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Care Transitions for Medication Safety in the Community Care Transitions for Medication Safety in the Community

Care Transitions for Medication Safety in the Community - PowerPoint Presentation

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Care Transitions for Medication Safety in the Community - PPT Presentation

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

transitions care source medication care transitions medication source uams patients pharmacist patient statbriefs toc readmission south hcup reports family

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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?Slide6
Slide7

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 LineSlide14
Slide15

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 studentsSlide16
Slide17

Development of TOC ServiceSlide18

Key PlayersSlide19

UAMS readmission statsSlide20

PharmD Impact

statsSlide21

UAMS South TOC WorkflowSlide22
Slide23
Slide24
Slide25
Slide26
Slide27
Slide28
Slide29
Slide30
Slide31
Slide32
Slide33

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