The Award for Excellence in Medication Safety is given jointly by the ASHP Foundation and the Cardinal Health Foundation. It is the only national award that recognizes a pharmacist-led interprofessional team for implementing significant institution-wide improvements in medication safety.
Cincinnati Children’s Hospital Medical Center is the most recent recipient, and was given $50,000 to further its innovations in medication safety. Two organizations were named finalists: Geisinger Chronic Pain Clinic in Danville, PA, and New York-Presbyterian in New York, NY each received $10,000.
Highlights of their medication safety initiatives are below.
Cincinnati Children’s Hospital Medical Center
Increasing Medication Safety for Pediatric Patients on Antibiotics
The use of vancomycin beyond 4 days of therapy for empiric courses creates a potentially unnecessary exposure to a nephrotoxic medication. Baseline data at Cincinnati Children’s Hospital Medical Center indicated that an average of six inpatients a week develop acute kidney injuries during or within a week of discontinuing a vancomycin course. Additional baseline evidence suggested that extended courses of vancomycin may have been unintended. To address these safety and care issues, pharmacists partnered primarily with physicians to implement a multistep, quality improvement initiative. Integrated within an existing antimicrobial stewardship program and acute kidney injury reduction efforts, a core team of pharmacists, physicians, the chief medical resident and a quality improvement expert developed the goals and implemented interventions in a stepwise approach using plan-do-study-act cycles. Cincinnati Children’s initiative had measurable results that:
- Decreased kidney injury associated with vancomycin exposure;
- Decreased vancomycin exposure;
- Decreased prolonged courses of vancomycin; and
- Increased oversight and approval for prolonged vancomycin exposure.
With their incremental and methodical approach, Cincinnati Children’s was able to provide guidance on the use of vancomycin throughout the institution in a matter of minutes each day. Their initiative is a sustainable and scalable framework that guides appropriate and safe use of antimicrobials and can promote the safe and effective use of other medications.
Read more about Cincinnati Children’s Hospital Medical Center's initiative.
Watch this video about Cincinnati Children's initiative.
Geisinger Chronic Pain Clinic
Enhanced Chronic Pain Management: Multifaceted Team-Based Care
The Geisinger Chronic Pain Clinic (CPC) offers a new model that replaces the fragmented systems of care that chronic pain patients typically navigate. Baseline data from the CPC found that one in four outpatient visits were related to chronic pain. In 2013 the CPC saw more than 17,000 patients with chronic pain-related diagnoses. Most patients sought medical attention within the CPC’s primary care service line. The CPC was the first of its kind on the East Coast to include a team of administrators, primary care and interventional pain physicians, pharmacists, registered nurses and social workers/addiction counselors. Development of the CPC focused on two areas: optimizing safe, effective and appropriate management of pain with opioids and assuring competency of providers.
Using a team-based comprehensive approach, Geisinger’s innovations demonstrated measurable outcomes that:
- Increased overall quality of care and patient functionality;
- Decreased reliance on opioids; and
- Decreased overall cost of care.
The Geisinger CPC brought long-term value to patients and the community. The CPC is expanding to additional sites and the team is adding addiction-trained social workers. Geisinger’s team-based approach is scalable and transferable to improve care and outcomes for patients and the larger community.
Read more about Geisinger Chronic Pain Clinic's initiative.
Watch this video about Geisinger's initiative.
New York, NY
Utilizing Technology for a Patient-Centered Approach to Medication Education
Clinicians (pharmacists, physicians, nurses) and individuals from information technology and quality divisions partnered to transform a commercially available patient intake survey software into a medication-teaching tool. Their goal was to potentiate the safe use of medications for solid organ transplant patients. Results from studies by Medicare and Agency for Healthcare Research and Quality reveal that one in five discharged patients will return to the hospital within 30 days, many resulting from an adverse drug event . Solid organ transplant recipients require numerous complex medication therapies that are critical to their post-transplant well-being.
- Decreased re-admissions of kidney transplant recipients;
- Increased patient empowerment and health literacy related to their medication regimens;
- Increased outreach and efficiency of pharmacists in the medication teaching process; and
- Improved HCHAPS scores related to the information provided about medications.
Expansion of NewYork-Presbyterian’s initiative to all organ transplant types in adult and pediatric populations is ongoing and includes the collection of additional quality metrics related to allograft outcomes. The concept of digital medication teaching is being integrated into general medicine and for patient populations at high-risk for readmission and for complications like heart failure and anticoagulation.
Read more about NewYork-Presbyterian's initiative.
Watch this video about NewYork-Presbyterian's initiative.