Expanding expedited partner therapy and HIV prophylaxis in the emergency department.

Purpose: Sexually transmitted infections (STIs) continue to have a disproportionate impact on individuals belonging to sexual, gender, and racial minorities. Across the nation, many emergency medicine pharmacists (EMPs) possess the skills and knowledge to expand the provision of expedited partner therapy (EPT) for STIs and provide HIV prophylaxis within existing practice frameworks. This report serves as a call to action for expanded provision of EPT and HIV prophylaxis by EMPs and highlights current barriers and solutions to increase pharmacist involvement in these practice areas.

Provision of Patient Care Services and Goals for Expansion in Community and Ambulatory Care Pharmacies in Southeastern North Carolina.

In February 2022, the North Carolina legislature expanded pharmacist dispensing authority without a prescription. We conducted a cross-sectional interview of currently licensed pharmacy managers of outpatient pharmacies located in five counties in southeastern North Carolina. Pharmacy managers were eligible to participate if their pharmacy was either a community pharmacy, clinic-based pharmacy, or outpatient health system pharmacy.

Implementation of Transgender/Gender Nonbinary Care in a Family Medicine Teaching Practice.

Purpose: Numerous studies have shown that transgender or gender nonbinary (TGNB) individuals encounter significantly more health care barriers, including overall lack of access to gender-affirming care providers. This study describes 2 assessments of transgender care services at a large family medicine teaching practice.

Methods: Staff and providers were invited to attend an optional, practice-wide, hourlong free training session on gender-affirming care offered on 3 different dates in 2019.

Development of a system-wide pharmacy operational weighted workload model at a large academic health system.

Purpose: The purpose of this study is to develop a standard operational and distributional weighted workload model that is applicable across an integrated, diverse healthcare system. This model aims to not only demonstrate the operational intensity of pharmacy practice but also to inform opportunities to decrease waste, increase efficiency, facilitate growth, and demonstrate value across operational and distributional pharmacy services.

Summary: Time studies were conducted at 8 hospitals within the UNC Health system to objectively measure time spent within each operational process in order to create a system-wide weighted workload model.

Implementation of a strategy for identification and monitoring of clinical outcome measures in a department of pharmacy.

Purpose: To describe a department of pharmacy strategy to identify and monitor outcome measures that represent the impact of clinical pharmacy services on patient outcomes.

Summary: Our department established the Clinical Impact Committee, with the goal of developing and maintaining an approach to demonstrate the impact of clinical pharmacists on patient care outcomes. We describe the committee's structure, aims, and key stakeholders, inclusive of both departmental leadership and clinical pharmacist representatives across service lines.

Report on 2020 Safe to Touch Consensus Conference on Hazardous Drug Surface Contamination.

Purpose: The 2020 Safe to Touch Consensus Conference on Hazardous Drug Surface Contamination was convened in order to gather subject matter experts in the field of hazardous drug (HD) handling to develop consensus statements regarding surface contamination monitoring for adoption by stakeholders in the drug supply chain, policy, and healthcare arenas.

Summary: The Safe to Touch conference convened virtually on September 22, 24, and 26, 2020. An expert panel of healthcare providers with experience in HD handling, monitoring, and research; pharmacy and nursing operations; and medication safety led the conference.

A proactive medical necessity review program reduces revenue loss associated with outpatient medical benefit drugs.

Purpose: A common denial trend that occurs with "outpatient medical benefit drugs" (ie, medications covered by a medical benefit plan and administered in an outpatient visit) is payers not requiring or permitting prior authorization (PA) proactively, yet denying the drug after administration for medical necessity. In this situation, a preemptive strategy of complying with payer-mandated requirements is critical for revenue protection. To address this need, our institution incorporated a medical necessity review into its existing closed-loop, pharmacy-managed precertification and denials management program.

Transforming data into insight: Establishment of a pharmacy analytics and outcomes team.

Purpose: The importance of a data management strategy is increasingly necessary for demonstrating value and driving performance within pharmacy departments. Data analytics capabilities often do not match the pace of data accumulation. At our organization, the establishment of an embedded pharmacy analytics and outcomes (PAO) team has been instrumental to pharmacy services in generating and demonstrating value and proactively supporting a business intelligence strategy grounded in a data-driven culture.

Conversion from paper to electronic acute care chemotherapy orders.

Purpose: UNC Medical Center converted to an electronic health record (EHR) in 2014. This conversion allowed for the transition of paper chemotherapy orders to be managed electronically. This article describes the process for converting inpatient paper chemotherapy orders into the new EHR in a safe and effective manner.

Evaluation of telepharmacy and the use of a gravimetric technology-assisted workflow system for remote sterile product pharmacist checks.

Purpose: To evaluate the impact of remote sterile product pharmacist checks when used with a gravimetric-based technology-assisted workflow (TAWF) system on product checking accuracy, pharmacist review time, workload sharing, cost savings, and staff perceptions.

