Each year, I look forward to the ASHP Midyear Clinical Meeting for the opportunity to network with colleagues, learn about recent advancements in drug therapy, and discuss new trends in healthcare. As I returned from the meeting, energized and educated, I took note of some of the most salient trends that will impact the practice of pharmacy in 2018 and beyond:
Trends for 2018:
1. Transitions of care and discharge management
Reducing patient readmissions to the hospital is an important indicator of quality patient care. The CMS Hospital Readmission Reductions Program is designed to encourage hospitals to implement programs that will minimize unexpected readmission of patients with specific disease states by penalizing hospitals with excess readmission ratios by reducing reimbursement payments.
A number of transitions of care and discharge management programs have been implemented which are designed to identify patients in high risk categories and reduce the incidence of readmission. The most successful of these programs involve members of the pharmacy team to provide patient drug therapy counseling at the time of hospital discharge and follow-up patient counseling post-discharge. Such programs have demonstrated an average reduction in 30-day readmission rates of 30%.
With penalties of up to 3% of CMS payments to a hospital, including pharmacists in a transition of care program is a great way to improve patient care and maximize hospital revenue. At this year’s meeting, we were proud to be part of this timely discussion with our own Transition Care Management program and new Discharge Management software module.
2. Opioid stewardship and pain management
On October 26, 2017 President Trump declared opioid addiction a “public health emergency” in the U.S. Although the announcement included no specific funding commitments or program details, it is clear that the opioid crisis has become one of the most critical healthcare issues in our country and around the world.
The opioid crisis has become one of the most critical healthcare issues in the US and around the world.
Pharmacists are uniquely qualified to assist in addressing the issues related to misuse and abuse of opioid drugs. Numerous presentations at the Midyear Meeting focused on the tools that pharmacists can utilize to identify patients who may have issues with opioid drugs and techniques that can be applied to assist these patients in dealing with drug dependence.
A pharmacist managed opioid stewardship programs is one option that health systems can implement to improve pain management, appropriate use of opioids and the quality of life for their patients. I invite you to read our blog to learn more about our perspective.
3. Antimicrobial stewardship programs (ASP)
JCAHO medication management standard MM.09.01.01 which addresses antimicrobial stewardship became effective and enforceable January 1, 2017. CMS is also developing conditions of participation (CoP) that will address ASP. The JCAHO standards are consistent with the CDC core elements of ASP.
Pharmacists are well positioned to take a leading role in the development, implementation and on-going management of a hospital ASP. Many healthcare institutions have implemented rapid diagnostic testing (RDT) systems that provide the identification of infecting organisms in much shorter timeframes than traditional microbiological testing. ASPs that include pharmacists performing the initial review of the RDT results with subsequent recommendations regarding the appropriate anti-infective therapy for a patient has shown significant improvement in patient outcomes, shorter lengths of stay, lower in drug costs and reduction in the resistance rates.
Pharmacists are in an ideal position to take on leading roles in the development, implementation, and management of antimicrobial stewardship programs.
As ASPs are implemented nationwide in order to comply with JCAHO and CDC requirements, pharmacists must be included as an integral part of these programs. Let us know if we can help you get started.
4. Expanded role of pharmacy technicians
The importance of pharmacy technicians in the practice of pharmacy has been well known for many years. This was reinforced several years ago with the specific inclusion of pharmacy technicians in the ASHP Pharmacy Practice Model Initiative (PPMI) and Practice Advancement Initiative (PAI) recommendations.
ASHP has taken another step to further emphasize that pharmacy technicians are a key member of the healthcare team through the creation of the Pharmacy Technician Forum which was formally announced at the Midyear Meeting. The Pharmacy Technician Forum is designed to provide pharmacy technicians with the education, tools and resources needed to advance their careers and solidify their roles in pharmacy practice.
Expanding the roles and optimizing the utilization of pharmacy technicians will be critical as pharmacists continue to identify opportunities to maximize their efficiency, productivity and clinical effectiveness. Ask us about our poster presentation showcasing our research on this topic. We’d be happy to share it with you.
5. Implementation and enforcement of USP <800> standards
The United States Pharmacopeia (USP) recently announced that it has postponed the official date for the implementation of the “General Chapter <800> Hazardous Drugs – Handling in Healthcare Settings” until December 1, 2019. The intent of the postponement is to align the content of USP <800> with the anticipated revisions of the USP <797> standards.
Although many pharmacy managers were relieved to hear of the postponement due to significant operational challenges posed by the new standards, it is important that all healthcare leaders recognize that the USP <800> standards are final and will be enforced as currently published beginning in December 2019.
Measures must be taken now to implement the operational and equipment changes necessary to assure compliance with the new standards and assure the safety of pharmacy staff involved in the compounding and handling of hazardous drugs.
Although the implementation and enforcement of USP <800> standards have been postponed, current rulings are final and regulation will begin in December 2019.
Start 2018 Off Right with PipelineRx
We at PipelineRx keep a pulse on the challenges and opportunities hospitals face and develop solutions to help amplify the impact of pharmacy to address those challenges. Contact us to learn more about how our flexible technology and clinical services can help you achieve your 2018 goals.
Kevin Jones, RPh, MBA, is VP of Pharmacy Services at PipelineRx. He has over 25 years of experience as a pharmacist and pharmacy manager in the hospital, institutional and home care settings, including serving as Director of Pharmacy at Denver Health Medical Center.
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