Nutrition in the Pediatric Patient
Hospitalized pediatric patients sometimes require nutrition support. Parenteral nutrition (PN), the delivery of nutrients into the circulatory system, is often used to maximize caloric intake while oral feedings or enteral feedings are established. Shamim Tejani, PharmD discussed the assessment and prescription of PN for the hospitalized pediatric patient.
5/9/12
Decreasing Costs in your Sterile Compounding Operation without Sacrificing Quality
There is a tremendous amount of pressure on pharmacy leadership to cut operating costs in their departments and many compliance elements of USP 797 are viewed as expensive and ripe for replacing or ripping out. Eric S. Kastango, MBA, RPh, FASHP provided actionable ideas that will improve the efficiency of your sterile compounding operation which will result in decreased costs without sacrificing quality.
A mistake-proofing device is any mechanism that either prevents a mistake from being made or makes the mistake obvious at a glance. The ability to find mistakes at a glance is essential because, as Shingo writes, "The causes of defects lie in worker errors, and defects are the results of neglecting those errors. It follows that mistakes will not turn into defects if worker errors are discovered and eliminated beforehand." Most mistake-proofing devices are physical objects which can be photographed.
Dr. John Grout has been researching, documenting and teaching Mistake-proofing for 20 years. Learn about this technique for eliminating defects, improving quality, and streamlining work. He discussed mistake-proofing within the specific context of health care, including lots of examples.
4/25/12
A Multidisciplinary Approach to Preventing Catheter Associated Urinary Tract Infections
The Indiana Heart Hospital in Indianapolis, Indiana decided to tackle Catheter Associated Urinary Tract Infections (CAUTIs) using multiple strategies. Establishing objective, straightforward criteria for insertion was one of the first steps of the journey. For years, hospitals nationwide have relied on urinary catheters as a habitual part of daily practice. The Indiana Heart Hospital leadership and staff spoke loudly and clearly that existing habits had to go and "catheter apathy" stops now.
Kelly Manning, RN, BSN, CIC reviewed their approach: The hospital formed a multidisciplinary CAUTI team, and then reclaimed and polished an old UTI Bundle formulated years earlier. Starting in the Intensive Care Unit and Emergency Department, specific plans set the course. Multiple strategies were implemented that led to heightened awareness of the seriousness of a catheter associated urinary tract infection, decreased catheter days and the frequency of catheter associated urinary tract infections.
4/18/12
Putting Pharmacogenomics into Practice Strategies for Successful Implementation
Leslie Mackowiak, RPh, MS briefly introduced pharmacogenomics and some standard terminology. She reviewed the experience of the pharmacists in supporting the practical application of pharmacogenomics into clinical practice using computer tools. This will involve describing the role of electronic health records and clinical decision support in facilitating drug management using pharmacogenomics. She identified strategies and techniques for pharmacists to lead the introduction of pharmacogenomics at their practice site.
Pharmacogenetic information is currently included in more than 200 drug labels in the United States and the field continues to grow rapidly. There has not been a commensurate effort to establish the resources, methods, and infrastructure, which would allow the translation of such evidence, representing a major obstacle in the application of testing.
Mackowiak described how Vanderbilt University Medical Center assembled a multidisciplinary, multidepartment team consisting of pathology, informatics, pharmacy, practicing clinicians, ethicists, and legal and regulatory administrators to oversee the implementation of pharmacogenetics.
4/11/12
Pharmacy Implications with Enteral Nutrition
Pharmacists must be knowledgeable about their patients' nutrition to provide complete care and maximize the efficacy and safety of concurrent medications. Many pharmacists are comfortable managing a patient's parenteral nutrition, but often are not involved in patient care relating to enteral nutrition, or "tube feeds." This includes the different components that constitute an enteral nutrition formulation, the interactions that may be present between enteral nutrition and pharmacotherapy, and managing side effects that arise from enteral nutrition.
Matthew Wanat, PharmD, BCPS provided a background on enteral nutrition for pharmacists, spoke about major drug-nutrition interactions and provided pharmacologic and non-pharmacologic interventions for managing side effects from enteral nutrition.
4/4/12
The Evidence Behind Extended-Infusion Piperacillin/Tazobactam
Bacteria are a common source of community- and hospital-acquired infections. Many bacteria are becoming increasingly resistant to current antimicrobial agents and this increase in resistance is outpacing discovery of novel antimicrobial agents. As a result, clinicians are challenged to make the best use of available antimicrobials to not only treat infections, but preserve the life-span of current agents.
Timothy Reilly, PharmD reviewed the current status of multi-drug resistant bacteria and the pharmacokinetic and pharmacodynamic principles that govern extended infusions of beta lactam antibiotics. He also described the available literature supporting the use of extended infusions of pipacillin/tazobactam and describe a community-based teaching hospital's experience with this treatment modality.
3/28/12
USP 797: The Infection Preventionist and Pharmacist as Partners in Medication Safety
Keith St. John, MS, CIC highlighted the infection control issues in sterile compounding pharmacy relative to USP Chapter 797 and their impact on medication safety.
Drug shortages have become one of the most serious, potentially life-threatening issues in health-system pharmacy practice. Today, the incidence of drug shortages has risen to critical levels, as of December 2011, there were over 250 documented shortages. To further compound the problem the shortage landscape is not expected to change for at least 3 years.
Shortages adversely affect drug therapy, compromise or delay treatment, and can even result in failure to properly treat disease and the consequent progression of disease. With so many current shortages--and new ones occurring daily--facilities with well-developed programs and active committees designed to address these issues are at a distinct advantage. Paul Arpino, PharmD, BCPS reviewed drug shortage programs, which should be designed to mitigate the impact of these events on patient care.
An Infection Control Risk Assessment is required by The Joint Commission (standard IC.01.03.01, EP 1 - 5). This assessment must include Geographic location, Community assessment, population served, care, treatment and services provided, analysis of surveillance activities, annual review and, prioritization. Patricia Keenan, RN, MSN, CPHQ, HACP provided information, tools and case studies to enable the practitioner to successfully navigate this standard.
3/7/12
Clinical Decision Support Options in a CPOE System
Clinical decision support is an essential feature in a CPOE system. Creating and maintaining the balance between ensuring patient safety, providing safe prescribing guidelines, while at the same time avoiding alert fatigue is a complex task. Lolita G. White, PharmD reviewed clinical decision support options and provide information needed to promote safe practices. An evaluation model for assessing and avoiding alert fatigue was also be presented.
2/29/12
Six Sigma and the GEMBA's Use in Prevention of HAIs
With the increasing emphasis on prevention of Healthcare-Associated Infections (HAIs), Infection Preventionists are being challenged to ensure evidence-based practice is at the bedside. Utilization of the Lean Six Sigma tools, specifically GEMBA, assists in understanding the delivery of healthcare at the patient level.
GEMBA has been utilized in the Manufacturing System prior to being introduced into healthcare. GEMBA allows one to "walk the process" to determine current state. The view is observed at the level of the healthcare worker and not from the 30,000-foot level. Kathy Ward, RN, MPH, CIC, described how using GEMBA can facilitate Infection Prevention at the staff level.
2/22/12
Quality in Compounding: QA, QC, CQI with USP and Practical Applications
The need for compounded products is increasing with personalized medicine. Ensuring the quality of a compounded preparation through verification includes: process, procedures and personnel. With continuous litigation and regulatory involvement it is necessary to have a quality assurance and quality control systems in place. This can help mitigate liability and ensure the overall safety of the patient by delivering accurate compounded preparations.
Thomas Kupiec, PhD reviewed the differences between quality control, quality assurance and continuous quality improvement; identified continuous quality improvement techniques that hospital pharmacists can use in their compounding processes; assessed the reasonable and appropriate quality control testing frequency based on specific compounding process; and gave examples of continuous quality improvement techniques for hospital pharmacies.
Michael Olesen looked at infectious diseases that are increasingly likely to require reporting or could pose a problem for managing them in the health care setting. He looked at diseases that are on our borders, that have been eradicated in the US but could easily come back, and some ecological conditions that could drive a higher prevalence of currently rare pathogens.
