Facilitating transformation in healthcare through medication safety and patient engagement

CONTRIBUTOR

Dianne Radigan

Vice President Community Relations Cardinal Health

Todd D. Sorensen, PharmD

Executive Director, Alliance for Integrated Medication Management (AIMM)

Recently the Cardinal Health Foundation announced its 2016 E3 (Effectiveness, Efficiency and Excellence in Healthcare) Patient Safety Grant winners, awarding nearly $2 million to 13 total hospitals and healthcare organizations across the country. All of the grantees were selected for their focus on improving medication safety for patients during transitions of care. Grantees’ projects also include strategies to increase patient engagement, because patients who are engaged in their healthcare decision-making tend to be healthier and have better outcomes.

As they develop their projects to improve patient safety and patient engagement, the grantees will also participate in the E3 Learning Collaborative, convened by the Cardinal Health Foundation and facilitated by the Alliance for Integrated Medication Management (AIMM).

AIMM is a non-profit organization that promotes quality improvement in medication management, particularly for high-risk, high-cost patients who have multiple chronic health conditions. Through the E3 Learning Collaborative, AIMM will support the grantees’ improvement transformations. The collaborative will encourage the healthcare organizations to learn from each other and accomplish more—faster than they could on their own.

Todd D. Sorensen, PharmD, is AIMM’s executive director. He is also the associate department head of the Department of Pharmaceutical Care and Health System at the University of Minnesota’s College of Pharmacy. Here, Sorensen chats with Dianne Radigan, vice president of the Cardinal Health Foundation, about the new Cardinal Health E3 Learning Collaborative.

Radigan: The grantees in the E3 Learning Collaborative are working on a wide variety of projects. Some of the organizations are working with pediatric patients, others with adults with chronic illnesses, and others with seniors. How will the various healthcare organizations help each other make improvements?

Sorensen: The great diversity in the E3 grant recipients is what makes this learning collaborative so exciting: Each project offers a diverse set of experiences. We expect that the lessons learned by each organization will help the others manage their own improvement efforts.

Though the patient population and clinical issues may be different from one organization to another, the principles for team-based care, quality improvement, and the approach to optimize medication use are largely the same.

Radigan: Let’s talk about why optimizing medication use in care transitions is such a critical issue.

Sorensen: Patients are frequently at risk for complications during care transitions. Transitions can be difficult to navigate, compounding the challenges and complications. Medication management is a large component in care transitions—and one of the most common causes of patient harm.

Medication issues are often the cause when a patient is readmitted to the hospital for reasons related to his or her initial admission. And healthcare systems now face financial consequences for those readmissions. Medication safety is a priority for safe care transitions.

Radigan: We know that in many cases, a key to improving medication safety is the more effective integration of pharmacy services. Why is that so critical to success?

Sorensen: Helping patients reach and sustain medication-related goals takes an inter-professional team. A pharmacist is essential to that team, and most of the organizations working with AIMM have incorporated a pharmacist into their healthcare team. Pharmacists bring a unique perspective and assessment process to patient care that is complimentary to that of physicians, nurses and other practitioners.

The pharmacist’s role becomes particularly significant when they are part of the healthcare team for patients with complicated medication regimens. With the pharmacist’s specialized medication expertise, he or she is able to capture the effective medication regimen that must be individualized to each patient’s medical condition(s).

Radigan: According to the National Institutes of Health, it takes an average of 17 years for evidence-based practices to be fully implemented into healthcare practices. How is AIMM helping healthcare organizations to make changes more quickly?

Sorensen: The AIMM process uses methods for accelerating improvement, and capitalizes on shared learning and collaboration. We have consistently seen the organizations that follow the AIMM process achieve their clinical goals for their patient populations within six to nine months. The organizations then spread their improvement strategies to broader populations of patients, scaling their successful practices in a matter of a few years.

Radigan: AIMM has more than eight years of experience in facilitating learning collaboratives, all of them focused on improving medication safety among high-risk patients. Tell us what makes them work.

Sorensen: We use a proven model: The Model for Improvement developed by Associates in Process Improvement and adopted by the Institute for Healthcare Improvement, that helps organizations rapidly identify strategies that can improve care and accelerate improvement. [The Model for Improvement emphasizes a “Plan-Do-Study-Act (PDSA)” cycle to test changes in real work settings, to determine if the change is an improvement.]

AIMM aligns local level quality improvement work with an action learning and sharing collaboration among entities that are focused on similar areas of improvement. This provides peer support and helps produce new ideas for change across organizations.

We guide organizations through a development plan to measure and evaluate the impact of their quality improvement work. The organizations become accountable for their own progress and track it through an AIMM-developed performance improvement template. This provides a reflection of how they are doing and where they are improving. It also provides direct outcomes to share with their health system’s senior leadership, and to keep their engagement in this work.

Radigan: What does a healthcare organization gain by participating in an AIMM Collaborative?

Sorensen: Organizations gain the “AIMM Experience”: Education and experience, transformational leadership and collaboration and interaction. This includes direct support in medication management practice development, and coaching to link practice development to a quality improvement agenda.

We also make additional resources available to teams, including the Change Package, which is a strategic guide to transforming practice, rich in examples from leading organizations that have been working on integrating medication management for almost 10 years. Teams learn to use effective leadership styles to obtain resources and scale and spread their services. Finally, teams receive the value-add of an all teach-all learn collaborative environment.

Radigan: What are your expectations for this new learning collaborative?

Sorensen: We are optimistic that the Cardinal Health Foundation funding will stimulate actions within individual grantee organizations that will allow them to achieve or exceed their goals in improving patient care, medication use and patient engagement. The sharing and collaboration from this learning community will produce successful and translatable strategies that would not have been identified had the organizations been working on their own.

Our focus will be to collect strategies from each of the E3 grant projects and share them with a broader audience, which in turn will support the work of organizations far beyond those who are in the E3 Learning Collaborative.

Since 2008, through its E3 Patient Safety Grant Program, the Cardinal Health Foundation has invested $16 million in hundreds of healthcare organizations across the country. Learn more about the program, and how organizations have leveraged these grants to achieve impressive results on our webpage and in the video above.