Pharmacist discharge summary: Impact of inpatient to community pharmacist handoff at hospital discharge.

Background: Community pharmacists are often the initial health professionals whom patients encounter after hospital discharge but are rarely provided relevant discharge information.

Objectives: Implement a pharmacist-to-pharmacist discharge summary (P2PDS) to improve the safety of pharmacist care provision to patients transitioning home from the hospital.

Practice Description: Inpatient pharmacists at an academic medical center conduct discharge medication reconciliation and release discharge electronic prescriptions to dispensing pharmacies.

An altered microbiome in a Parkinson's disease model Drosophila melanogaster has a negative effect on development.

Parkinson's disease (PD) is the second most common neurodegenerative disease, besides Alzheimer's Disease, characterized by multiple symptoms, including the well-known motor dysfunctions. It is well-established that there are differences in the fecal microbiota composition between Parkinson's disease (PD) patients and control populations, but the mechanisms underlying these differences are not yet fully understood. To begin to close the gap between description and mechanism we studied the relationship between the microbiota and PD in a model organism, Drosophila melanogaster.

The high-value pharmacy enterprise framework: Advancing pharmacy practice in health systems through a consensus-based, strategic approach.

Purpose: The high-value pharmacy enterprise (HVPE) framework and constituent best practice consensus statements are presented, and the methods used to develop the framework's 8 domains are described.

Summary: A panel of pharmacy leaders used an evidence- and expert opinion-based approach to define core and aspirational elements of practice that should be established within contemporary health-system pharmacy enterprises by calendar year 2025. Eight domains of an HVPE were identified: Patient Care Services; Business Services; Ambulatory and Specialty Pharmacy Services; Inpatient Operations; Safety and Quality; Pharmacy Workforce; Information Technology, Data, and Information Management; and Leadership.

Primary care pharmacy technicians: Effect on pharmacist workload and patient access to clinical pharmacy services.

Purpose: Improve patient access to clinical pharmacy services and decrease pharmacist technical task workload in primary care (PC) clinics.

Summary: Due to concerns with the amount of technical tasks performed by University of Wisconsin Health PC clinical pharmacists negatively impacting their capacity to care for patients and perform clinical tasks, the pharmacy department piloted a new PC pharmacy technician role that involved completion of technical tasks previously performed by PC pharmacists. PC pharmacist daily technical and clinical activities were identified through shadowing and quantified by a 4-week period of work sampling.

Inpatient pharmacists' patient referrals to a transitions-of-care pharmacist: Evaluation of an automated referral process.

Objectives: To evaluate the impact of a pharmacist screening and automated referral process that identifies patients at risk for readmission due to medication-related problems (MRPs).

Setting: University of Wisconsin (UW) Hospital is 505-bed flagship hospital that is part of UW Health, an academic health system.

Practice Description: The integrated pharmacy practice model at UW Health has inpatient pharmacists who perform discharge medication reconciliation.

Prospective daily review of discharge medications by pharmacists: Effects on measures of safety and efficiency.

Purpose: Results of a pilot project to improve the safety and efficiency of the discharge process by adding daily pharmacist review and preparation of discharge medication orders to an existing discharge medication reconciliation workflow are reported.

Summary: Due to patient capacity issues, the pharmacy department of a large tertiary medical center implemented changes to the existing medication discharge workflow. A steering committee was established, with subgroups responsible for workflow development, electronic medical record enhancement, and data collection designated.

Refill-Based Medication Use Quality Measures in Kidney Transplant Recipients: Examination of Proportion of Days Covered and Medication Possession Ratio.

Background: The Pharmacy Quality Alliance's definition of proportion of days covered (PDC) and medication possession ratio (MPR) have not been examined as potential quality measures in the kidney transplant recipient population.

Objectives: To (a) describe the frequency distribution of MPR and PDC using mycophenolic acid products in a real-world kidney transplant recipient population and (b) evaluate associations between MPR and PDC with late (> 90 days after transplantation) biopsy-proven acute rejection (BPAR).

Methods: This was a retrospective cohort study combining data from the Wisconsin Allograft Recipient Database with University of Wisconsin (UW) Health Specialty Pharmacy prescription claims and dispensing data from March 10, 2006, to June 30, 2012.

Creation of a certification requirement for pharmacists in direct patient care roles.

Purpose: Steps taken by a large health system to require certification for all pharmacists in direct patient care roles are detailed.

Summary: Major supply chain changes and rising payer expectations are reshaping pharmacy practice, resulting in expanded responsibilities for pharmacists and a heightened need for certification in specialized practice areas. In response, the pharmacy leadership team at UW Health, the integrated health system of the University of Wisconsin-Madison, used an iterative process and a "rolling" FAQ format to develop and implement a certification requirement.

Critical Care Pharmacist Market Perceptions: Comparison of Critical Care Program Directors and Directors of Pharmacy.

While hospital beds continue to decline as patients previously treated as inpatients are stabilized in ambulatory settings, the number of critical care beds available in the United States continues to rise. Growth in pharmacy student graduation, postgraduate year 2 critical care (PGY2 CC) residency programs, and positions has also increased. There is a perception that the critical care trained pharmacist market is saturated, yet this has not been evaluated since the rise in pharmacy graduates and residency programs.

Improving medication information transfer between hospitals, skilled-nursing facilities, and long-term-care pharmacies for hospital discharge transitions of care: A targeted needs assessment using the Intervention Mapping framework.

Introduction: Patients transitioning from the hospital to a skilled nursing home (SNF) are susceptible to medication-related errors resulting from fragmented communication between facilities. Through continuous process improvement efforts at the hospital, a targeted needs assessment was performed to understand the extent of medication-related issues when patients transition from the hospital into a SNF, and the gaps between the hospital's discharge process, and the needs of the SNF and long-term care (LTC) pharmacy. We report on the development of a logic model that will be used to explore methods for minimizing patient care medication delays and errors while further improving handoff communication to SNF and LTC pharmacy staff.

Single-Dose Basiliximab Induction in Low-Risk Renal Transplant Recipients.

Objectives: To compare the efficacy of a single dose of basiliximab with two doses in preventing acute rejection in selected low-risk renal transplant recipients.

Methods: This observational study of 760 kidney transplant recipients considered to be at low immunologic risk (peak panel reactive antibody less than 10%) compared patient and graft outcomes following a single-dose versus a two-dose regimen of basiliximab.

Main Results: No differences were found in patient survival (92% vs 92%, p=0.

Antithymocyte globulin is associated with a lower incidence of de novo donor-specific antibodies in moderately sensitized renal transplant recipients.

Background: Recent evidence suggests that de novo donor-specific antibodies (dnDSA) are associated with antibody-mediated rejection (ABMR) and graft failure after kidney transplantation. The effects of induction immunosuppression on dnDSA are unknown.

Methods: The study population comprised 114 consecutive moderately sensitized (positive DSA and negative flow crossmatch) recipients who received deceased donor renal transplants between December 2009 and November 2011.

Peripheral administration of antithymocyte globulins: a review of current literature.

Antithymocyte globulin (ATG) preparations are purified gamma-immune globulin products used for the prevention and treatment of transplant organ rejection. Manufacturer labeling recommends administration of the currently available ATG preparations (rabbit antithymocyte globulin and equine antithymocyte globulin) via a high-flow vein; typically this is achieved through a central line. The necessity of maintaining central-line access may delay or prevent the administration of these products and place patients at increased risk of morbidity.