2/15/12
Top USP 797 Gaps: Results from the 2011 Compliance Survey
Eric S. Kastango, MBA, RPh, FASHP, and Kate Douglass, MS, RN, APN,C, CRNI, reviewed the findings from the first of its kind national survey of USP 797 compliance. Overall compliance scores for the hospital pharmacy industry were reviewed along with the top areas for improvement.
2/8/12
Measuring Medication Harm: Advantages of Using a Trigger Tool
Adverse drug events continue to be the single most frequent source of healthcare mishaps, continually placing patients at risk of injury. This is not unexpected, given that drug treatment is the most common medical intervention and medication use is a highly complex, multidisciplinary, and largely manual process. Assessing the actual safety of drug use has been historically difficult, mainly because traditional methods such as chart audits and voluntary reporting of data have been shown to be expensive, insensitive, and largely ineffective for detecting mistakes in drug administration and drug-related adverse clinical events (ADEs). Computerized methods for detecting ADEs -- employing sentinel words or "triggers" in a patient's medical records -- are effective but expensive and require customized software linkage to pharmacy databases.
Frank Federico, R.Ph showed participants how to use the Institute for Healthcare Improvement (IHI) ADE Trigger Tool to measure harm, collect data and use the information to direct improvement projects within a hospital.
2/1/12
Medication Safety - Everyone's Responsibility, No One's Priority
Medication errors are a significant problem across disciplines and practice settings in healthcare. Efforts to reduce medication errors have placed the greatest emphasis on system changes. Strategies include using technology, improving processes, identifying high-risk medications and establishing safe practices for them, and building a culture of safety.
Zahra Khudeira, PharmD, Medication Safety Manager of Sinai Health System in Chicago, discussed the medication use process and vulnerabilities that exist within the process. She offered some practical interventions that can improve patient safety. The goal of this webinar was to assist those hospitals without a medication safety pharmacist in providing an action list of tasks.
1/11/12
Best Practices in Applying Standardized Definitions for NHSN Reporting
The valid and reliable detection of HAIs allow for facility-based identification of increases in endemic infection rates, the recognition of adverse trends and the assessment of performance improvement initiatives.
The primary goal of data transparency is the advancement of patient safety through the reduction of HAIs. However, recent assessments of the quality of central-line associated bloodstream infection (CLABSI) data has revealed a high degree of variability in reported surveillance practices by Infection Preventionists (IPs), with underreporting of cases and misinterpretation of case definition criteria. These findings raise the question: how accurate is the data being reported?
Joan Hebden, RN, MS, CIC, reviewed efforts to define the best practices for surveillance through state validation studies, qualitative research and educational initiatives to assist IPs with the application of National Healthcare Safety Network (NHSN) criteria.
1/11/12
Establishing and Advancing Clinical Pharmacy Services in Community Hospitals
Misty Boachie, Pharmacy Clinical Coordinator at Henry Medical Center, discussed strategies for establishing clinical pharmacy programs and ensuring their continued success. At a time when all hospitals are experiencing a financial crunch, relatively small community hospitals are especially hard hit. Hear about approaches for developing clinical services with minimal impact to the bottom line. Topics included creative methods for covering clinical shifts, motivating pharmacists, and staff development. A timeline of Henry's own clinical evolution was presented along with specific examples of implementation techniques and ideas for continued growth and progress.
Henry Medical Center is a 215-bed, non-teaching community hospital located in Stockbridge, Georgia -- 20 miles south of Atlanta.
12/14/11
Effective Pharmacy Interactions with "The C-Suite"
Jim Jorgenson, Chief Pharmacy Officer and Vice President of Indiana University Health, provided the pharmacist with background information about the current healthcare environment, with an emphasis on how the hospital/health-system and priorities of the C-Suite are affected. The overall goal is to enable the pharmacist to gain knowledge and confidence in preparation to present to the C-Suite on topics affecting pharmacy and the medication use process. Specific case examples of presentations that worked and did not work were provided.
Darryl Rich, surveyor for The Joint Commission, presented a webinar that gave the participant an understanding of The Joint Commission's 2012 requirements for its medication management standards and medication-related National Patient Safety Goal requirements, discussed compliance issues found on past surveys, new requirements and current interpretations along with examples of best practices for meeting the requirements.
DISCLAIMER: Please note that this presentation is current
as of 11/16/11. The Joint Commission reserves the right to change the
content of the information as appropriate.
11/9/11
Reduction of IV Room Waste at St. Rita's Medical Center
At the beginning of 2010, St. Rita's Medical Center pharmacy was experiencing a loss of $10,000 to $12,000 monthly due to inefficiencies in some of the IV room processes. The annual impact of these inefficiencies equated to approximately $140,000 in avoidable cost to the organization. It was thought that this waste was attributed to many factors. Some of these factors included compounding medications too far in advance for patients scheduled doses, IV admixtures lost in transit to the units, high dollar medications being wasted for various reasons, and also having par levels set too high.
Nancy L. Rampe, PharmD, Pharmacy Department Supervisor at St. Rita's Medical Center, shared her team's experiences in making changes to policies and procedures needed in order to eliminate the wasted time, supplies and costs that were being incurred within the organization.
Mark Shigihara RPh, CMR, discussed the patient journey from the dual perspective of a healthcare provider and a patient. Pancreatic cancer is one of the most deadly cancers but Mark has battled it for more than four years with a maximum-blitz approach to integrative therapy. As November is Pancreatic Cancer Awareness Month, share his journey to gain a further appreciation of the challenges a patient faces and innovative therapeutic options. Woven into the presentation were inspirational insights which are impactful for anyone facing challenges.
10/26/11
Successes of a Clostridium difficile Infection (CDI) Reduction Team
Clostridium difficile is a challenging organism to treat and its associated pathogenicity leads to increased morbidity and mortality. A multidisciplinary quality team designated as the Clostridium difficile Infection (CDI) Reduction Team was initiated at Huntsville Hospital as part of the Antimicrobial Stewardship Program. The purpose of the CDI Reduction Team is to implement strategies referred to as the CDI Clinical Pathway to reduce the occurrence of Clostridium difficile associated diarrhea throughout the hospital and community. Edward Eiland, PharmD, MBA, BCPS (AQ-ID), will review Huntsville Hospital's implementation of a pathway that addresses microbiology lab diagnostics, isolation procedures, treatment recommendations, and monitoring parameters.
10/26/11
Developing a Business Case for Advancing Pharmacy Services
Times are tough, capital dollars are scarce. Pharmacy leaders are often challenged with limited resources and high performance expectations, and they struggle with effectively presenting ideas to senior leadership to obtain new resources to expand the services and contributions of the pharmacy department. You have identified a major initiative that you want your department to implement, but you aren't sure of the steps to make your vision become a reality, especially in light of the current economic realities of health-care. What do you need to hand your boss so that they quickly understand the cost/benefit of the program you want to implement? How do you create a tool that makes your item stand out in the request for capital or new personnel? Steve Rough, MS, RPh, walked through the major steps of a successful business proposal.
10/19/11
The 5 W's of Isolators and Complying with USP Chapter 797
Eric S. Kastango, MBA, RPh, FASHP, explored the 5 W's (what, where, who, when and why) in relation to the use of isolators and the necessary activities required to comply with the current USP Chapter 797. Topics included cleaning, environmental sampling, certification and the use of sterile gloves.
10/12/11
Practice Models and Efficiencies in Clinical Pharmacy Documentation
Robert Adamson, PharmD, discussed the benefits and limitations of the current pharmacy documentation platforms. He discussed the key elements to implementing a pharmacy documentation tool and described the integration of a documentation and surveillance program into a pharmacy practice model.
9/21/11
EHR Technology Certification for Hospitals: Complete and Modular Options
To be eligible for the CMS Medicare and Medicaid EHR Incentive Programs, a hospital must possess Certified EHR Technology complying with 100 percent of the government criteria. Bambi Rose, RHIT, of BLR Solutions, and Jim Tate of EMR Advocate, explored the importance of technology certification as well as the different paths to obtaining it. In addition, the process of readiness assessment and who should be on your core team was discussed.
