February 26, 2015 These presenters have nothing to disclose IHI Expedition Expedition: Improving Medication Safety from the Patient’s Perspective Session 1: Improving Polypharmacy E. Robert Feroli Jr., PharmD, FASHP Amanda Brummel, PharmD, BCACP Frank Federico, RPh Joelle Baehrend
Today’s Host 2 Dorian Burks, Project Coordinator, Institute for Healthcare Improvement, is a current coordinator for web-based Expeditions. He also contributes to the IHI work in the Triple Aim and Improvement Capability focus areas, as well as the Leading Quality Improvement series. Dorian is a member of the Diversity and Inclusion Council at IHI, where he and fellow staff members develop strategies to enhance IHI’s inclusive culture, both internally and externally. Dorian graduated from Massachusetts Institute of Technology in Cambridge, MA where he received his Bachelor of Science degree in Biology and humanities concentration in Anthropology.
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8 By joining Passport, your entire staff gets access to a wide range of web-based tools to help prioritize, deploy, and accelerate your improvement initiatives without leaving your desks. Passport membership will: • Bring IHI's world-class expertise to your doorstep (virtually) and support multiple teams closest to the point of care as they make rapid improvements in the areas of greatest concern to hospitals today. • Help your staff meet its continuing education requirements for physicians, nurses, and pharmacists. • Give your middle managers the skills they need to guide your organization's efforts to improve patient care and achieve its strategic goals. • Save you time, set your teams up for success, and facilitate more effective use of your resources. For more information or to enroll, email Passport@ihi.org
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What is an Expedition? ex • pe • di • tion (noun) 1. an excursion, journey, or voyage made for some specific purpose 2. the group of persons engaged in such an activity 3. promptness or speed in accomplishing something
11 Expedition Director Joelle Baehrend, Fellowship Director, IHI, is also a developer for IHI’s Patient Safety Focus Area. She was previously a project manager for the 100,000 Lives Campaign and platform lead for the 5 Million Lives Campaign. Baehrend’s other work at IHI has included participation on IHI’s business team, product development, including the satellite broadcast of IHI’s National Forum on Quality Improvement in Health Care, as well as project management for the Improving Flow Through Acute Care Settings IMPACT Community. Baehrend received a Master of Arts in English literature from Indiana University of Pennsylvania in 1996 and served as adjunct faculty at Massasoit Community College before joining IHI in 2000.
12 Chat What is your goal for participating in this Expedition? Please send your message to All Participants 12
Today’s Agenda 13 Ground Rules & Introductions Pre- Survey Debrief Improving Polypharmacy Action Period Assignment IHI’s Model for Improvement
14 Ground Rules We learn from one another – “All teach, all learn” Why reinvent the wheel? - Steal shamelessly This is a transparent learning environment All ideas/feedback are welcome and encouraged!
15 Expedition Objectives At the conclusion of this Expedition, participants will be able to: Explain the importance of including patients and their families in efforts to improve medication safety Identify different approaches to improve medication safety Describe examples of medication safety improvement efforts at other organizations Plan tests of change to begin or continue medication safety improvement
16 Schedule of Calls Session 1 – Improving Polypharmacy Date: Thursday, February 26, 1:00 – 2:30 PM Eastern Time Session 2 – Health Literacy and Medication Safety Date: Thursday, March 12, 1:00 – 2:00 PM Eastern Time Session 3 – Improving Medication Adherence Date: Thursday, March 26, 1:00 – 2:00 PM Eastern Time Session 4 – Medication Reconciliation Date: Thursday, April 9, 1:00 – 2:00 PM Eastern Time Session 5 – Safe Management of Newly Released Anticoagulants and High-Alert Medications Date: Thursday, April 23, 1:00 – 2:00 PM Eastern Time
17 Pre-Work Assignment & Survey Results • Complete the IHI Open School Course QI 102: The Model For Improvement: Your Engine for Change • Complete the Expedition: Improving Medication Safety from the Patient’s Perspective Pre- Survey
18 Survey Results - Themes Top three barriers to improving medication safety: • Staff resources • Medication reconciliation (at transitions in levels of care; resolving discrepancies; identifying the most reliable list) • Cultural challenges; resistance to change Top two barriers to engaging patients in this work: • Patient education and health literacy • Time
19 Survey Results - Themes Points of pride in improving medication safety: Medication reconciliation form in patients’ admin records • • Unit based pharmacists Technology – computerized medication systems, smart • pumps CPOE, barcoding • Color coding for high risk medications What are you hoping to learn in this Expedition?: • General improvement ideas • More reliable processes for medication reconciliation • Ways to engage patients in improving medication safety • Learn from others doing this work
20 Survey Results - Current State My hospital has a process to address medication management and reduce polypharmacy where appropriate. • Do not know current status of this practice: 5% • Do not currently have this practice in place: 11% • Have a process that supports this practice: 47% • Process is reliably applied: 11% • Need further clarification on this practice: 26%
21 Faculty Frank Federico, RPh, Executive Director, Strategic Partners, Institute for Healthcare Improvement (IHI), works in the areas of patient safety, application of reliability principles in health care, preventing surgical complications, and improving perinatal care. He is faculty for the IHI Patient Safety Executive Training Program and co-chaired a number of Patient Safety Collaboratives. Prior to joining IHI, Mr. Federico was the Program Director of the Office Practice Evaluation Program and a Loss Prevention/Patient Safety Specialist at Risk Management Foundation of the Harvard Affiliated Institutions, and Director of Pharmacy at Children's Hospital, Boston. He has authored numerous patient safety articles, co-authored a book chapter in Achieving Safe and Reliable Healthcare: Strategies and Solutions, and is an Executive Producer of "First, Do No Harm, Part 2: T aking the Lead." Mr. Federico serves as Vice Chair of the National Coordinating Council for Medication Error Reporting and Prevention (NCC-MERP). He coaches teams and lectures extensively, nationally and internationally, on patient safety.
22 Improving Polypharmacy E. Robert Feroli and Amanda Brummel
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