1
|
Tong EY, Edwards GE, Hua PU, Mitra B, Dyk EV, Yip G, Coutsouvelis J, Siderov J, Tran Y, Dooley MJ. Implementation of Partnered Pharmacist Medication Charting in haematology and oncology inpatients. J Oncol Pharm Pract 2024; 30:636-641. [PMID: 37350675 DOI: 10.1177/10781552231180468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
AIM Partnered Pharmacist Medication Charting (PPMC) in patients admitted under general medical units has been shown to reduce medication errors. The aim of this study is to evaluate the impact of the PPMC model on medication errors in patients admitted under cancer units in Victorian hospitals. METHODS A prospective cohort study comparing cohorts before and after the introduction of PPMC was conducted. This included a 2-month pre-intervention phase and 3-month intervention phase. PPMC was implemented during the intervention phase as new model of care that enabled credentialed pharmacists to chart all admission medications, including pre-admission or new medications and cancer therapies, in collaboration with the admitting medical officer. The proportion of medication charts with at least one error was the primary outcome measure. RESULTS Seven health services across Victoria were included in the study. The majority of health services were using paper-based prescribing systems for oncology. Of the 547 patients who received standard medical medication charting, 331 (60.5%) had at least one medication error identified compared to 18 out of 416 patients (4.3%) using the PPMC model (p < 0.001). The median (interquartile range) inpatient length of stay was 5 (2.9-10.6) days in pre-intervention and 4.9 (2.9-11) days in intervention (p = 0.88). In the intervention arm, 42 patients had cancer therapy charted by a pharmacist with no errors. CONCLUSIONS PPMC was successfully scaled into cancer units as a collaborative medication safety strategy. The model was associated with significantly lower rates of medication errors, including cancer therapies. PPMC should be adopted more widely in cancer units in Australia.
Collapse
Affiliation(s)
- Erica Y Tong
- Pharmacy Department, Alfred Health, Melbourne, Victoria, Australia
| | - Gail E Edwards
- Pharmacy Department, Alfred Health, Melbourne, Victoria, Australia
| | - Phuong Uyen Hua
- Pharmacy Department, Alfred Health, Melbourne, Victoria, Australia
| | - Biswadev Mitra
- Pharmacy Department, Alfred Health, Melbourne, Victoria, Australia
| | - Eleanor Van Dyk
- Pharmacy Department, Alfred Health, Melbourne, Victoria, Australia
| | - Gary Yip
- Pharmacy Department, Alfred Health, Melbourne, Victoria, Australia
| | - John Coutsouvelis
- Pharmacy Department, Alfred Health, Melbourne, Victoria, Australia
- Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Jim Siderov
- Department of Pharmacy, Austin Health, Heidelberg, Victoria, Australia
| | - Yen Tran
- Department of Oncology, Epworth Healthcare, Richmond, Victoria, Australia
| | - Michael J Dooley
- Pharmacy Department, Alfred Health, Melbourne, Victoria, Australia
- Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| |
Collapse
|
2
|
O'Connor S, Matthews H, Hornby C. VicTAG chemotherapy audit toolkit: Improving chemotherapy quality and safety. J Oncol Pharm Pract 2023; 29:416-421. [PMID: 36567674 DOI: 10.1177/10781552221148118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Off-protocol prescribing of systemic anti-cancer therapy (SACT) can lead to concerns about effectiveness of patient care. To identify variations in practice, a toolkit was developed for health services to address patient safety and the risk of sub-optimal outcomes for patients. DATA SOURCES Following significant incidents with SACT in South Australia and New South Wales, the Department of Health and Human Services, Victoria (the department) conducted an assessment of Victorian public health services to understand current practice regarding SACT protocol governance. A literature review examining SACT auditing was also undertaken to guide improvements. A department supported Chemotherapy Audit Toolkit (CAT) was created for implementation at public hospitals in Victoria. A post-implementation survey was done on uptake and issue identification. DATA SUMMARY An initial assessment showed that 27% of Victorian public health services were undertaking retrospective review of SACT dosing, which was targeted for improvement. The literature review identified little guidance, however an audit of current sector practices found several audit methodologies. A process that involved audits by health services assessing their own practice was adopted. The toolkit was developed and piloted with health services. A post-implementation survey showed that 20% of services were using the toolkit, 35% were implementing the toolkit and 45% did not use the toolkit. CONCLUSIONS The VicTAG CAT has been adopted by more than half of Victorian public health services and is being used to influence prescribing. Implementation of the toolkit has been affected by resource reallocation due to the COVID-19 pandemic. The CAT is available online.
