Time savings of weekly versus three-times-per-week administration of erythropoiesis stimulating agents in United States dialysis patients.

Objective: Previous research suggests that erythropoiesis stimulating agent (ESA) administration in dialysis is a time-consuming task and switching to less frequently dosed ESAs may offer operational efficiencies. Our objective was to describe and measure the time spent on tasks in the ESA administration process in US dialysis centers, and to estimate potential efficiency gains of using weekly (QW) administration vs three-times-per-week (TIW) administration.

Methods: We conducted a time and motion study of staff time required to prepare, administer and document ESA doses.

The VHA New England Medication Error Prevention Initiative as a model for long-term improvement collaboratives.

Background: Quality improvement collaboratives (QICs) are a widely applied strategy for implementing change in health care organizations. Alternative collaborative methodologies were compared to gain insight into the elements important for QIC success.

Methods: A modified version of a previously described QIC evaluation tool was used to assess the methods and characteristics of the Medication Error Prevention Initiative (MEPI) and to compare MEPI with two other long-term ongoing QICs--the Vermont-Oxford Network's Neonatal Intensive Care QIC and the Northern New England Cardiovascular Disease Study Group, and the shorter-term Breakthrough Series QICs of the Institute for Healthcare Improvement (IHI).

Proper dose, preparation, and storage of botulinum neurotoxin serotype A.

Purpose: The proper dose, preparation, and storage of the formulation of botulinum neurotoxin serotype A (botulinum toxin type A) that is available in the United States (Botox) are described.

Summary: The recommended dose of botulinum toxin type A varies widely from 1.25 Units to 100 Units, depending on the site.

Considerations in darbepoetin alfa cost and reimbursement: a model for pharmacy managers.

With health care administrators focusing on the financial aspects of patient care, pharmacy budget managers must be able to evaluate all financial implications of drugs under formulary review. Clinical considerations, dosing equivalency, direct and indirect costs, payer mix, and reimbursement level are issues that should be considered by a multidisciplinary team. A pharmacoeconomic evaluation of darbepoetin alfa compared with epoetin alfa is presented as a model to help pharmacy budget managers address these issues and develop an evaluation of two high-cost drugs to determine which would be the better agent to have on their formulary.

Billing for inpatient hospital care.

Pharmacy personnel billing patients for services rendered is discussed. Billing for services is a critical function for maintaining the financial viability of health care institutions. Poor understanding of the system can lead to incorrect documentation, which can result in a claim rejection.