State Pharmacy Regulators' Opinions on Regulating Pharmaceutical Care Outcomes

1998 ◽  
Vol 32 (6) ◽  
pp. 642-647 ◽  
Author(s):  
David P Nau ◽  
David B Brushwood
Keyword(s):  
Drug Therapy ◽  
Patient Care ◽  
Pharmaceutical Care ◽  
Survey Instrument ◽  
Board Members ◽  
Self Assessment ◽  
Initial Mailing ◽  
Care Outcomes ◽  
Poor Outcomes

OBJECTIVE: To examine the opinions of state pharmacy regulators regarding responsibility for the outcomes of drug therapy, and approaches that might be taken to regulate for pharmaceutical care outcomes. DESIGN: Surveys were sent to the executive secretaries of state pharmacy boards. The executive secretaries were encouraged to seek input from other board staff and board members in formulating a response. Reminder postcards were sent to all subjects 1 week after the initial mailing. MEASURES: The survey instrument was divided into three sections. The first section identified 10 approaches that state boards could use to regulate for outcomes and asked subjects to indicate the utility of each. The second and third sections asked the subjects to determine the extent to which pharmacies and pharmacists, respectively, should be responsible for outcomes potentially related to pharmaceutical care. RESULTS: Forty-one usable surveys were returned. All approaches to regulation were viewed as potentially useful, and scores for three approaches indicated that they would be consistently helpful for effective regulation of pharmaceutical care outcomes. The pharmacy was viewed as solely responsible for poor outcomes related to systems deficiencies, a lack of self-assessment, inadequate references, equipment, and technician support. Pharmacists were assigned greatest responsibility for outcomes related to prescription filling, and less responsibility for outcomes related to patient care. However, there was considerable variation in responses to many of the items, reflecting the diverse opinions of pharmacy regulators on these issues. CONCLUSIONS: While pharmacy regulators appear open to some outcomes-oriented approaches to regulation, there is no clear consensus on responsibility for pharmaceutical care outcomes.

scholarly journals Pediatric Endocrinology in the Time of COVID-19: Considerations for the Rapid Implementation of Telemedicine and Management of Pediatric Endocrine Conditions

2020 ◽  
Vol 93 (6) ◽  
pp. 343-350
Author(s):  
Molly O. Regelmann ◽  
Rushika Conroy ◽  
Evgenia Gourgari ◽  
Anshu Gupta ◽  
Ines Guttmann-Bauman ◽  
...  
Keyword(s):  
Patient Care ◽  
Care Patient ◽  
The Novel ◽  
Patient Privacy ◽  
Pediatric Endocrinology ◽  
Quality Of Patient Care ◽  
Care Outcomes ◽  
Novel Coronavirus ◽  
The Impact

<b><i>Background:</i></b> Pediatric endocrine practices had to rapidly transition to telemedicine care at the onset of the novel coronavirus disease 2019 (COVID-19) pandemic. For many, it was an abrupt introduction to providing virtual healthcare, with concerns related to quality of patient care, patient privacy, productivity, and compensation, as workflows had to change. <b><i>Summary:</i></b> The review summarizes the common adaptations for telemedicine during the pandemic with respect to the practice of pediatric endocrinology and discusses the benefits and potential barriers to telemedicine. <b><i>Key Messages:</i></b> With adjustments to practice, telemedicine has allowed providers to deliver care to their patients during the COVID-19 pandemic. The broader implementation of telemedicine in pediatric endocrinology practice has the potential for expanding patient access. Research assessing the impact of telemedicine on patient care outcomes in those with pediatric endocrinology conditions will be necessary to justify its continued use beyond the COVID-19 pandemic.

scholarly journals Pharmaceutical care – vitamins and minerals, crucial information for the pharmacist in proper patient care

2019 ◽  
Vol 75 (9) ◽  
pp. 510-518
Author(s):  
Michał Abendrot ◽  
Piotr Merks ◽  
Urszula Kalinowska-Lis
Keyword(s):  
Patient Care ◽  
Pharmaceutical Care ◽  
Crucial Information

Documentation of goals of care (GOC) by medical oncologists is associated with improved oncology patient end-of-life (EOL) care outcomes.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 1507-1507
Author(s):  
Han Xiao ◽  
Michael Riley ◽  
Richard Donopria ◽  
Steven Martin ◽  
Judith Eve Nelson ◽  
...  
Keyword(s):  
Patient Care ◽  
Linear Regression Analysis ◽  
Cancer Center ◽  
Oncology Patient ◽  
Patient Goals ◽  
Medical Oncologists ◽  
Hospice Referral ◽  
Care Outcomes ◽  
Eol Care ◽  
The Impact