Collapse
Affiliation(s)
- Shaun O'Connor
- Department of Health, Commissioning and System Improvement, Melbourne, Australia.,60078St Vincent's Public Hospital, Melbourne, Australia
| | - Helen Matthews
- Victorian Therapeutic Advisory Group, Melbourne, Australia
| | - Colin Hornby
- Department of Health, Commissioning and System Improvement, Melbourne, Australia
| |
Collapse
|
3
|
Ryan M, Ward EC, Burns CL, Carrington C, Cuff K, Mackinnon M, Snoswell CL. An evaluation of telephone versus videoconference consults for pre-treatment medication history taking by cancer pharmacists. J Telemed Telecare 2022; 28:750-756. [DOI: 10.1177/1357633x221122140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Introduction The primary aim was to compare the successful completion rates of pre-treatment medication history consults conducted by pharmacists with patients either via an unscheduled telephone consult (current standard care) or a scheduled videoconference consult model. Secondary aims were to examine pharmacist perceptions of the telephone and videoconference consults and explore patient (+/− support person) perceptions of videoconference consults. Method Completion data were collected and compared for the two modalities. In addition, pharmacists commented on any positive/negative factors impacting all consults. For the final 35 participants completing a videoconference consult, patients, support people, and pharmacists involved, completed a survey exploring perceptions and satisfaction. Results A significantly higher completion rate ( p < 0.0001) was found for the videoconferencing model, with 94% (76 of 81) completed successfully compared to 72% (76 of 105) of the unscheduled telephone consults. Pharmacists reported multiple factors impacting the success of the telephone consults including scheduling issues and patient factors. Survey responses revealed that 100% of patients/support people and 82% of pharmacists reported satisfaction with videoconference consults. Surveyed participants noted some technical issues, however, the ‘ability to show/view medication containers and/or labels’ and ‘convenience of scheduled time’ were benefits of the videoconference model. Discussion Results indicate that pre-treatment medication history consults should be offered via videoconference to maximise success.
Collapse
Affiliation(s)
- Marissa Ryan
- Pharmacy Department, Princess Alexandra Hospital, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
- Centre for Online Health, The University of Queensland, Brisbane, Australia
| | - Elizabeth C Ward
- Centre for Functioning and Health Research, Metro South Hospital and Health Service, Brisbane, Australia
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Clare L Burns
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Speech Pathology Department, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Christine Carrington
- Pharmacy Department, Princess Alexandra Hospital, Brisbane, Australia
- School of Pharmacy, The University of Queensland, Brisbane, Australia
| | - Katharine Cuff
- Division of Cancer Services, Princess Alexandra Hospital, Brisbane, Australia
| | - Mhairi Mackinnon
- Division of Cancer Services, Princess Alexandra Hospital, Brisbane, Australia
| | - Centaine L Snoswell
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- School of Pharmacy, The University of Queensland, Brisbane, Australia
| |
Collapse
|
4
|
Lam P, Campbell A, Chynoweth T, Crawford A, Giles C, Kho JCL, Wood A, Bunte M, Munro C, Mellor Y. Standard of practice in dispensing and distribution for pharmacy services. JOURNAL OF PHARMACY PRACTICE AND RESEARCH 2021. [DOI: 10.1002/jppr.1785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Patrick Lam
- Dispensing and Distribution Standard of Practice Working Group The Society of Hospital Pharmacists of Australia Collingwood Victoria
- Pharmacy Department Monash Health Victoria Australia
| | - Andrew Campbell
- Dispensing and Distribution Standard of Practice Working Group The Society of Hospital Pharmacists of Australia Collingwood Victoria
- Sir Charles Gairdner Hospital Nedlands Western Australia Australia
| | - Tom Chynoweth
- Dispensing and Distribution Standard of Practice Working Group The Society of Hospital Pharmacists of Australia Collingwood Victoria
- Pharmacy Department Monash Health Victoria Australia
| | - Ashley Crawford
- Dispensing and Distribution Standard of Practice Working Group The Society of Hospital Pharmacists of Australia Collingwood Victoria
- SA Pharmacy Central Adelaide Local Health Network South Australia Australia
- Drug and Alcohol Services South Australia Southern Adelaide Local Health Network South Australia Australia
| | - Christopher Giles
- Dispensing and Distribution Standard of Practice Working Group The Society of Hospital Pharmacists of Australia Collingwood Victoria
- Pharmacy Practice Unit Icon Group Pharmacy Services Queensland Australia
| | - Janice Chien Lin Kho