9/14/11
CLABSI Prevention Strategies for the Pediatric Patient
Prevention of central line-associated bloodstream infection (CLABSI) in the pediatric population is unique and challenging. Brenda Vason, RN, BSN, CIC, provided information on prevention efforts and barriers relative to preventing CLABSIs in the medical, surgical and the pediatric ICU patient. She reviewed how to design a hospital-wide program to address these barriers, change culture, decrease and sustain line infection rates. Vason explained how team work; staff education and physician champions are keys to implementing a successful program.
Healthcare agencies need evidence-based guidance for pandemic preparedness, such as how to conduct surveillance, implement visitor, staff, and patient screening, and allocate limited resources. Terri Rebmann, PhD, RN, CIC, presented evidence-based best practices identified during past pandemics, including the 2009 H1N1 pandemic. Identification of best practices can be used to develop better pandemic plans for future events. Best practices that were covered by the webinar included biosurveillance, surge capacity, decontamination, isolation, quarantine, personal protective equipment, anti-infective therapy, vaccination, and crisis standards of care. Instructions were also provided on how to asses hospital or healthcare agency plans for pandemic preparedness.
Rebmann described the background/history on the impact of past pandemics and the potential future threat of pandemics, described emergency management planning issues related to infection prevention during pandemics and described how to assess hospital or healthcare agency plans for pandemic preparedness.
8/24/11
Accountable Care for Pharmacy Executives and Decision Makers
L. David Harlow III, RPh, highlighted new healthcare reimbursement models and how they will likely impact pharmacy in integrated health systems. He described the challenges faced by current pharmacy models and offer insights for viewing changes needed to meet the coming and current challenges. Special emphasis was placed on describing the ACO concept and its impact of C-suite discussions impacting pharmacy practice.
8/17/11
The Joint Commission Infection Control 2011 Update
The Joint Commission recently approved a new National Patient Safety Goal for 2012 that will focus on catheter-associated urinary tract infections (CAUTI) in hospital and critical access hospital accreditation programs. This webinar demonstrated how to design or enhance an infection control program that meets key infection control challenges and The Joint Commission IC standards. Louise Kuhny, Senior Associate Director of Standards Interpretation at The Joint Commission, presented information so that attendees will be able to design or enhance an effective infection control program that meets The Joint Commission IC standards, successfully comply with expanded NPSG 7 requirements and implement evidence-based best practices for preventing Nosocomial infections.
DISCLAIMER: Please note that this presentation is current as of 8/17/2011. The Joint
Commission reserves the right to change the content of the information as
appropriate.
8/16/11
Risk Evaluation and Mitigation Strategy (REMS)
This free webinar, sponsored by Facts & Comparisons®, will provide an overview of the Risk Evaluation and Mitigation Strategy (REMS), its potential impacts, and challenges associated with REMS. This webinar will benefit healthcare professionals across the continuum of care.
Catheter-associated urinary tract infection (CAUTI) is the most frequently occurring type of healthcare-associated infection (HAI) found in the hospital setting. Much attention has been focused on this topic, with the primary goal of preventing this type of infection from occurring. The Joint Commission has recently approved a 2012 safety goal to address CAUTI and the expectation is that hospitals and critical access hospitals will follow evidence-based guidelines in an effort to prevent them from occurring. Teal Jeffers, RN, MSN, provided an in-depth look at the prevalence of CAUTI and discussed the proven essential steps that should be taken to prevent them from occurring. The webinar addressed barriers to following procedures, and also explored solutions to overcoming these obstacles.
8/3/11
MDR Acinetobacter baumannii in the Short Term and Long Term Acute Care Setting
Multi-drug resistant Acinetobacter baumannii is a health care-associated pathogen that can live for months in both a wet and dry environment. The high prevalence of this organism in the hospital environment results in colonization of the skin and respiratory tract. Mortality due to MDR Acinetobacter baumaunnii can run as high as 80%.
Jackie Whitaker, RN, MS, LHCRM, CIC, reviewed a study of interventions used to reduce the incidence of Acinetobacter baumannii infection and colonization. Interventions included 10% hypochlorite disinfection, hand hygiene, special contact isolation for suspected and confirmed cases, an educational tool for clinicians, patient and visitors, daily isolation rounds, automated report functions, and standardized nursing unit isolation practices.
Learn how the tragic story of two-year old Emily Jerry's untimely death from a medication error in Ohio in 2006 has positively impacted the entire patient safety movement. Emily's father Christopher Jerry turned tragedy into triumph through the establishment of The Emily Jerry Foundation and the passage of "Emily's Law" in Ohio in 2009. Hear the compelling story of how Eric Cropp, the pharmacist involved in Emily's death, and Christopher Jerry have teamed up in Emily's honor in an effort to make medical facilities safer for everyone, especially our children!
7/20/11
Pharmacists' Role in Diabetes Care Management
Diabetes mellitus affects 25.8 million Americans and has an enormous impact on the United States health care system. Pharmacists are health professionals who can positively affect the care of persons with diabetes through self-management and medication education. Innovative pharmacist practices in diabetes management have improved clinical and economic health care outcomes.
Daphne Smith-Marsh, PharmD, reviewed clinical practice recommendations for diabetes management, discussed innovative and collaborative pharmacist practices in diabetes management and described the Certified Diabetes Educator (CDE) credential.
7/13/11
Who Says You're Competent to Compound CSPs? Evaluating Your Sterile Compounding Training and Competency Program
USP Chapter 797 calls for compounding personnel to be adequately skilled, educated, instructed, and trained to correctly perform and document a number of specific tasks. There are several resources that are being used, but are you using them effectively? How do you know if these resources are adequate in providing your staff with the necessary and accurate information to keep CSPs sterile and patients safe? Eric S. Kastango, MBA, RPh, FASHP, reviewed best practices and resources for sterile compounding training and competency.
6/29/11
Optimizing Core Measures Performance through Pharmacist-Driven Programs
Centers for Medicare and Medicaid Services (CMS) and The Joint Commissions worked together to align the measure specifications for the Quality Improvement Organizations (QIO). Now CMS link reimbursement to the hospital quality-of-care data.
Youbin Kim, PharmD and Sam Ho, PharmD, described various pharmacist-driven clinical programs at Riverside County Regional Medical Center that have enhanced the quality of patient care, improved CMS Core Measures, and provided safe use of medications with financial justifications.
6/22/11
Alert Fatigue with Drug-Drug Interaction Software: The Way Forward
Dr. Andrew Seger and Dr. John Horn discussed drug-drug interaction (DDI) alerting limitations and how it fails both patients and practitioners. They reviewed the results of studies evaluating DDI alerts and how they are received by practitioners. In addition, they presented information that will describe potential solutions to potentially improve the quality of DDI alerting. Common approaches to the problem of alert fatigue, including limiting the categories of alerts that trigger and database customization, were reviewed with emphasis on the advantages and limitations of each approach. From this presentation, attendees were able to describe how DDI alerting works from an informatics perspective and develop strategies to enhance the quality of DDI alerting locally.
6/1/11
Joint Commission National Patient Safety Goal 7: Prevention of Healthcare-Associated Infection
The Joint Commission partners with its accredited organizations to promote patient safety and quality in United States healthcare facilities. One of their key national priorities is the reduction, and even elimination, of healthcare-associated infections that contribute significantly to patient morbidity and mortality. The Joint Commission chooses a subset of standards, known as National Patient Safety Goals, to put a "spotlight" on such issues of national significance. National Patient Safety Goal 7 focuses on hand hygiene, multidrug-resistant organisms, central line-associated bloodstream infections and surgical site infections. Louise Kuhny, Senior Associate Director of Standards Interpretation at The Joint Commission, presented a webinar that will help accredited organizations better understand how surveyors will be evaluating compliance with NPSG 7, and provided insight into strategies for reducing these serious infections.
DISCLAIMER: Please note that this presentation is current as of 6/1/2011. The Joint
Commission reserves the right to change the content of the information as
appropriate.
The deadline for the Centers for Medicare and Medicaid (CMS) mandate to report
surgical site infections (SSI) to the National Healthcare Safety Network (NHSN)
is rapidly approaching. Tom Jordan, RN, BS, Director of Infection Prevention,
reviewed the basics of the SSI module in NHSN's Patient Safety Component.
This review included each aspect of the SSI reporting process as well as
NHSN's transition to using Standardized Infection Ratios (SIR).
