Post on 28-Jun-2020
Deaconess Health System Pharmacy Department
Fiscal Year 2013–2014
Annual Report
WELCOME from the DEPARTMENT OF PHARMACY
Carrie Morton, PharmD, MBAPharmacy Director
I am excited to serve in a new role on the pharmacy leadership team and in administration this year at Deaconess.
Shortly after I accepted the position of pharmacy director in April 2014, the department was reorganized to better align with the growing health system and focus on population health management.
As pharmacy director, it’s my pleasure to present the Deaconess Health System Pharmacy Department Annual Report for the fiscal year ending October 2014. Despite the pharmacy leadership changes this past year, we continued to provide high-quality care to the patients of Deaconess Health System.
This year we continued to expand our role in the ambulatory setting by expanding our Medication Assistance Program and adding additional protocols to the Medication Therapy Management Clinic.
We also supported multiple initiatives focused on improving chronic conditions within the organization to help us achieve the quality metrics we’re striving for with value-based purchasing and our accountable care organization. All of this was occurring while we continue to support the needs of our inpatients at Deaconess Hospital, Deaconess Gateway Hospital, Deaconess Cross Pointe, The Heart Hospital and The Women’s Hospital.
2013–2014 Annual Report | DEACONESS PHARMACY DEPARTMENT
Table of ContentsDeaconess Health System Mission, Vision and Goals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Pharmacy Organizational Chart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Highlights of 2014 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Inpatient ServicesDeaconess Hospital, Deaconess Gateway Hospital, The Heart Hospital, Deaconess Cross Pointe
Inpatient Pharmacy Operations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Inpatient Clinical Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Pharmacy Surgical Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Women’s Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Outpatient Services Deaconess Family Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Pharmacy Benefit Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Deaconess Medication Therapy Management Clinic . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Anticoagulation Clinic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Outpatient Infusion Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Home Care Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20
Medication Assistance Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
SupportPurchasing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Information Technology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Education and TrainingDeaconess Health System Pharmacy Residents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Deaconess Health System Pharmacy Student Rotations . . . . . . . . . . . . . . . . . . . . . . 28
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DEACONESS PHARMACY DEPARTMENT | 2013–2014 Annual Report
MISSION, VISION AND GOALS
2013–2014 Fiscal Year Goals by Deaconess FIRST Pillars
With our new leadership team in place and with the input from the employees in the pharmacy department in various forums
in September 2014, we redefined our mission and vision statement to better align the pharmacy department with the growth and direction of Deaconess Health System.
MissionThe Deaconess Pharmacy Department is an innovative team that safely and efficiently provides quality medication therapy and outcomes to the patients and communities we serve.
VisionTo be the regional leader in evidence-based medication therapy by providing safe, quality and cost-effective programs that ensure proper medication use, utilize the latest advances in technology, and improve the health of our employees, patients and community.
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• Increasing quality, resulting in growth
o Design and implement Alaris drug library and EPIC Willow for The Women’s Hospital
o Expand Deaconess Family Pharmacy services for The Women’s Hospital employees
o Successfully convert The Heart Hospital and The Women’s Hospital employees to the prescription drug plan
o Design and implement at least one population management strategy to improve patient outcomes for 30-day readmission rates, populations costs, and medication adherence
• Fantastic people, increasing quality and top financial performance
o Report at least two changes every 30 days to improve metrics for quality, patient safety, costs or employee engagement
• Top financial performance
o Report pharmacy savings or enhanced revenue through P&T, value analysis, revenue cycle or service line greater than or equal to $1.2 million.