Methods: A double-arm, prospective study was conducted at 4 pharmacy locations for a 90-day period. Each compounded sterile product (CSP) checked by a remote pharmacist was also checked by a local pharmacist at the site of CSP preparation.

Evaluation of gravimetric-based technology-assisted workflow for nonhazardous sterile product preparation.

Purpose: The impact of a gravimetric-based technology-assisted workflow (TAWF) system on the nonhazardous compounded sterile product (CSP) error capture rate, production times, and pharmacy staff perceptions of compounding methods was evaluated.

Methods: For 2 weeks prior to TAWF implementation, staff used a punch clock to document production times with a volumetric method. Preimplementation error data were captured in a previous study; TAWF software captured error and time data in the postimplementation period.

Current practices in the delivery of pharmacogenomics: Impact of the recommendations of the Pharmacy Practice Model Summit.

Purpose: This report examines and evaluates pharmacogenomics as an emerging science as it relates to the Practice Advancement Initiative and its predecessor the Pharmacy Practice Model Initiative's consensus statements for optimal pharmacy practice models.

Summary: Pharmacogenomics is one of many emerging sciences to impact medication management and delivery of patient care. Increasingly, biomarkers are included in drug labeling and can assist pharmacists with personalizing medicine to optimize patient therapies and avoid adverse effects.

Multicenter study to evaluate the benefits of technology-assisted workflow on i.v. room efficiency, costs, and safety.

Purpose: The benefits of technology-assisted workflow (TAWF) compared with manual workflow (non-TAWF) on i.v. room efficiency, costs, and safety at hospitals with more than 200 beds are evaluated.

Essential factors demonstrating readiness of primary care practices for clinical pharmacy services.

Purpose: The characteristics of primary care practices that are necessary to establish and maintain ambulatory care clinical pharmacy services were identified.

Methods: A focus group of 15 ambulatory care pharmacists in Western North Carolina developed a survey of 26 practice readiness statements pertaining to the development of clinical pharmacy services in primary care. National ambulatory care pharmacy experts were then surveyed using a modified Delphi model for consensus building to determine which items were essential.

Evaluation of a gravimetric-based technology-assisted workflow system on hazardous sterile product preparation.

Purpose: The impact of a gravimetric-based technology-assisted workflow (TAWF) system on hazardous compounded sterile product (CSP) production time, staff perception of safety, and job satisfaction was evaluated.

Methods: For 2 weeks before implementation of a gravimetric-based TAWF, staff utilized an automated punch clock to document the time to prepare and check CSPs compounded volumetrically. Simultaneously, an anonymous, online survey was e-mailed to staff to evaluate their perceptions regarding the safety of volumetric preparation and satisfaction with their role preparing CSPs.

Ten year experience with student pharmacist research within a health system and education center.

Introduction: Skills gained from research experience allow student pharmacists to evolve as practitioners, innovators and perpetual learners in an increasingly complex healthcare environment. Data published regarding pharmacy resident research are focused on external dissemination rates and research programs. Little is published regarding student research.

Understanding the influences and impact of patient-clinician communication in cancer care.

Background: Patient-clinician communication is thought to be central to care outcomes, but when and how communication affects patient outcomes is not well understood.

Objective: We propose a conceptual model and classification framework upon which the empirical evidence base for the impact of patient-clinician communication can be summarized and further built.

Design: We use the proposed model and framework to summarize findings from two recent systematic reviews, one evaluating the use of shared decision making (SDM) on cancer care outcomes and the other evaluating the role of physician recommendation in cancer screening use.

Patient-centered communication in digital medical encounters.

Objective: Patients are increasingly using the secure messaging function available through online patient portals to communicate with their health care providers, yet little is known about the characteristics of conversations that occur. The goal of this study is to describe the types of messages initiated by patients communicating via patient portals and to assess whether providers employ patient-centered strategies in their electronic responses.

Design: A total of 193 messages from 58 message threads between patients and providers were collected during a one-week period in a large health care system.

Pharmacist-Provided Medication Management in Interdisciplinary Transitions in a Community Hospital (PMIT).

Background: Medication management during transitions of care (TOC) impacts clinical outcomes. Published literature on TOC implementation is increasing, but data remains limited regarding the optimal role for the inpatient pharmacist, particularly in the community health setting.

Objective: To evaluate the impact of a dedicated inpatient TOC pharmacist on re-presentations following discharge.

Assessment of a candidate marker constituent predictive of a dietary substance-drug interaction: case study with grapefruit juice and CYP3A4 drug substrates.

Dietary substances, including herbal products and citrus juices, can perpetrate interactions with conventional medications. Regulatory guidances for dietary substance-drug interaction assessment are lacking. This deficiency is due in part to challenges unique to dietary substances, a lack of requisite human-derived data, and limited jurisdiction.