Lauren E Glaze PharmD Assistant Professor of Pharmacy Practice UAMS South Family Medical Center Objectives Define transitional care and its impact on healthcare outcomes and expenditures Describe the development of a Transitions of Care TOC service ID: 687450
Download Presentation The PPT/PDF document "Care Transitions for Medication Safety i..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Care Transitions for Medication Safety in the Community
Lauren E. Glaze,
PharmD
Assistant Professor of Pharmacy Practice
UAMS South Family Medical CenterSlide2
Objectives
Define transitional care and its impact on healthcare outcomes and expenditures
Describe the development of a Transitions of Care (TOC) service
Identify medication-related strategies to decrease hospital readmissions
Review examples of pharmacist-led interventions to enhance transitions of care in rural communitiesSlide3
Transitions of Care
“
The movement of patients between health care locations, providers, or different levels of care within the same location as their conditions and care needs change.”
-
National Transitions of Care Coalition, 2008
Source: Healthy Transitions Colorado, 2015.Slide4
Barriers to Successful Care Transitions
Multiple providers
Different EMRs
Medication discrepancies Poor communication
Lack of patient/family education Inadequate planning and goal settingSlide5
Why focus on care transitions?Slide6Slide7
2011 Readmission C
osts
$
41.3 billion
in hospital costs for 3.3 million adult 30-day readmissions
Medicare $4.3 billion
Medicaid $839 millionPrivate Insurance $785 million
Source:
Hines
AL, et al. 2014. http
://www.hcup-us.ahrq.gov/reports/statbriefs/sb172-Conditions-Readmissions-Payer.pdf.Slide8
Source
: New England Journal of
Medicine, 2009
Centers for Medicare & Medicaid, 2012Slide9
Source
: HCUP Statistical Briefs #153 and #154: http://www.hcup-us.ahrq.gov/reports/statbriefs/statbriefs.jsp Slide10
Source
: HCUP Statistical Briefs #153 and #154: http://www.hcup-us.ahrq.gov/reports/statbriefs/statbriefs.jsp Slide11
CMS Data
64% of Medicare patients received
no post-acute care between discharge
and readmission
76%
of readmissions may be preventableMedicare beneficiaries
report greater dissatisfaction in discharge-related care than any other aspect of care CMS measuresU.S. Department of Health & Human Services. New HHS Data Shows Major Strides Made in Patient Safety, Leading to Improved Care and Savings. May 7, 2014
.Slide12
Hospital Readmission Reduction Program (CMS)
YEAR
READMISSION DIAGNOSIS
PENALTY
2013*
Acute MI, CHF
2015
COPD, TKA, THA
2016
CABG surgery
2017
Aspiration pneumonia, sepsis
* CMS Transitional Care Billing introducedSlide13
The Bottom LineSlide14Slide15
Patient-Centered Medical Home (PCMH) and Rural Health Clinic (RHC)
7 counties in South
Arkansas
Adult Primary Care, Pediatrics, Senior Care, OB/GYN
Family Medicine faculty physicians, residents, and studentsSlide16Slide17
Development of TOC ServiceSlide18
Key PlayersSlide19
UAMS readmission statsSlide20
PharmD Impact
statsSlide21
UAMS South TOC WorkflowSlide22Slide23Slide24Slide25Slide26Slide27Slide28Slide29Slide30Slide31Slide32Slide33
Why Involve the Pharmacist?
Prevent medication errors
Address medication concerns
Avoid Adverse Drug Events
Provide medication counseling
Assess medication adherence and efficacySlide34
Pharmacist Interventions
Improper drug selection
Subtherapeutic
dosages
Supratherapeutic
dosagesMedication non-adherenceTherapeutic duplicationsTherapeutic omissions
Drug interactionsDrugs with no indicationsTreatment failuresSlide35
UAMS Outcomes
Completed ___ TOC services since September 2015 (___ weekly discharged patients)
Billed 14 Medicare patients
Billed Medicaid for ____ patients on EOY reportsSlide36
Clinical Outcomes
QI resultsSlide37
QI Group Benefits
ACT SouthwestSlide38
Partnership Feedback
Hospital
Home health
SNF/Assistant Living
Community pharmacistsSlide39
Patient Success StoriesSlide40
Future Endeavors
Discharge med rec sent to patient’s preferred pharmacy
Monthly adherence checks with community pharmacist and at subsequent PCP clinic visitsSlide41
Future EndeavorsSlide42
Future Endeavors
Expand to other South Arkansas Hospitals
Med rec at admission by inpatient pharmacist
“Meds
to
Beds” programFollow-up face to face visits in patient’s homeSlide43
Question
Which of the following is not a barrier to successful care transitions?
Different EMRs
Multiple providers
Medication discrepancies
Great communicationLack of patient educationSlide44
Questions?Slide45
TOC ResourcesSlide46
Care Transitions for Medication Safety in the Community
Lauren E. Glaze,
PharmD
Assistant Professor of Pharmacy Practice
UAMS South Family Medical Center