Development and implementation of autoverification standardization in the adult and pediatric emergency department.

Disclaimer: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

Transforming Health Care from Volume to Value: Targeting Essential Therapies for Improved Health.

The healthcare landscape is evolving rapidly due to escalating costs from the traditional fee-for-service model. Value-based care has emerged as a viable solution, and initiatives focus on areas prone to overuse, waste, or high costs, such as advanced imaging and avoidable acute care resource utilization. Improving medication use is an important component of this work, and it requires organizational commitment, interdisciplinary collaboration, and targeted strategies for specific therapeutic areas.

Multimodal Intervention Assessing the Appropriateness of Acid Suppression Therapy is Associated With Reduced Prescriptions at the Time of Discharge for Hospitalized Inpatients.

Background: Acid suppression therapy (AST), including proton pump inhibitors and histamine 2 receptor antagonists, are an overused class of medications. When used inappropriately, AST leads to polypharmacy, increased healthcare costs, and possible negative health consequences.

Objective: To assess whether an intervention including prescriber education combined with a pharmacist-driven protocol was effective in reducing the percentage of patients who were discharged with inappropriate AST.

Establishing the Content Validity of a Student Pharmacist Patient Counseling Competency Assessment in Oncology.

The goal of this project was to establish content validity and describe internal consistency of a patient counseling competency assessment instrument used to evaluate student pharmacists practicing in an oncology setting. The study involved a modified e-Delphi panel of oncology clinical pharmacy specialists, clinical pharmacy generalists, and oncology pharmacy residents. Iterative rounds of the e-Delphi process were conducted until consensus was reached on most instrument items.

Ensuring safe and optimal medication use in older community residents: Collaboration between a nurse and a pharmacist.

The purpose of this retrospective review is to describe 1) a nurse-pharmacist collaboration within a home based nurse-occupational therapist-handyman program called CAPABLE and 2) potential medication problems and 3) information communicated to participants and prescribers about those problems. A chart review was performed for each participant that one CAPABLE nurse referred to the pharmacists. We identified recommendations provided by pharmacists, synthesized common questions posed to the pharmacists' and developed exemplar cases of participant encounters.

Expansion of inpatient clinical pharmacy services through reallocation of pharmacists.

Purpose: The redesign of an inpatient pharmacy practice model through reallocation of pharmacy resources in order to expand clinical services is described.

Methods: A pharmacy practice model change was implemented at a nonprofit academic medical center to meet the increasing demand for direct patient care services. In order to accomplish this change, the following steps were completed: reevaluation of daily tasks and responsibilities, reallocation of remaining tasks to the most appropriate pharmacy staff member, determination of the ideal number of positions needed to complete each task, and reorganization of the model into a collection of teams.

Implementation of an emergency department-based clinical pharmacist transitions-of-care program.

Purpose: The implementation of an emergency department (ED)-based clinical pharmacist transitions-of-care (TOC) program is described.

Summary: The intervention program consisted of collaboration between ED and ambulatory care pharmacists to provide patient-specific comprehensive medication review and education in the ED setting and to help ensure a coordinated transition to the ambulatory care setting by scheduling an ambulatory pharmacy clinic or home-based visit. Patients who sought care at an adult ED for an exacerbation of asthma, chronic obstructive pulmonary disease (COPD), or congestive heart failure (CHF) were assessed for issues with medication adherence or administration technique, patient-specific concerns regarding medication use, access to medications at discharge, the need for modification of chronic therapy, contraindicated medications, and vaccination status, if applicable.

Development and implementation of a postdischarge home-based medication management service.

Purpose: The development and implementation of a postdischarge home-based, pharmacist-provided medication management service are described.

Summary: A work group composed of pharmacy administrators, clinical specialists, physicians, and nursing leadership developed the structure and training requirements to implement the service. Eligible patients were identified during their hospital admission by acute care pharmacists and consented for study participation.