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Safety, Quality, and the Pharmacy Practice Model Initiative: Aligning for Success. Scott Knoer, M.S., Pharm.D. Chief Pharmacy Officer Cleveland Clinic. Objectives. - PowerPoint PPT Presentation
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Safety, Quality, and the Pharmacy Practice Model Initiative: Aligning for Success
Scott Knoer, M.S., Pharm.D.Chief Pharmacy Officer
Cleveland Clinic
Objectives
• Describe metrics and a process that can be used to measure the quality of change that occurred and ensure that a positive change has taken place
• Describe how organizations have implemented safety and quality principles in daily practice
A Case Study at the Cleveland Clinic
• Impacting metrics that count- HCAHPS medication scores- HF readmission reduction
Insured Payor Mix
53.2 53.1 52.8 52.5 52.6
68.2 71.2 74.2
46.8 46.9 47.5 47.4
31.8 28.8 25.847.2
52.547.5
0
10
20
30
40
50
60
70
80
2010 YTDJune
FC11 FC12 FC13 FC14 FC15 FC16
Governmental CommercialGovt. No Huron Coml. No Huron
Note: Based on gross charges. Excludes strategic projects in forecasted period.Detail
%
Exchange
-$96
-$118-$129
-160
-120
-80
-40
02014 2015 2016
Detail
$Millions
Projected Impact of Healthcare Reform
HCAHPS Scores
• Hospital Consumer Assessment of Healthcare Providers & Systems
• Measures patients’ perceptions of their hospital experience
• Tied to hospital reimbursement
Why Do HCAHPS Scores Count?
• Publically reported measures • Beginning this year, government
reimbursement is directly tied into HCAHPS Scores
• Underperformers will get less money
Medication Domain Questions
• Purpose of new medications explained • Side effects described • Medication Communication
- Composite score based on the percent of patients responding ‘Always’
HF Readmissions• Unplanned readmissions cost Medicare
$17.4 billion a year, and HF is the most frequent reason for rehospitalizations (Jencks et al., 2009).
• Reducing readmission rates has the potential to lead to significant cost savings
• You get paid less if you have high readmissions
http://www.medscape.com/viewarticle/722234
Ask 3, Teach 3
• Ask 3• Patients will be encouraged to "Ask 3"
so they understand the name, purpose and possible side effects of their medications
Ask 3, Teach 3
• Teach 3: System wide pharmacy competency- The name of the medication - Describe the purpose of the
medication - Explain possible side effects (Note:
It’s important to use the words possible side effects in the conversation)
Pharmacy HF Education
• Every Cleveland Clinic patient discharges with a primary diagnosis for HF receives discharge education from a pharmacist
• System competency
Bedside Delivery of Medications
• Bedside delivery option for discharge Rx for all HF patients- Tech driven literacy survey- iPad education pilots
Summary of Projects
• Patient Experience- Bedside discharge delivery- HF education- Ask 3, teach 3 education
Enterprise Medication HCAHPS Scores
Enterprise 30-Day HF Readmissions
Future
• Expand discharge delivery option to all patients- Leverage technology
• iPads•Portable credit card readers
• Expand RPh education to selected groups
• Manage the continuum
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Every Life Deserves World Class Care
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