- Dispensing and Distribution Standard of Practice Working Group The Society of Hospital Pharmacists of Australia Collingwood Victoria
- Pharmacy Department Fiona Stanley Hospital Western Australia Australia
| | - Anna Wood
- Dispensing and Distribution Standard of Practice Working Group The Society of Hospital Pharmacists of Australia Collingwood Victoria
- Pharmacy Department Sunshine Coast University Hospital Queensland Australia
| | - Michelle Bunte
- The Society of Hospital Pharmacists of Australia Collingwood Victoria Australia
| | - Courtney Munro
- The Society of Hospital Pharmacists of Australia Collingwood Victoria Australia
| | - Yee Mellor
- The Society of Hospital Pharmacists of Australia Collingwood Victoria Australia
| |
Collapse
|
5
|
Bunte M. Standards of practice for clinical pharmacy services – Chapter 16: My Health Record. JOURNAL OF PHARMACY PRACTICE AND RESEARCH 2021. [DOI: 10.1002/jppr.1774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Michelle Bunte
- The Society of Hospital Pharmacists of Australia Collingwood 3066 Australia
| |
Collapse
|
6
|
Ryan M, Carrington C, Ward EC, Burns CL, Cuff K, Mackinnon M, Snoswell CL. Changing from telephone to videoconference for pre-treatment pharmacist consults in cancer services: Impacts to funding and time efficiency. J Telemed Telecare 2021; 27:680-684. [PMID: 34726996 DOI: 10.1177/1357633x211048393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: This study examined the reimbursement opportunity and the time efficiency of a standard care model of unscheduled telephone consults compared to scheduled videoconference consults for obtaining pre-treatment medication histories for patients with cancer. Methods: Data related to (a) the available and the claimed activity-based funding for both models and (b) the number of contacts and the duration of each contact to complete the patient's medication history via either unscheduled telephone or scheduled videoconference consults were collected and compared. Results: Data was collected for 86 telephone and 56 videoconference consults. The actual activity-based funding claimed for telephone consults was $0, even though $86 of activity-based funding was available for each consult. This represented a $0 reimbursement for the staff time spent conducting the telephone consults, and a missed opportunity to claim $86 per consult. Activity-based funding was claimed for all but one videoconference consult with an average of $205 received per consult, when $221 per consult was available. Videoconference consults were an average of 2.3 min shorter than telephone consults. Discussion: When compared to unscheduled telephone consults, the scheduled videoconference consults represented increased reimbursement and equivalent time efficiency for the cancer pharmacist completing pre-treatment medication histories.
Collapse
Affiliation(s)
- Marissa Ryan
- Pharmacy Department, 1966Princess Alexandra Hospital, Brisbane, Australia.,Centre for Online Health, 1974The University of Queensland, Brisbane, Australia.,Centre for Health Services Research, 1974The University of Queensland, Brisbane, Australia
| | - Christine Carrington
- Pharmacy Department, 1966Princess Alexandra Hospital, Brisbane, Australia.,School of Pharmacy, 1974The University of Queensland, Brisbane, Australia
| | - Elizabeth C Ward
- Centre for Functioning and Health Research, 157829Metro South Hospital and Health Service, Brisbane, Australia.,School of Health and Rehabilitation Sciences, 1974The University of Queensland, Brisbane, Australia
| | - Clare L Burns
- School of Health and Rehabilitation Sciences, 1974The University of Queensland, Brisbane, Australia.,Speech Pathology Department, 3883Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Katharine Cuff
- Division of Cancer Services, 1966Princess Alexandra Hospital, Brisbane, Australia
| | - Mhairi Mackinnon
- Division of Cancer Services, 1966Princess Alexandra Hospital, Brisbane, Australia
| | - Centaine L Snoswell
- Pharmacy Department, 1966Princess Alexandra Hospital, Brisbane, Australia.,Centre for Online Health, 1974The University of Queensland, Brisbane, Australia.,Centre for Health Services Research, 1974The University of Queensland, Brisbane, Australia.,School of Pharmacy, 1974The University of Queensland, Brisbane, Australia
| |
Collapse
|
7
|