1507 Background: Documenting GOC is integral to patient care and quality performance but has been underutilized by oncologists due to many barriers. As oncologists play a key role in initiating GOC discussions, we implemented a clinical initiative to improve their GOC documentation and evaluated the impact of such documentation on patient care during the EOL (last 30 days of life). Methods: We launched the initiative among 270 medical oncologists in an academic cancer center in 4/2020. A newly formulated GOC note to ease documentation was embedded in oncology outpatient and inpatient notes. Oncologists completed components in the GOC note that applied to their communication about GOC with the patient: 1) cancer natural history, 2) patient goals, and 3) EOL discussion: patient resuscitation preferences and, when pertinent, receptivity to hospice referral. GOC notes were pulled to a centralized location in the electronic health record (EHR) that displays documents relevant to patients’ values, goals and preferences. A dashboard allowed continual monitoring of documentation performance. We evaluated the association between GOC notes and outcomes of patient care at EOL. We further analyzed the impact of EOL discussion on EOL care. Results: The GOC note completion rate steadily rose after implementation. GOC notes were present in EHR for 46% of 10,006 patients who were either seen in outpatient clinic or discharged from hospital during the 1st week of January 2021. Among 1790 patients who died between 7/1/20 and 12/31/20 and had either at least an outpatient visit or hospitalization during EOL, the median days from first GOC note and first EOL discussion to the patient’s death were 71 days and 24 days, respectively. Linear regression analysis demonstrated that patients who had GOC note 60 days before death spent less time as inpatient during EOL (0.4 day less/patient, from 8.1 to 7.7, P = 0.01). When EOL discussion was documented 30 days before death, patients also spent less time in the hospital (1.2 days less/patient, from 9.7 to 8.5, P < 0.001) and in the ICU (0.3 days less/patient, from 1.7 to 1.4 ICU days, P = 0.04), and were 4% less likely to receive chemotherapy (from 38% to 34%, P = 0.004) at EOL. During the same period, among 1,009 patients with hospital admission in the last 30 days of life, those with a prior documented EOL discussion had shorter inpatient stay (7.7 vs 13.1 days, P < 0.001) and were more likely to be discharged to hospice (34% vs 22%, P = 0.003). Conclusions: During the COVID-19 pandemic, we successfully implemented GOC documentation by medical oncologists that is easily visible by the full care team. Documentation of GOC including EOL discussion was associated with fewer days in the hospital and ICU, increased hospice referral, and lower likelihood of receiving chemotherapy during patients’ last 30 days of life.

Staffing Patterns for Patient Care and Support Personnel in a General Pediatric Unit

PEDIATRICS ◽  
1994 ◽  
Vol 93 (5) ◽  
pp. 850-854 ◽  
Author(s):  
Keyword(s):  
Patient Care ◽  
Public Hospital ◽  
Inpatient Unit ◽  
Her Family ◽  
Appropriate Care ◽  
Care And Support ◽  
Staffing Patterns ◽  
Age Appropriate ◽  
Pediatric Inpatient ◽  
Care Outcomes

The mission of a pediatric inpatient unit, no matter how large or small, whether in a private or public hospital, is to provide optimum, age-appropriate care for each patient and to lend sensitive and understanding support to his or her family. The key to success in achieving this mission is the quality and commitment of the personnel on the unit. If the skills and the dedication are present and there is flexibility in staffing assignments, the desired patient care outcomes will be inevitable.

The impact of a nutrition support team on patient care outcomes in a pediatric ICU

2008 ◽  
Vol 27 (2) ◽  
pp. 313 ◽  
Author(s):  
Heitor Pons Leite ◽  
Simone Brasil de O. Iglesias
Keyword(s):  
Patient Care ◽  
Nutrition Support ◽  
Care Outcomes ◽  
Support Team ◽  
Pediatric Icu ◽  
The Impact

scholarly journals Timing of respiratory virus molecular testing in emergency departments and its association with patient care outcomes: a retrospective observational study across six Australian hospitals

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e030104 ◽  
Author(s):  
Nasir Wabe ◽  
Ling Li ◽  
Maria R Dahm ◽  
Robert Lindeman ◽  
Ruth Yimsung ◽  
...  
Keyword(s):  
Observational Study ◽  
Patient Care ◽  
Respiratory Virus ◽  
Laboratory Data ◽  
Respiratory Viruses ◽  
Retrospective Observational Study ◽  
Molecular Diagnostic ◽  
Molecular Testing ◽  
Care Outcomes ◽  
Virus Testing

ObjectiveA rapid molecular diagnostic test (RMDT) offers a fast and accurate detection of respiratory viruses, but its impact on the timeliness of care in the emergency department (ED) may depend on the timing of the test. The aim of the study was to determine if the timing of respiratory virus testing using a RMDT in the ED had an association with patient care outcomes.DesignRetrospective observational study.SettingLinked ED and laboratory data from six EDs in New South Wales, Australia.ParticipantsAdult patients presenting to EDs during the 2017 influenza season and tested for respiratory viruses using a RMDT. The timing of respiratory virus testing was defined as the time from a patient’s ED arrival to time of sample receipt at the hospital laboratory.Outcome measuresED length of stay (LOS), >4 hour ED LOS and having a pending RMDT result at ED disposition.ResultsA total of 2168 patients were included. The median timing of respiratory virus testing was 224 min (IQR, 133–349). Every 30 min increase in the timing of respiratory virus testing was associated with a 24.0 min increase in the median ED LOS (95% CI, 21.8–26.1; p<0.001), a 51% increase in the likelihood of staying >4 hours in ED (OR, 1.51; 95% CI, 1.41 to 1.63; p<0.001) and a 4% increase in the likelihood of having a pending RMDT result at ED disposition (OR, 1.04; 95% CI, 1.02 to 1.05; p<0.001) after adjustment for confounders.ConclusionThe timing of respiratory virus molecular testing in EDs was significantly associated with a range of outcome indicators. Results suggest the potential to maximise the benefits of RMDT by introducing an early diagnostic protocol such as triage-initiated testing.

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