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Erschienen in: Journal of Medical Systems 1/2016

01.01.2016 | Systems-Level Quality Improvement

Utilization of a Pharmacy Clinical Surveillance System for Pharmacist Alerting and Communication at a Tertiary Academic Medical Center

verfasst von: Benjamin Hohlfelder, Chad Stashek, Kevin E. Anger, Paul M. Szumita

Erschienen in: Journal of Medical Systems | Ausgabe 1/2016

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Abstract

The objective of this analysis is to describe the utilization metrics of a pharmacy clinical surveillance system (PCSS) at a tertiary, academic medical center.We performed a retrospective database analysis assessing rule-based alerts (RBA), interventions and pharmacist communication notes documented in the PCSS from January 1, 2014 to December 31, 2014. Reports were generated on 92 unique RBAs sent to clinicians for evaluation. Metrics assessed included the number of RBAs that were triggered, clinically evaluated, intervened on by pharmacists, and therapeutic category of interventions. Pharmacy communication notes were also evaluated.A total of 399,979 RBAs were triggered through the PCSS. During that time, pharmacists documented a total of 17,733 interventions. The most common RBAs were related to lab abnormalities (132,487; 33 %) and anticoagulation/antiplatelet therapy (126,425; 32.1 %). Interventions were most frequently related to RBAs regarding anticoagulation/antiplatelet therapy (6412; 36 %) and antimicrobial therapy (3320; 19 %). Pharmacist communication was most commonly related to clarification of medication and lab orders, and therapeutic drug monitoring.Based on utilization metrics presented, the implementation of a PCSS has successfully generated RBAs to aid pharmacists in clinical practice and improved departmental documentation and communication. Further analysis is warranted to assess the impact of the RBAs, interventions, and communication notes on outcomes such as hospital cost and adverse drug events.
Literatur
1.
Zurück zum Zitat Bates, D. W., Miller, E. B., Cullen, D. J., et al., Patient risk factors for adverse drug events in hospitalized patients. Arch. Int. Med. 159:2553–2560, 1999.CrossRef Bates, D. W., Miller, E. B., Cullen, D. J., et al., Patient risk factors for adverse drug events in hospitalized patients. Arch. Int. Med. 159:2553–2560, 1999.CrossRef
2.
Zurück zum Zitat Bates, D. W., and Gawande, A. A., Improving safety with information technology. NEJM 348:2526–2534, 2003.PubMedCrossRef Bates, D. W., and Gawande, A. A., Improving safety with information technology. NEJM 348:2526–2534, 2003.PubMedCrossRef
3.
Zurück zum Zitat Poon, E. G., Keohane, C. A., Yoon, C. S., et al., Effect of bar-code technology on the safety of medication administration. NEJM 362:1698–1707, 2010.PubMedCrossRef Poon, E. G., Keohane, C. A., Yoon, C. S., et al., Effect of bar-code technology on the safety of medication administration. NEJM 362:1698–1707, 2010.PubMedCrossRef
4.
Zurück zum Zitat Bates, D. W., Teich, J. M., Lee, J., Seger, D., Kuperman, G. J., Ma’Luf, N., Boyle, D., and Leape, L., The impact of computerized physician order entry on medication error prevention. JAMIA. 6:313–321, 1999.PubMedPubMedCentral Bates, D. W., Teich, J. M., Lee, J., Seger, D., Kuperman, G. J., Ma’Luf, N., Boyle, D., and Leape, L., The impact of computerized physician order entry on medication error prevention. JAMIA. 6:313–321, 1999.PubMedPubMedCentral
5.
Zurück zum Zitat Sequist, T. D., Gandhi, T. K., Karson, A. S., Fiskio, J. M., Bugbee, D., Sperling, M., Cook, E. F., Orav, E. J., Fairchild, D. G., and Bates, D. W., A randomized trial of electronic clinical reminders to improve quality of care for diabetes and coronary artery disease. JAMIA. 12:431–437, 2005.PubMedPubMedCentral Sequist, T. D., Gandhi, T. K., Karson, A. S., Fiskio, J. M., Bugbee, D., Sperling, M., Cook, E. F., Orav, E. J., Fairchild, D. G., and Bates, D. W., A randomized trial of electronic clinical reminders to improve quality of care for diabetes and coronary artery disease. JAMIA. 12:431–437, 2005.PubMedPubMedCentral
6.
Zurück zum Zitat Hicks, L. S., Sequist, T. D., Ayanian, J. Z., Shaykevich, S., Fairchild, D. G., Orav, E. J., and Bates, D. W., Impact of computerized decision support on blood pressure management and control: a randomized controlled trial. J. Gen. Intern. Med. 23:429–441, 2008.PubMedPubMedCentralCrossRef Hicks, L. S., Sequist, T. D., Ayanian, J. Z., Shaykevich, S., Fairchild, D. G., Orav, E. J., and Bates, D. W., Impact of computerized decision support on blood pressure management and control: a randomized controlled trial. J. Gen. Intern. Med. 23:429–441, 2008.PubMedPubMedCentralCrossRef
7.
Zurück zum Zitat Calloway, S., Akilo, H. A., and Bierman, K., Impact of a clinical decision support system on pharmacy clinical interventions, documentation efforts, and costs. Hosp. Pharm. 48:744–752, 2013.PubMedPubMedCentralCrossRef Calloway, S., Akilo, H. A., and Bierman, K., Impact of a clinical decision support system on pharmacy clinical interventions, documentation efforts, and costs. Hosp. Pharm. 48:744–752, 2013.PubMedPubMedCentralCrossRef
8.
Zurück zum Zitat Harinstein, L. M., Kane-Gill, S. L., Smithburger, P. L., Culley, C. M., Reddy, V. K., and Seybert, A. L., Use of an abnormal laboratory value-drug combination alert to detect drug-induced thrombocytopenia in critically ill patients. J. Crit. Care 27:242–249, 2012.PubMedCrossRef Harinstein, L. M., Kane-Gill, S. L., Smithburger, P. L., Culley, C. M., Reddy, V. K., and Seybert, A. L., Use of an abnormal laboratory value-drug combination alert to detect drug-induced thrombocytopenia in critically ill patients. J. Crit. Care 27:242–249, 2012.PubMedCrossRef
Metadaten
Titel
Utilization of a Pharmacy Clinical Surveillance System for Pharmacist Alerting and Communication at a Tertiary Academic Medical Center
verfasst von
Benjamin Hohlfelder
Chad Stashek
Kevin E. Anger
Paul M. Szumita
Publikationsdatum
01.01.2016
Verlag
Springer US
Erschienen in
Journal of Medical Systems / Ausgabe 1/2016
Print ISSN: 0148-5598
Elektronische ISSN: 1573-689X
DOI
https://doi.org/10.1007/s10916-015-0398-9

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