5/18/11
Right Sizing HAI Prevention Measures for Critical Access Hospitals
Critical access hospitals (CAH) are rural acute care hospitals consisting of no more than fifteen acute care beds and ten swing beds if desired. Some of these facilities also have long term care facilities associated with them. These limited service hospitals and long term care centers play a critical role in providing healthcare services in rural and frontier communities. Resources for infection prevention and control are very limited in these settings. It is often times difficult to implement evidence-based national recommendations for prevention, control and surveillance activities due to lack of infection prevention expertise and resources. Bonnie Barnard, MPH, CIC, reviewed the obstacles faced by these facilities and presented ideas for "right sizing" national recommendations for this setting.
5/11/11
Medication Stock Challenges: What's a Pharmacy To Do?
Current medication recalls and shortages have caused practitioners to have to think about the "best drug available" rather than the "best drug to treat the disease." Medication stock shortages present significant risk to patients, as substitutions can lead to error and misuse. Denise Fields, PharmD, will share strategies and communication tools used at Decatur County Memorial Hospital.
5/4/11
Preventing Ventilator-Associated Pneumonia: A Six Year Experience
In this presentation, Coretha Weaver, RN, BSN, CIC, provided an overview of the progress made nationally with preventing ventilator-associated pneumonia (VAP) over the past six years. She discussed the initiation and progression of the VAP project at Erlanger Health System and the ongoing team approach they have established to keep the work moving forward. She discussed some of the successes, failures, and confounding issues the team has encountered over the past six years and their plans for the future to prevent VAP.
4/27/11
Clostridium difficile Infection: An Update on the Current State of Prevention
Clostridium difficile infection currently represents one of the most challenging issues in healthcare. Not only is the incidence of disease outpacing that caused by other multidrug resistant organisms, but the severity of disease is equally alarming. Emergence of Clostridium difficile infection is impacted by antibiotic therapy and may develop despite judicious use and antimicrobial management programs. This organism also poses tremendous environmental issues as C. difficile may survive on surfaces for months and routine hospital germicides are relatively ineffective. Ruth Carrico, PhD, RN, FSHEA, CIC, touched on the changing epidemiology of this disease, the current challenges presented to healthcare facilities, and some innovative approaches that may prove helpful as part of a comprehensive patient safety program.
4/20/11
The Joint Commission and Safe Injection Practices
During Joint Commission surveys in 2010, standards compliance related to the injectable and infusion medications remains one of the top issues. Darryl Rich Pharm.D., surveyor for the Joint Commission, discussed the standards related to the use of injectable and infusion medications as well as the Joint Commission requirements related to multidose vials, and the CDC safe injection practices guidelines. He discussed common reasons for non-compliance and strategies to address these common reasons.
DISCLAIMER: Please note that this presentation is current
as of 4/20/11. The Joint Commission reserves the right to change the
content of the information as appropriate.
4/13/11
What's "Bugging" You About USP 797 Environmental Sampling?
Since June 2008, the expanded USP Chapter 797 environmental sampling requirements have been in effect. It continues to be part of the chapter that generates lots of questions. Dr. Alice Weissfeld, PhD, D(ABMM), F(AAM) of Microbiology Specialists Inc., and Eric S. Kastango, MBA, RPh, FASHP, reviewed the Environmental Sampling requirements of USP Chapter 797 and answer your questions about air, surface and gloved fingertip sampling. They also shared their experiences with the issues and challenges in maintaining an effective and appropriate environmental sampling program.
Not since "prospective payment" has two words caused so much activity in
hospitals and health systems. Demonstrating "Meaningful Use" of health
information technology can mean millions of stimulus dollars for a health system
and even more once penalties kick in. Stage I of Meaningful Use preparation is
well on the way with many hospitals. Stage II and III will up the ante,
requiring even more input from pharmacy. John Poikonen, PharmD, outlined the
key elements of Meaningful Use, its opportunity for the medication use process
and the way pharmacists can have an impact.
3/30/11
Joint Commission Readiness for Infection Control
Brenda Helms, RN, BSN, MBA/HCM, CIC discussed preparing for a Joint Commission
survey, spending time on the risk assessment, evaluation and plan. Different
approaches to rounding will be discussed. She also went over the processes in
place that helped her facility to achieve a deficiency-free Joint Commission
survey. Helms also examined the importance of a culture of readiness and how
persistent readiness -- whether TJC is expected to show up or not -- can reduce
the stress related to a survey. She relayed some key elements that put
into place during the survey to help with the success of the survey.
Fred Massoomi, Pharm.D., FASHP, reviewed the laws and regulations governing
disposal of pharmaceutical waste, including hazardous drugs. Compliance with the
Joint Commission, USP 797 and government bodies were covered. Recent best
practice documents released by the EPA and some new proposed changes to the DEA
CSA were reviewed.
Antimicrobial stewardship is a system of policies and procedures coordinated
through a multidisciplinary approach. Its primary goal is to integrate evidence
based medicine and clinical practice to appropriately treat patients with
infectious diseases. As our delivery of healthcare in the 21st century evolves,
healthcare facilities are recognizing the need for stewardship programs to
optimize infectious disease treatment, improve patient outcomes, control cost,
and promote safety.
Amanda C. Hansen, PharmD examined implementing an antimicrobial stewardship
program (ASP). ASP development is challenging but the benefits are tangible as
evident in literature which describes decreases in healthcare associated
infection rates including a reduction in Clostridium difficile infections and
decreased bacterial resistance. Further, quality-improvement and safety data
demonstrate better outcomes associated with the timely and appropriate use of
empiric antimicrobials as a result of ASP practices.
In this webinar, Eileen O'Rouke, Infection Preventionist at Lankenau Medical
Center:
Described basic morphology of microorganisms:
- Gram stain: gram positive, gram negative; microscopic shape: cocci: pairs,
clusters, chains; rods; Acid fast
- Value of gram stain in directing treatment
- Media: enrichment, selective, differential
Reviewed methods of detection and sensitivity testing of organisms:
- Automated detection methods
- Kirby Bauer for additional sensitivity testing
- Extended spectrum Beta Lactamase -- ESBLs
- Turnaround time for test results
- Importance of proper specimen collection
- Colonization vs infection
Presented infectious disease case studies
- Utilize case studies to coordinate previous discussion: patient arrives,
cultures taken, results, interpretation
In this webinar, Ann Wittkowsky, Pharm.D., CACP, FASHP, FCCP, reviewed
epidemiology, pathophysiology and risk factors for stroke in patients with
atrial fibrillation. She evaluated the role of traditional and new
antithrombotic agents for stroke prevention in AF. Finally, she examined
development and management of patient-specific treatment plans for stroke
prevention in AF.
2/23/11
VAP Prevention - Making Rapid Change by Focusing on Key Targets
Nancy Landor, RN, MS, CPHQ, examined an initiative started by the Healthcare
Association of New York State (HANYS) focused on preventing
ventilator-associated pneumonia in critical care units. She reviewed the
goals set for the initiative, which required participating hospitals to use the
Center for Disease Control and Prevention National Healthcare Safety Network
(NHSN). Landor shared some best practices that resulted from the 50 New York
hospitals that took part in the collaborative.
2/16/11
Locking the Revolving Door of Readmissions: The Pharmacist's Role in Keeping
Patients Healthy, Happy and At Home
Hospitals' avoidable readmission rates have come under close scrutiny by payers
and policymakers because of the potential of high savings associated with them.
According to a recent study, unplanned readmissions cost Medicare $17.4 billion
in 2004. The study found that 20 percent of Medicare fee-for-service patients
were readmitted within 30 days of discharge. In addition to having financial
implications, avoidable readmissions are increasingly viewed as a quality issue
by payers, health care organizations, and patients, with some research showing
that readmission rates may be correlated with quality of care. Tackling the
issue of preventable readmissions will require improving care coordination
between inpatient and outpatient care providers, engaging and educating the
patient to manage their own care, expanding the use of technology to facilitate
patient identification, risk stratification and to support care processes. While
clearly a multidisciplinary effort, pharmacists can play important roles in
reducing readmissions via provision of medication education and chronic disease
management, medication reconciliation and ensuring use of evidence-based
therapies.