Chazan G, Jupp J, Bauters T, Duncan N, Weddle KJ, Nomura H, O'Connor S, Chan A, Alkhudair N, Alshamrani M, Buie LW, Chambers P, Chieh TW, DeRemer DL, Duvivier F, Katabalo D, McFarlane T, Mckavanagh D, Mensah K, Martinez EM, Rowan G, Sae-Teaw M, Tadesse TA, Weru I, Alexander M. Impact of coronavirus of 2019 on the delivery of pharmacy services to patients with cancer: An international survey of oncology pharmacy practitioners. J Oncol Pharm Pract 2021; 28:1832-1847. [PMID: 34693814 DOI: 10.1177/10781552211048892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The coronavirus of 2019 pandemic has necessitated vast and rapid changes in the way oncology pharmacy services are delivered around the world. METHODS/AIMS An international survey of oncology pharmacists and technicians was conducted via the International Society of Oncology Pharmacy Practitioners and collaborating global pharmacy organisations to determine the impact that the coronavirus of 2019 has had on pharmacy service delivery, pharmacy practitioners and oncology practice. RESULTS The survey received 862 responses from 40 different countries from September to October 2020. The majority of respondents were pharmacists (n = 841, 97.6%), with 24% involved in the direct care of patients with the coronavirus of 2019. Of the survey participants, 55% increased their time working remotely, with remote activities including dispensing, patient assessment/follow-up and attending multi-disciplinary rounds. Respondents reported a 72% increase in the use of technology to perform remote patient interaction activities and that participation in educational meetings and quality improvement projects was reduced by 68% and 44%, respectively. Workforce impacts included altered working hours (50%), cancelled leave (48%) and forced leave/furloughing (30%). During the pandemic, respondents reported reduced access to intensive care (19%) and anti-cancer (15%) medications. In addition, 39% of respondents reported reduced access to personal protective equipment, including N95 masks for chemotherapy compounding. Almost half of respondents (49%) reported that cancer treatments were delayed or intervals were altered for patients being treated with curative intent. A third of practitioners (30%) believed that patient outcomes would be adversely impacted by changes to pharmacy services. Sixty-five percent of respondents reported impacts on their mental health, with 12% utilising support services. CONCLUSION The coronavirus of 2019 pandemic has altered the way oncology pharmacy services are delivered. These results demonstrate the adaptability of the oncology pharmacy profession and highlight the importance of formal evaluation of the varied practice models to determine the evidence-based practices that enhance pharmacy services and, thus, should be reinstated as soon as practical and reasonable.
Collapse
Affiliation(s)
- Grace Chazan
- Sir Peter MacCallum Department of Oncology, 60078University of Melbourne, Australia.,Department of Medical Oncology, 3085Peter MacCallum Cancer Centre, Australia
| | - Jennifer Jupp
- Pharmacy Services, 3146Alberta Health Services, Canada
| | - Tiene Bauters
- Pharmacy Department, 60200Ghent University Hospital, Belgium
| | - Nick Duncan
- Pharmacy Department, 156807Queen Elizabeth Hospital, UK
| | | | - Hisanaga Nomura
- Department of Data Science/Pharmacy, 444492National Cancer Center Hospital East, Japan
| | - Shaun O'Connor
- Pharmacy Department, St Vincent's Hospital, Australia.,Commissioning and System Improvement Division, 1457Department of Health Victoria, Australia
| | - Alexandre Chan
- Department of Clinical Pharmacy Practice, 8788University of California, USA
| | - Nora Alkhudair
- Department of Clinical Pharmacy, College of Pharmacy, 37850King Saud University, Saudi Arabia
| | - Majed Alshamrani
- Pharmaceutical Care Services, 47798Ministry of National Guard Health Affairs, Saudi Arabia
| | - Larry W Buie
- Pharmacy Department, 5803Memorial Sloan Kettering Cancer Center, USA
| | - Pinkie Chambers
- 4919University College London Hospital NHS Trust & University College London School of Pharmacy, UK
| | - Tan Wen Chieh
- Pharmacy Department, 69844University Malaya Medical Centre, Malaysia
| | - David L DeRemer
- Department of Pharmacotherapy and Translational Research, 15505University of Florida College of Pharmacy, USA
| | | | - Deogratias Katabalo
- 227206Bugando Medical Center, Tanzania.,150778Catholic University of Health and Allied Sciences, School of pharmacy, Department of Pharmacy Practice and Therapeutics, Tanzania
| | | | - Daniel Mckavanagh
- Office of the Chief Clinical Information Officer, Clinical Excellence Queensland, 1288Queensland Health, Australia
| | - Kofi Mensah
- Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, 98763Kwame Nkrumah University of Science and Technology, Ghana.,Discipline of Pharmaceutical Sciences, College of Health Sciences, 56394University of KwaZulu-Natal, South Africa.,Pharmacy Practice Department, Faculty of Pharmacy and Pharmaceutical Sciences, 98763Kwame Nkrumah University of Science and Technology, Ghana
| | | | - Gail Rowan
- Pharmacy Department, 3085Peter MacCallum Cancer Centre, Australia
| | - Manit Sae-Teaw
- Faculty of Pharmaceutical Sciences, Ubon Ratchathani University, Thailand
| | - Tamrat Assefa Tadesse
- School of Pharmacy, College of Health Sciences, 37602Addis Ababa University, Ethiopia
| | - Irene Weru
- Pharmacy Division, 285569Kenyatta National Hospital, Kenya
| | - Marliese Alexander
- Sir Peter MacCallum Department of Oncology, 60078University of Melbourne, Australia.,Pharmacy Department, 3085Peter MacCallum Cancer Centre, Australia
| |
Collapse
|