Advancing Pharmacy Practice through an Innovative Ambulatory Care Transitions Program at an Academic Medical Center.

Hospital readmissions are common and often preventable, leading to unnecessary burden on patients, families, and the health care system. The purpose of this descriptive communication is to share the impact of an interdisciplinary, outpatient clinic-based care transition intervention on clinical, organizational, and financial outcomes. Compared to usual care, the care transition intervention decreased the median time to Internal Medicine Clinic (IMC) or any clinic follow-up visit by 5 and 4 days, respectively.

Implementation of the flipped residency research model to enhance residency research training.

Purpose: The attainment of fundamental research skills to create and disseminate new knowledge is imperative for the advancement of pharmacy practice. Research training is an important component of postgraduate residency training; however, the traditional model of performing residency research has several limitations that have hindered the ability of residents to complete high-quality research projects. Therefore, our institution developed and implemented the flipped residency research model with the 2013-2014 pharmacy practice residency class.

Improved Adherence Rates and Clinical Outcomes of an Integrated, Closed-Loop, Pharmacist-Led Oral Chemotherapy Management Program.

Purpose: To address the growing use of oral anticancer therapy, an integrated, closed-loop, pharmacist-led oral chemotherapy management program was created within an academic medical center.

Methods: An integrated, closed-loop, pharmacy-led oral chemotherapy management program was established. From September 2014 until June 2015, demographic information, rates of adherence, patient understanding of treatment, pharmacist interventions, patient and provider satisfaction, and molecular response rates in patients with chronic myeloid leukemia (CML) were collected.

Creating a learning organization to help meet the needs of multihospital health systems.

Purpose: The considerations that leaders of multihospital health systems must take into account in developing and implementing initiatives to build and maintain an exceptional pharmacy workforce are described.

Summary: Significant changes that require constant individual and organizational learning are occurring throughout healthcare and within the profession of pharmacy. These considerations include understanding why it is important to have a succession plan and determining what types of education and training are important to support that plan.

Health Care Systems and Transitions of Care: Implication on Interdisciplinary Pharmacy Services.

Effective medication management is critical to successful patient outcomes. Pharmacists and pharmacy technicians working within North Carolina Health Systems provide a variety of services that aid in those successful outcomes. By leveraging the North Carolina Clinical Pharmacist Practitioner designation along with integrated health records, health system pharmacists are uniquely positioned to provide expert clinical support to patients.

Expanding care through a layered learning practice model.

Purpose: The outcomes of a patient-centered layered learning practice model (LLPM) in which the clinical specialist acted as the attending pharmacist and managed a pharmacy team to provide direct patient care were evaluated.

Methods: Two 30-day evaluations were conducted on the acute care malignant hematology and medical oncology services of the University of North Carolina Medical Center in 2011. The primary objective of this study was to design an LLPM that used a team to expand the pharmacist care services offered.

Impact of an innovative blood factor stewardship program on drug expense and patient care.

Purpose: An innovative pharmacist-led program to improve prescribing, dosing, and monitoring of clotting factor therapy within a large health system is described.

Summary: In an initiative to optimize patient outcomes and control costs associated with the use of clotting factor concentrates, the pharmacy department at University of North Carolina Medical Center (UNCMC) led the development of a "factor stewardship program" in collaboration with UNCMC hematologists. Key steps in program development and implementation included (1) selection of one formulary product within each clotting factor class, (2) establishment of guidelines on blood factor prescribing, order review, compounding, and administration, and (3) initial and ongoing education of pharmacy, nursing, and medical staff.

Using lean principles to improve outpatient adult infusion clinic chemotherapy preparation turnaround times.

Purpose: The workflow and chemotherapy preparation turnaround times at an adult infusion clinic were evaluated to identify opportunities to optimize workflow and efficiency.

Methods: A three-phase study using Lean Six Sigma methodology was conducted. In phase 1, chemotherapy turnaround times in the adult infusion clinic were examined one year after the interim goal of a 45-minute turnaround time was established.

Experience of health-system pharmacy administration residents in a longitudinal human resource management program.

Purpose: The experience of health-system pharmacy administration (HSPA) residents in a longitudinal human resource (HR) management program is described. The subsequent benefits to the residents, department, and profession are also discussed.

Summary: Postgraduate year 2 HSPA residents at an academic medical center desired more responsibility for managing an operational area.

Method to determine allocation of clinical pharmacist resources.

Purpose: An objective methodology to guide decisions by hospital pharmacy departments on the best use of clinical pharmacist personnel is described.

Summary: To help determine the optimal deployment of state-licensed Clinical Pharmacist Specialist (CPS) staff, a task force led by the pharmacy department at University of North Carolina (UNC) Hospitals developed an objective approach to evaluating the relative need for and potential impact of CPS expertise within the medical center's many service units. After analyzing several years of patient census and medication-use data and using information from proprietary databases (Thomson Reuters) to calculate a "service-specific pharmacy intensity score" for each hospital service, the task force identified five staff-allocation metrics best suited to the medical center's service-based pharmacy coverage model.

Effects of a new sterile product preparation and delivery process on operational efficiency and cost.

Purpose: Process changes in a hospital pharmacy's batch preparation of sterile products to reduce product and human resource waste are described.

Summary: The pharmacy information system and direct observation were used in the collection of data on the existing i.v.