Steve Riddle, BS Pharm, BCPS, FASHP provided background information on the
current state of hospital readmissions in the U.S. and described common causes
for readmissions and the patient risk factors associated with these events. He
discussed the potential consequences of readmissions on performance
measurement and financial reimbursement for health-systems. Further, he described various solutions and successful programs that have reduced hospital
readmissions and discussed specific approaches involving pharmacist-supported care
processes that have impacted readmissions.
2/9/11
The New Oral Anticoagulants: Cause for Celebration or Concern?
New, oral anticoagulants present one of the biggest paradigm shifts that has
ever happened in the world of anticoagulation management. To assure the safe and
effective use of these medications, it is critical that practitioners understand
their pharmacokinetic and pharmacodynamic differences. Further, this knowledge
must be combined with a critical evaluation of clinical trials on which their
approval is or will be based. Finally, hospitals, integrated health systems, and
clinics will need to take significant and numerous actions to assure these
agents are used safely in a systematic fashion. Michael Gulseth, Pharm.D.,
BCPS, provideed the knowledge base required to begin taking these actions.
2/2/11
Creating Teams Who Play: A Collaborative Approach to Reducing Sepsis Mortality
Gita Patel, RPh, PharmD, and Nicki Roderman, RN, MSN, CCRN, discussed the
prevalence and pathophysiology of sepsis and describe the contents and
methodology of the implementation of a successful sepsis program at a community
hospital.
In the world of health-system pharmacy, there is constant concern over costs -
whether salary costs, drug costs or other related costs. This webinar gave an
example of how one hospital has approached the challenge of pharmacy expense
management, measurement and telling the pharmacy "story." Michael R. McDaniel, R.Ph., MBA, FASHP, Director of Pharmacy Services at
Hunstville Hospital, shared the story of rising drug and salary expenses and the
pathway of analysis that showed the facility that these trends were beneficial
to the organization rather than detrimental. These tools and tips can be used by
any pharmacy department to analyze their processes and finances and to prepare a
powerful story how what the pharmacy department contributes in their facility.
1/19/11
Watch Your Step: IV Room Flow with USP 797
This interactive webinar reviewed IV room flows in different
cleanroom
arrangements. Eric Kastango, MBA, RPh, FASHP, reviewed of when and
where to gown, where to walk, how to move components in and compounded sterile
preparations out. Bad/acceptable cleanroom behavior was
reviewed. Attendees were asked questions about process flow and observed behaviors.
12/29/10
From Intention to Outcome: Things You Can Do Tomorrow to Manage
What's On Your Mind Today As a result of active listening, Barbara L. Olson,
MS, RN, FISMP described how human vigilance contributes to positive outcomes in
highly reliable systems. She listed barriers, redundancies, and opportunities to detect and correct
errors as they relate to the medication use process. She describe how behavioral expectations, articulated in the National
Patient Safety Goals, add reliability to the work of
interdisciplinary teams and listed three ways "old data" can be used to shape new expectations.
12/16/10
Strategies to Reduce Hospital Pharmacy Claims Denials
Health systems continue to face declining reimbursement rates and increasing
regulations; therefore, they are constantly looking for ways to reduce costs and
improve revenue. Saint Barnabas Health Care System (SBHCS) recognized an
opportunity to effectively manage their pharmacy claims which reduced
unnecessary denials from federal and non-federal insurers. Ellen Fan, R.Ph. explained the steps taken to implement a pharmacy claims management program at
SBHCS. She also offered strategies to help reduce hospital drug denials and
increase reimbursement on medication-associated claims.
12/15/10
Gram Negative Resistance: The Gathering Storm
Emerging resistance in a variety of gram negative bacteria are making infections
due to these organisms increasingly difficult to treat. James Lewis, PharmD,
discussed current epidemiologic resistance trends in common gram negative
bacteria. In addition, potential options for the antibiotic management of
multidrug resistant gram negative organisms will be discussed.
12/1/10
Federally Mandated CLABSI and SSI Reporting to NHSN
On July 30, the Centers for Medicare and Medicaid Services (CMS) released its
final rule for the FY 2011 Hospital Inpatient Prospective Payment System (IPPS).
They have required for the first time that all Medicare-participating hospitals
report data on healthcare-associated infections (HAIs), specifically central
line-associated bloodstream infections (CLABSIs) and surgical site infections
(SSIs), through the Centers for Disease Control and Prevention (CDC)'s National
Healthcare Safety Network (NHSN).
Data collection begins January 1st, 2011. Will your hospital be ready? Hospitals
that do not submit CLABSI and SSI data will be subject to a reduction in their
Medicare Annual Payment Update starting in FY 2013. This data will also be
publicly reported on the CMS Hospital Compare Web site. For hospitals not
already participating in NHSN, the next few months are critical as they prepare
to collect and submit data. Tom Jordan, RN, BS, CIC provided information on
how to navigate within NHSN and to ensure compliance with this new requirement.
11/17/10
Rome Wasn't Built in a Day: Current and Future Challenges with
Medication Reconciliation
Michelle Thoma, RPh, PharmD, reviewed the current status of the Joint
Commission's National Patient Safety Goal for Medication Reconcilation,
provided recommendations for implementing medication reconciliation across
the continuum of care, and discussed results from recent projects which
measured the impact of computerized provider order entry on medication
reconciliation processes.
11/10/10
Positive Deviance: Another Tool for Infection Prevention
Most healthcare personnel respond that hand hygiene and standard precautions
are essential in preventing infection, however, observations of behavior
don't always match the expected actions. Positive deviance offers another
approach or tool to achieve sustainable behavior changes that can decrease
and prevent transmission of infection. Dottie Borton, Infection
Preventionist at Albert Einstein Healthcare Network, provided an
overview of positive deviance as well as some outcome examples of
implementation at one healthcare facility.
Chris George, RN, Project Manager of the Keystone Center for Patient Safety
& Quality, discussed the benefits of using checklists to improve
compliance with critical processes for safe patient care, what makes a good
checklist and how to implement a culture that supports the use of
checklists.
10/20/10
The Joint Commission Hospital Pharmacy Update for 2011
Darryl Rich, surveyor for The Joint Commission, helped attendees achieve
the following objectives:
List the three most problematic Medication Management standards in
terms of non-compliance by organizations surveyed in hospitals in 2010 and
the most common reason why each was scored non-compliant.
Cite the most problematic medication management issues related to
radiopharmaceuticals and nuclear medicines.
List two new changes to the Medication Management standards for 2011.
List the top three most problematic medication-related National
Patient Safety Goals' requirements for hospitals in 2010 including the
most common reasons for non-compliance.
Describe the new requirements for National Patient Safety Goals for
medication reconciliation in 2011 and how they differ from the previous
requirements.
DISCLAIMER: Please note that this presentation is current
as of 10/20/10. The Joint Commission reserves the right to change the
content of the information as appropriate
10/13/10
The Impact of Health Care Reform on Hospitals: Rising to the Occasion to
Improve Care
Health care reform has arrived via HR 3590, The Patient Protection and
Affordable Care Act. Numerous changes will be rolling out over the health
care landscape in the coming years. Key areas of focus include expansion of
hospital quality measures, increasing focus on hospital-acquired infections
and conditions, reducing hospital readmissions and incorporating patient
satisfaction as measured by the HCHAPS survey. For the first time, hospital
reimbursement by CMS will be tied to performance related to these
indicators. In addition, greater emphasis will be placed on coordination of
care both within the hospital and for care transitions related to
admissions, transfers and discharges.
Tom Jordan, RN, BS, CIC and Steve Riddle, BS Pharm, BCPS, FASHP, discussed the content of HR3590 and the demands it will place on hospitals.
Opportunities for infection preventionists and pharmacists to demonstrate
their value in driving quality improvement processes and improving patient
outcomes were shared.
10/7/10
10 Tips for a More Efficient USP 797 Compliant Cleanroom
This webinar was a holistic approach to examining key factors that
affect the operational efficiency of a 797 compliant sterile compounding
operation. Eric S. Kastango, RPh, MBA, FASHP, examined activities such
as forecasting, planning, staging and labeling.
09/22/10
The Seven Habits of Highly Effective Pharmacists
Ernie Anderson reviewed Stephen R. Covey's "The 7 Habits of Highly
Effective People" and applied the principles to leadership within
pharmacy.