2013–2014 Annual Report | DEACONESS PHARMACY DEPARTMENT
PHARMACY ORGANIZATIONAL CHART
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DEACONESS PHARMACY DEPARTMENT | 2013–2014 Annual Report
FANTASTIC PEOPLEPharmacist Certifications and Designations• 39.4% of pharmacist have at least one advanced credential:
o Board-Certified Pharmacotherapy Specialist (BCPS)
o Certified Anticoagulation Care Provider (CACP)
o Advanced Cardiovascular Life Support (ACLS)
o Basic Life Support (BLS)
o Master of Business Administration (MBA)
o Master of Health Administration (MHA)
o Making a Difference in Infectious Disease Certification (MAD-ID)
Pharmacists with Advanced Credentials
Residency-Trained Pharmacists
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2014 Highlights by Deaconess FIRST Pillars
2013–2014 Annual Report | DEACONESS PHARMACY DEPARTMENT
Pharmacy Department Nurse Degrees and Certifications• All nurses that staff in the Deaconess
Anticoagulation Clinic (DAC) have their advanced certification – Certified Anticoagulation Care Provider (CACP)
Percent of nursing degrees
Technician Certifications• All pharmacy technicians are required to
become certified pharmacy technicians (CPhT) within one year of hire
Awards• Lindsay Whisenant received the Great
Catch Award in September 2014
• Maitri Vyas received Technician of the Year
• Emily Hicks received Pharmacist of the Year
INCREASING QUALITYGrand Rounds Presentations• Antimicrobial Stewardship Strategies
Including Dosing and Regimens Presenter: Jeff Starkey, PharmD, BCPS, MAD-ID
• Diabetic Guidelines, New Diabetic Medications and Literature Update Presenter: Traci Fritschle, PharmD, BCPS
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• Pain Control Including Equianalgesic Dosing Presenter: Kelli Lovell, PharmD, CACP
• Ambulatory Care Clinical Practice Guidelines Update Presenter: Jessica Stansbury, PharmD
• Practical Approaches to Medication Safety by Maximizing Technology Presenter: Michelle Schymik, PharmD, BCPS
Additional Presentations• Federal Changes on Opioid Prescribing:
Deaconess Physicians Presenter: Anna Gibson, PharmD
• Cardiac Medications: Red Shoe Series Presenter: Allyson Murray, PharmD, BCPS
• Hyperthyroid and Hypothyroid Lecture: University of Southern Indiana Nurse Practitioner Course Presenter: Jessica Stansbury, PharmD
• Diabetes Lecture: University of Southern Indiana Nurse Practitioner Course Presenter: Jessica Stansbury, PharmD
• Integrated Perspectives on Leveraging Specialty Pharmacy to Achieve ACO Goals: Series of webinars hosted by Avalere, Armada and Specialty Pharmacy Association of America (SPAA) Presenter: Carrie Morton, PharmD, MBA
• Transitioning from Charge-on-Dispense to Charge-on-Administration: Epic’s Spring 2014 Pharmacy Advisory Council Presenters: Scott Fordyce, PharmD; Stacey Donovan; Debra Rorie, RPh
DEACONESS PHARMACY DEPARTMENT | 2013–2014 Annual Report
Health System Committees with Pharmacist Involvement• Anesthesia Committee• Anticoagulation Leadership Team• Cardiovascular Core Care Team• Chronic Disease Management Team• Critical Care Core Team• Community Benefit Committee• Care Integration Steering Committee• Drug Control Team• Emergency Management Committee• Falls Team• Health Plan Beneficiary Task Force• Health Plan Steering Team• Heart Hospital Executive Committee• Infection Control• Medicine Core Care Team• Medication Reconciliation Team
• Moderate Sedation Team• Nutrition Support Team• Oncology Committee• Patient Care Leadership• Patient Safety Coalition• Pediatric Core Care Team• Pharmacy and Therapeutics Committee• Physical Environment Committee• Pneumonia/Influenza Committee• Renal Services Team• Sepsis Team• Stewardship Team• Stroke Committee• Surgical Core Care Team• Vein Preservation Committee• Value Analysis Committee
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RESULTING IN GROWTHPublicationsGranko R, Morton C, Schassfsma K. Role of Executive Coaching in Pharmacy Management. Am J Health-Syst Pharm. 2013; 70:1883-1884
Theising K, Wu K, Scheehan AH. Impact of Peer Assessment on Student Pharmacists’ Behaviors and Self-Confidence. Currents in Pharmacy Teaching and Learning. 2014; 6(1): 10-14
Growth in pharmacy services• Pharmacist began working in Cystic Fibrosis Clinic
• MTM Clinic added asthma wellness plan for Deaconess health plan beneficiaries
SUPERIOR SERVICE• Deaconess Anticoagulation Clinic patient satisfaction fiscal year average was 96.2,
exceeding outpatient satisfaction target of 94.7
• Average turnaround time of a stat order exceeds Epic overall average of nine minutes
Average Stat Turnaround Time
2013–2014 Annual Report | DEACONESS PHARMACY DEPARTMENT
SUPERIOR SERVICE (CONT.)• Medication Assistance Program (MAP) continues to serve patients in need of
prescription assistance.
Patients Served (Average) by MAP
TOP FINANCIAL PERFORMANCE• The pharmacy department reported approximately $600,000 in savings to value
analysis through purchasing, formulary, and operational initiatives to reduce costs.
