Evaluation and optimization of a clinical pharmacist driven transitions of care model for malignant hematology
| Autor: | Jessica J Auten, Lucas S Wind, Jill S Bates, Benyam Muluneh, Thomas G. Knight, Matthew C. Foster, Leonardo Marucci, Crista J Creedle |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Patient Transfer Medication Systems Hospital medicine.medical_specialty MEDLINE Documentation Pharmacists Patient Care Planning 03 medical and health sciences Patient Admission 0302 clinical medicine Patient Education as Topic Internal medicine medicine Electronic Health Records Humans Pharmacology (medical) In patient 030212 general & internal medicine Intensive care medicine Retrospective Studies Insurance Health Hematology business.industry Communication Insurance Benefits Middle Aged Quality Improvement Clinical pharmacy Oncology Hematologic Neoplasms 030220 oncology & carcinogenesis Female business |
| Zdroj: | Journal of Oncology Pharmacy Practice. 27:283-287 |
| ISSN: | 1477-092X 1078-1552 |
| Popis: | Purpose To implement and optimize a pilot transitions of care model for scheduled chemotherapy admissions in patients with hematologic malignancies at our institution. Methodology: We utilized the plan-do-study-act (PDSA) quality improvement technique to prospectively measure success of interventions related to improving transitions of care processes that occurred in multiple stages including development of standardized operating procedures, electronic medical record documentation, and education to the malignant hematology multidisciplinary group. Chart review was performed retrospectively for at least nine patients per PDSA cycle. Areas of intervention addressed and measured regarding communication between the ambulatory care and acute care settings included: admission purpose, processes related to insurance benefits investigations for specialty medications required in the post-discharge setting, and plan for growth factors, prophylactic antimicrobials, and follow-up. Results and conclusions: We included 28 patients and performed a total of three PDSA cycles demonstrating specific improvements in: communication regarding status of benefits investigations performed for specialty medications prior to admission, resolution of these benefits investigations at various time points, improvement in efficient use of the electronic medical record for chemotherapy orders, and patient instructions for appropriate use of prophylactic antimicrobials. Although improvement was noted initially with prescribing of discharge antiemetics and antimicrobials, regression to baseline was noted with the third PDSA cycle. |
| Databáze: | OpenAIRE |
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