This high level overview of the 7 Habits is geared toward
pharmacists at all
levels of practice. He focused on a holistic approach to balancing
all
aspects of life including work, family, professional and personal.
The webinar highlighted the personal victory of character habits that
comes
through pro-activity, vision and goals setting, and time management.
It then focused on the relational victory that comes through working
effectively
with people. Finally, Anderson examined four personal disciplines
that
allow growth and personal effectiveness.
09/15/10
Opportunities for Improving Core Measure Performance Through Pharmacist
Intervention
The 2009 Patient Protection and Affordable Care Act (H.R.3590) brings the
concept of pay-for-performance (P4P) into legislative reality. Impending
negative financial implications and increasing transparency of poor
performance will further drive hospitals and health-systems to focus on
quality and safety. Areas of emphasis include Core Measures, Hospital
Consumer Assessment of Healthcare Providers and Systems (HCAHPS), hospital
readmissions, and hospital-acquired conditions. Pharmacists can make
significant contributions to impact performance in each of these domains.
Darin Smith, PharmD, described key activities performed by
pharmacists
at Norman Regional that impact core measure performance.
Additionally, he provided an overview of other opportunities for the
pharmacist to impact
performance within the value based purchasing model.
09/08/10
The Joint Commission Infection Control 2010 Update
As of January 2010, The Joint Commission has issued three new National
Patient Safety Goals (NPSG 7) for infection control: multidrug-resistant
organisms, central line associated bloodstream and surgical site infections.
This webinar demonstrates how to design or enhance an infection control
program that meets key infection control challenges and The Joint Commission
IC standards.
Louise Kuhny, Senior Associate Director of Standards Interpretation at The
Joint Commission presented information so that attendees will be able to
design or enhance an effective infection control program that meets The
Joint Commission IC standards, successfully comply with expanded NPSG 7
requirements and implement evidence-based best practices for preventing
Nosocomial infections.
DISCLAIMER:
Please note that this presentation is current as of 9/8/10. The Joint
Commission reserves the right to change the content of the information as
appropriate.
Ernie Anderson, System Vice President of Caritas Christi Health Care System,
delivered a series of presentations on Leadership in
Pharmacy. Anderson exploreed
the concept of inside-out leadership - namely, all leadership starts with
the character of the individual. He will highlight the differences between
leadership and management as well as each person's individual ways of
thinking as unique. He will look at gender differences and assess the
complementary nature of a management team.
Drawing from several management books as references, Anderson highlighted
how managers and leaders influence others, persuade others and supervise
others. He encouraged leaders to write their own life plan and examine
the concept of emotional intelligence in order to improve leadership among
pharmacy departments.
08/25/10
Exploring the Implementation of NQF-Endorsed Safe Practice 18:
Pharmacist Leadership Structures and Systems
In this webinar, Dr. Hayley Burgess described national priorities for
medication safety including measures, standards and practices, focusing on
the NQF endorsed safe practice 18: Pharmacist Leadership Structures and
Systems. She discussed critical lessons to develop a focus on the
leadership journey and ability to influence safety initiatives through
execution, a sense of urgency and engagement of the team. She also
described implementation options and programs designed to meet national
patient safety objectives.
John R. Horn, Pharm.D., discussed the role of the cytochrome P450 system
in drug metabolism. Understanding the pathway of metabolism for an object
drug enables one to predict precipitant drugs that are likely to interact.
The risk of a potential drug interaction to an individual patient will
depend on many factors including genetics, doses of object and precipitant
drugs, underlying disease states, and route of drug administration.
Evidence defining the potential risk of a drug interaction is often limited.
Numerous factors can alter the outcome of drug interaction studies and these
factors need to be carefully controlled to obtain the best data possible.
Interactions with conflicting outcome data, including warfarin and
clopidogrel, was discussed to illustrate the factors that can alter the
study outcomes.
08/18/10
Precautions with MDROs: Shouldn't Standard Be the Standard?
The use of Standard versus Contact Precautions for patients with multi-drug
resistant organisms such as methicillin-resistant Staphylococcus aureus has
been widely debated over recent years. Recent data raise the question of the
risk versus the benefit of placing patients in isolation. As new multi-drug
resistant organisms continue to emerge, a facility-specific approach to
infection prevention that will encompass all organisms and all situations
should be considered.
Nancy Parris, RN, RHIA, MPH, CIC, CPHQ, provided a practical approach on
when and how to implement an isolation program emphasizing Standard
Precautions and minimizing the use of Contact Precautions in healthcare
facilities, including acute care, long-term care and out-patient settings.
Regulatory considerations, such as The Joint Commission and Centers for
Medicare and Medicaid, was discussed.
08/11/10
Using Data and Technology to Improve and Monitor Medication Turnaround
Times
Sam Calabrese, Director of Inpatient Pharmacy Services at The Cleveland
Clinic, reviewed the implementation of a medication tracking system to
identify bottlenecks within a medication distribution system. He reviewed
technology used to improve turnaround times by providing efficient
medication distribution and focused on a decentralized distribution model
using automated dispensing cabinets, carousel technology, and delivery
tracking by MedBoard.
08/11/10
New Research on Preventing Hospital Infection
Betsy McCaughey, Ph.D., former Lieutenant Governor of New York State
and
Chairman/Founder of the Committee to Reduce Infection Deaths (RID),
reviewed the latest research on healthcare-associated infections and
the
newest strategies to prevent them.
08/04/10
Understanding USP 71 Sterility Tests and Extended BUD
One of the most frequently asked questions recently asks how to extend the
Beyond-Use Date (BUD) of compounded sterile preparations (CSPs). Eric S.
Kastango, RPh, MBA, FASHP, reviewed the requirements of USP Chapter 797
necessary to complete in order to extend BUD. The use and limitation of
sterility tests according to USP 71 was reviewed, along with process
verification.
07/28/10
Sepsis Management: The Latest Evidence-Based Practice
What is the Surviving Sepsis Campaign (SSC) and why is it sweeping the
nation?
Sepsis is the body's response to infection. The forms of sepsis include
severe sepsis, which occurs when acute organ dysfunction or failure results
and septic shock, which occur in severe sepsis when the cardiovascular
system begins to fail, depriving vital organs of an adequate oxygenated
blood supply.
In 2004, the SSC guidelines were developed to improve the management,
diagnosis, and treatment of sepsis. The guidelines aim to reduce mortality
from sepsis via a multi-point strategy. In this webinar, Kirsten
Pyle-Springer, RN, CCRN, presented case reviews on handling sepsis.
06/30/10
Build Your Med Safety Pyramid: The Pharmacist s Role in Medication
Safety
The management of medications has become increasingly complex, and
opportunities for medication misadventures abound. The Institute of Medicine
estimates that a hospital patient is subject to at least one medication
error every day. Over 1.5 million preventable adverse drug events occur each
year, adding billions of dollars in hospital costs. Mishaps can be
devastating to patients and healthcare providers.
What can you do to stay out of the medication error headlines and stay in
line with initiatives to keep your patients safe from harm? Deb Saine, MS,
RPh, discussed roles of the pharmacist in improving medication safety,
with suggestions for getting started or moving your safety program forward.
Safety strategies were presented through sample work and case studies.
Healthcare costs, and particularly pharmacy costs, continue to increase each
year. Many factors are expected to impact national pharmaceutical
expenditures in the United States in 2010. These factors affect the
hospital, community, and clinic settings to different extents. Key
influences including drug development, comparative effectiveness research,
and the economic climate all play important roles. Fred Doloresco, PharmD,
MS focused on the effects that these influences have had on
pharmaceutical expenditures in the recent past and how they may affect
present and future expenditures. Trends in total healthcare expenditures
were discussed, as well as comparisons of several forecasts of national
pharmaceuticals.
06/02/10
The Joint Commission: Medication Storage Compliance Issues and Solutions
A to Z
MM.03.01.01, the standard related to medication storage, continues to be the
top Medication Management Standard where findings have been scored on Joint
Commission accreditation surveys in 2009, and #7 among all standards overall
with 33% of organizations surveyed receiving a finding in 2009.
Although compliance has improved over past years, it still presents a
challenge to many hospitals. Darryl S. Rich, Pharm.D., a Joint Commission
hospital surveyor, discussed the common reasons for non-compliance and
the common issues related to medication storage, along with examples of how
to achieve compliance and improve medication storage issues in your
hospital.
DISCLAIMER:
Please note that this presentation is current as of 6/2/10. The Joint
Commission reserves the right to change the content of the information as
appropriate.
05/26/10
The Building Wave of Pay-for-Performance: Is Your Practice Ready for the
Rising Tide?
The current United States' healthcare environment is in turmoil with
costs
rising and many concerns about the quality and safety of the care
provided.
The concept of value-based purchasing seeks to address these
problems by
asserting that buyers should hold providers of health care
accountable for
both cost and quality of care. Pay-for-performance (P4P), a type of
value-based purchasing, provides an incentive-based reimbursement
system
that rewards providers based on performance evaluated using
standardized
measures. P4P is already in use in managed care and in some
hospitals. This webinar with Steve Riddle, BS Pharm, BCPS, FASHP,
explored the basic premise of P4P, reviewed current P4P models and
discussed how pharmacists can best prepare for and participate in
this new
model.
05/19/10
Pediatric Pain Management and Medication Error Prevention
Pain in a pediatric patient can be a difficult issue to treat. While we know
that children feel pain just like adults, they do not always have the same
ability to describe to explain their pain. Infants that cannot talk will be
unable to tell their caregiver "where it hurts." Even older children, can
tell you that their stomach hurts, and point to their tummy, but they cannot
discern if the pain is truly from an upset stomach, an inflamed appendix, or
some other GI/GU issue. To add to the confusion of pediatric pain control,
parents often try to treat their children with over-the-counter medications,
and the labeling can be confusing. Many medication dosing errors occur due
to the packaging and varying concentrations of liquid medications that are
sold over the counter. When a patient is in the hospital, pain management
can be on a totally different level, with multiple dosage forms (PO, IV,
etc.) and administration techniques (epidurals, PCAs, etc).
This webinar with Tara Smith, PharmD, addressed the importance of managing pain in a child
accurately and effectively. It is one of the areas where a miscalculation in
dosing can lead to detrimental effects very quickly.
05/12/10
Beyond the Drug Budget: Documenting Pharmacy's Impact on Overall Health
System Costs
The impact pharmacists have in improving clinical outcomes and reducing drug
expenses has been well-documented and well-accepted. However, the greatest
impact of many pharmacy initiatives is seen in areas outside the actual
pharmacy budget. Through a series of case studies, the ability of strong
clinical pharmacy programs to impact the overall budget of health systems
was examined.
05/05/10
Hazardous Drugs: Managing them from Cradle to Grave
This webinar focused on the lifecycle of hazardous drugs as they are
stored, handled, compounded and properly disposed of in a manner that
protects personnel and the environment. Eric S. Kastango and Charlotte Smith
explained the difference between OSHA hazardous drugs and EPA hazardous
waste and addressed how current disposal practices may put organizations
at risk. Find out how common hazardous drug disposal practices have been
violating federal law for 30 years and why the EPA is finally taking action.
04/28/10
Documenting and Sharing the Benefits of a Clinically Strong Department
of Pharmacy
Michael R. McDaniel, R.Ph., MBA, FASHP, Director of
Pharmacy Services at
Huntsville Hospital, examined the importance of documentation for a
clinical pharmacy department. He shared tactics that can strengthen
clinical pharmacy including developing a strong clinical suite of services,
documenting the workload, recording the value of these services, using tools
to enhance productivity, and sharing the workload involved.
McDaniel showed how these practices culminate in a return on investment (ROI)
statement to see the cost-saving impact of the department's work.
04/14/10
Cloud Computing and Health Care: Facing the Future
Although cloud computing and software-as-a-service (SaaS) have been around
for quite some time, their use in health care has been limited. However,
recent encouragement by the U.S. government for health care systems to
provide integrated electronic information across the continuum of patients,
providers and health care systems has made some IT professionals eager to
investigate alternative computing models, such as cloud computing.
Concerns over migrating toward the cloud are understandable as questions
regarding security, control and usability have not been fully addressed.
However, the cloud computing model can provide health care organizations
with an efficient, scalable, economical, and user friendly system for data
storage and retrieval. Consideration of the cloud model is necessary at this
time secondary to decreased capital budgets, limited resources, the ever
increasing mobility of healthcare providers, and the need for integrated
health care data. This webinar introduced cloud computing as a feasible
model for health care as well as covered some of the pros and cons of moving
to the cloud.
This webinar examined the principles of DOWNTIME, an acronym for the
eight process wastes: Defects, Over-production, Waiting, Non-utilized
Resources/Talent, Transportation, Inventory, Motion, and Excess Processing.
These can be used to identify waste or non-value added activities as they
relate to medication order processing.
During this webinar, Eric showed how implementing Lean methodologies and
Six Sigma practices can streamline medication workflows and optimize clean
room practices.
03/17/10
How Pharmacies Can Win the War Between Talent
The War for Talent is a popular urban myth about corporations dealing with
a talent shortage that could damage companies survival. It has been used to
justify training programs, organization development interventions and
succession planning. But in the next decade, a new war will emerge: the War
Between Talent. This war will affect four areas: baby boomers vs.
Generation X/Generation Millennium, home country workers vs. outsourced
foreign workers, permanent vs. interim employees, and humans vs. robots.
Dr. Laurence J. Stybel, Executive in Residence at the Sawyer School of
Business at Suffolk University, addressed the implications of this war on
hospital pharmacies and gave specific recommendations on how facilities
can be successful in this transition period. Stybel answered how
individuals in pharmacy can best manage their careers, what new products and
services in the talent management field will be useful, and the emerging
standards for corporate leaders in managing talent.
03/03/10
Reducing the Risk of Patient Harm from Anticoagulation Therapy
Matthew Grissinger, RPh, FASCP, Director of Error Reporting Programs at the
Institute for Safe Medication Practices (ISMP), discussed barriers to optimal anticoagulation therapy
and safety, common types of errors that occur with anticoagulants, and how
human factors and practice issues can increase the risk of those errors
among physicians, health-system pharmacists, nurses and patients. An
overview of the key elements in medication systems and results from ISMP's
anticoagulation self-assessment was presented to lay the foundation for
in-depth discussion about the weaknesses in these key elements that lead to
errors with the use of anticoagulants. Error prevention strategies, including
improving order communication, storage, and administration of products, were covered.
02/17/10
Improving Nursing & Pharmacy Communication by Reducing Missing Meds
Charles McCluskey, Pharm.D., Director of Pharmacy Services at Riverside
Methodist Hospital, discussed his organization's success with tackling lost and
missing medications by collaborating closely with nursing leaders. The
implementation of a medication tracking system has shown missing medication
requests reduced from 150-175 per day to 90 per day, and $50,000 in gained
productivity for the hospital staff. Charles outlined how aggregated
data from tracking medication deliveries has allowed his team to address
questions on turnaround times for shifts, nursing units, medications and
personnel. Through robust reporting capabilities, Charles discussed
how he uses the data to quantify and demonstrate performance.
02/03/10
Clarifying Training Requirements of USP 797
A critical element of compliance to USP 797 involves training and
competency around sterile compounding. There are often questions about how
to ensure those who perform sterile compounding are trained to meet the
Chapter requirements. While each facility is different in terms of work
streams and processes, the underlying concepts around training and
competency are the same, and include several critical areas that should be
considered regardless of facility type.
During this webinar, Eric presented the rationale for the training
guidelines within the chapter, offered some practical advice on evaluating
current training activities, and discussed critical elements of any training
program.
1/20/10
Strategic and Operational Planning - The Execution
Do you struggle with how to get from good intentions to great outcomes?
Pfeffer and Sutton called it the Knowing-Doing Gap. I like to refer to it as
The Execution because that generally gets the team s attention! The old
proverb is still true that you just can t get there if you don t know where
you re going, but it doesn t end there.
Joyce A. Tipton talked about a systematic process for Strategic and
Operational Planning that is a defined year-long cycle that will help you to
determine where you should be going, how you are going to get there, who is
responsible, how you will measure it, and why do you do what you do in the
first place.
1/6/10
Surgical Site Infection due to MRSA: Facts, Fiction, and Frustration
A recent study by researchers at Duke University in North Carolina found
that a single patient infected with MRSA can cost a hospital $60,000.
Deverick Anderson, one of the study's authors, presented his
findings and
explored other related issues, including: The latest research on SSI
due to MRSA, including epidemiology, risk factors, and outcomes,
preventative
strategies for SSI, strategies to specifically prevent SSI due to
MRSA and
the controversies surrounding these strategies.
11/18/09
USP 797: De-mystifying Beyond-Use Dating
Determining beyond-use dating (BUD) continues to vex pharmacists and
technicians and is one of the most frequently asked questions of the
chapter. Historically, BUDs were assigned solely on chemical stability
data. USP Chapter 797 requires that both chemical stability and
microbial stability be factored when assigned BUD to CSPs.
In an effort to bring clarity to this criticality important aspect of
the USP chapter, Eric S. Kastango reviews beyond-use dating and the
requirements as they apply to USP 797.
11/11/09
Closing the Black Hole of Pharmacy with Medication Tracking
Charles presents his organization's success with recording and tracking
preparation and delivery activities of orders that has produced a 32%
reduction in lost and missing medications (i.e., preventable waste). Charles
outlines how his staff, and nursing, can monitor delivery times to
reduce calls to pharmacy and minimize lookup time. Charles also describes how
tracking medications enhances the workflow by queuing and prioritizing
orders to gain efficiency while reducing waste and re-work. Through robust
reporting capabilities, Charles will discuss how he can use the data
collected to quantify and demonstrate performance to administration and
nursing.
10/29/09
From 22% to 0% Pharmacist Turnover, How Benefis Health System Did It Dominick Caselnova from Benefis Health System describes their
multi-faceted approach to improving retention and recruitment. From
2000-2002, the turnover rate averaged 22% yearly. From 2003-2005 this
decreased to an average of 4.7% yearly. For the last two consecutive
years, the turnover rate has been 0%.
10/14/09
The Joint Commission Medication Management Update for Pharmacists Darryl S. Rich, Pharm.D., M.B.A., FASHP, Surveyor for The Joint
Commission, presents what pharmacists need to know going in to 2010:
- Medication management standards and medication-related NPSGs causing
the most trouble for pharmacies in the last year
- Successful strategies observed for compliance with the problematic
standards and medication-related NPSGs
- Compliance issues and strategies for NPSG 3E and revised NPSGs
for 2010 DISCLAIMER:
Please note that this presentation is current as of 10/14/09. The Joint
Commission reserves the right to change the content of the information as
appropriate.
9/23/09 Pharmacy Face-Off: BCMA vs. CPOE, Which Comes First?
John Poikonen takes on Steven Rough in our first "pharmacy face-off."
Pharmacists debate on Bar Code Medication Administration or Computerized
Physician Order Entry and which should be implemented first.
9/2/09
The Top 10 Gaps in USP 797 Compliance
Eric S. Kastango, MBA, RPh, FASHP, reviews the top 10 gaps that have
been personally observed or reported in surveys. In addition to identifying
these gaps, practical solutions and resources are offered to help remove
your roadblocks and then close your gaps.
8/26/09
Implementation and Measurement of a Standard Pharmacy Clinical Practice
Model Across a Multi-Hospital System
Steve Pickette, R.Ph., BCPS, Director System
Pharmacy Clinical Services
for Providence Health & Services, describes their health care delivery
system initiative to convert 27 hospitals to a standard
pharmacy clinical
practice model.
8/11/09
Infection Control and Antimicrobial Stewardship: Our Only Two Strategies
to Combat Antimicrobial Resistance
Robert P. Rapp, PharmD, FCCP, Professor Emeritus for the College of
Pharmacy and College of Medicine at the University of Kentucky, focuses on
ways that all healthcare professionals can improve both infection control
and antimicrobial stewardship.
7/28/09
Pediatric Medication Safety Across the Continuum of Care
Elora Hilmas, PharmD, BCPS, reviews medication safety challenges faced
by pediatric patients as they transition through inpatient and outpatient
care. Medication safety solutions are reviewed along with suggestions for
how pharmacists can promote medication safety for pediatric patients.
7/9/09
Projecting and Managing Future Drug Expenditures - 2009
Lee Vermeulen, Director of the Center for Drug Policy in the Department
of Pharmacy at the University of Wisconsin Hospital and Clinics, discusses
expenditure trends and a pharmaceutical expenditure forecast for 2009 along
with several examples of innovative cost-containment initiatives.
7/1/09
Identifying and Preventing Medication Errors Associated with Look-Alike
Drug Names
Matthew Grissinger, RPh, FISMP, FASCP, Director of Error Reporting
Programs for the Institute for Safe Medication Practices (ISMP) identifies
the factors that contribute to drug name similarity and confusion,
recognizes the areas in the medication-use process where drug names could be
confused, and discusses strategies to prevent errors associated with
look-alike drug names.
6/9/09
Use of Isolators in Compliance With USP 797
James T. Wagner of Controlled Environment Consulting breaks down the
components that make up a Compounding Aseptic Isolator in order to assess
applicability to your operation. The use of isolators may eliminate the need
for a cleanroom but it does not eliminate all facility requirements.
Specific facility requirements needed for installation of isolators will be
summarized. Field certification requirements will be described.
5/14/09
Cleanroom Compliance and USP 797: How Pharmacies are Tackling Tasks,
Documentation Logs, Competencies and More
This webinar features multiple hospital pharmacies showing examples of
how they are managing USP 797 sterile compounding and other non-sterile
routine pharmacy processes through the use of web-based software. Real-life
users of Simplifi 797 show how they tackle traditional and non-traditional
tasks both inside and outside of the cleanroom environment.
4/30/09
Getting Above the Radar: Funding Pharmacy Equipment or Programs
Michael R. McDaniel, R.Ph., MBA, FASHP, Director of
Pharmacy Services at
Huntsville Hospital focuses on some advice, tips, tactics and strategies
that a department of pharmacy can use to their advantage when seeking
funding for new capital projects, or other types of equipment or programs.
4/15/09
Medication Management and The Joint Commission: A 2009 Survey Experience
Jennifer Davis, Pharmacy Director at Exempla Lutheran Medical Center,
describes her recent Joint Commission survey experience in February 2009 and
identifies techniques that could assist hospital pharmacies during their
survey experience.
3/5/09
Seven Deadly Myths of USP Chapter 797
Eric S. Kastango, MBA, RPh, FASHP, covers the seven deadly myths
surrounding USP Chapter 797. The webinar also provides information on how to
achieve compliance and stay compliant.
2/17/09
Antimicrobial Stewardship Programs - A Necessity in 2009 for Managing
Antimicrobial Resistance in Health Systems
Debra A. Goff, PharmD, FCCP, Infectious Disease Specialist and
Co-director of the Antimicrobial Stewardship Program (ASP) at The Ohio State
University Medical Center, presents the challenges associated with
antimicrobial stewardship program implementation and examples of successful
multidisciplinary approaches to antimicrobial stewardship.
2/4/09
National Patient Safety Goal for Anticoagulation: Has Your Facility Met
the Standard?
Michael P. Gulseth, Pharm. D., BCPS, Program Director for
Anticoagulation Services at Sanford USD Medical Center provides an overview
of the 2009 National Patient Safety Goal and efforts to meet the goal. The
evidence to support the goal along with practical ideas of how to meet the
goal are presented.
10/15/08
Pharmacist Recruitment Strategies That Work
Damita Freeman Jones, Regional Pharmacy Recruitment Manager for The
Cleveland Clinic, will speak on how she was able to hire 30 pharmacists in
one year while retaining the health-system's existing personnel. She reviews
more than 10 traditional and non-traditional methods she used for recruiting
pharmacists and managers.
5/8/08
The Ins and Outs of a Clinical Rules Engine
Michael R. McDaniel, R.Ph., MBA, FASHP, Director of
Pharmacy Services at
Huntsville Hospital, speaks on his hospital's use of
pharmacy clinical rules
engines, from his home-grown PhRED system to future uses with new web-based
and built-in clinical systems. You will learn: the what and why of a
clinical rules engine, benefits and staff response, and uses/examples of
clinical rules.
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