• MAP continues to offset the costs of medications for patients and the health system by connecting patients with prescription assistance programs and foundations
MAP Value of Prescriptions
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‘05–’06 ‘06–’07 ‘07–’08 ‘08–’09 ‘09–’10 ‘10–’11 ‘11–’12 ‘12–’13 ‘13–’14
DEACONESS PHARMACY DEPARTMENT | 2013–2014 Annual Report
INPATIENT PHARMACY OPERATIONSPharmacy Locations• Deaconess Hospital Pharmacy • Deaconess Gateway Hospital Pharmacy
Serves patients of• Deaconess Hospital• Deaconess Cross Pointe• Deaconess Gateway Hospital• The Heart Hospital at Deaconess Gateway • The Women’s Hospital – after hours
Inpatient Services Deaconess Hospital, Gateway Hospital, The Heart Hospital, Cross Pointe
2013–2014 Accomplishments by Deaconess FIRST Pillars
Fantastic People• Lindsay Whisenant received
the Great Catch Award in September 2014
Increasing Quality• Numerous tweaks in Epic
and to P&P to improve medication safety
• Developed Beyond Use Date Reference Chart
• Created IV room training manual
Resulting in Growth• Piloted pharmacist medication
reconciliation at discharge and collected data on error rates and types of errors
Superior Service• Average turnaround time for
stat medication order to be verified was 3.97 minutes (Epic average: 9 minutes)
Top Financial Performance• Negotiated contract
to include a needed pharmaceutical refrigerator (cost avoidance)
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FY2013/14 (excludes TWH)Average Daily Census 314Annual Admissions 25,785Annual Drug Spend $32,138,389Annual Doses Dispensed 2,003,477
2013–2014 Annual Report | DEACONESS PHARMACY DEPARTMENT
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DEACONESS PHARMACY DEPARTMENT | 2013–2014 Annual Report
INPATIENT CLINICAL QUALITY IMPROVEMENTS
2013–2014 Accomplishments by Deaconess FIRST Pillars
Fantastic People• Deaconess Pharmacy and
Therapeutics Committee is composed of multiple physicians as well as nurses, pharmacists and ancillaries
• Dr. Matt Kolleck, Deaconess hospitalist, is chairman
Increasing Quality• Seven new medications added to
formulary
• Eight drug-use evaluations completed
• Five new therapeutic interchanges approved
• Five new protocol developments
Resulting in Growth• Alaris dataset build for The
Women’s Hospital
• Development of vein preservation protocol
• Ten pharmacist competency programs developed
Superior Service• Quarterly Pharmacy Department
newsletters
• Monthly P&T newsletters
Top Financial Performance• More than $125,000 annual savings
through P&T Committee review
Antimicrobial Stewardship• New dosing protocols
• Antimicrobial auto stop protocol
• Annual antibiogram review
• Sepsis pathways
• Surgical antimicrobial prophylaxis streamlining
Safety/Medication Maximization• Renal dosing protocols
• Dose rounding
• Drug-drug interactions
• ISMP review
• Best practice alerts
Patient Care• More than 29,000 consults
• More than 130,000 pharmacist interventions
• More than 22,000 medication reconciliations
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2013–2014 Annual Report | DEACONESS PHARMACY DEPARTMENT
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PHARMACY SURGICAL SERVICESSatellite Locations• Deaconess Hospital
• Deaconess Gateway Hospital
Satellite Hours• Weekdays: 0600–1600
Serves Patients of• Deaconess Hospital
• Deaconess Gateway Hospital
• The Heart Hospital at Gateway
• Consultant pharmacist for Evansville Surgery Centers
Surgery Satellite Staff• Five trained pharmacists
• Five trained technicians
Population Served
2013–2014 Accomplishments by Deaconess FIRST Pillars
Increasing Quality• Developed order set for ENT cases
Resulting in Growth• Implemented medication provision
for expansion of eye surgery cases
• Implemented medication provision for anesthesia service for the endoscopy product line
Top Financial Performance• Conversion to Thrombin 5000 Unit
Spray Kit, saving $7,500 annually
• Completed anesthesia gas drug use evaluation and education to providers to reduce drug expense and improve outcomes
Surgery location # of surgeries
Deaconess Hospital 7156Deaconess Gateway Hospital
6574
The Heart Hospital 1425
DEACONESS PHARMACY DEPARTMENT | 2013–2014 Annual Report
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The pharmacy located in The Women’s Hospital supports the pharmaceutical
needs of inpatient adults and NICU patients, the OB/GYN emergency department, inpatient and outpatient surgeries, Boston IVF and The Breast Center.
Lead PharmacistTom Petersen, PharmD
Hours of OperationWeekdays: 0600–1800
Weekends: 0700–1530
Women’s Hospital Staff• Eight trained technicians
• Eight trained pharmacists
o One residency-trained pharmacist
o Two BCPS-certified pharmacists
o Two CACP-certified pharmacists
o Four ACLS/PALS-trained pharmacists
2013–2014 Accomplishments by Deaconess FIRST Pillars
Fantastic People• Eleven pharmacists presented
topics at the Deaconess Pediatrics Conference
Increasing Quality• Alaris “Smart Pump” database
build and implementation
• Venous Thromboembolism (VTE) Prophylaxis/Outcomes (see graph on next page)
• C-Section Antibiotic Prophylaxis/Outcomes (see graph on next page)
Resulting in Growth• Supported medication needs of:
o Boston IVF expansion
o TWH Breast Center opening
Superior Service• Drug shortage management
Top Financial Performance• Addition of Family Pharmacy for
TWH employee prescriptions
Inpatient Services
The Women’s Hospital
FY2014Births 3108Doses dispensed 216,275NICU TPNs 3043Drug spend $1,089,492
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DEACONESS PHARMACY DEPARTMENT | 2013–2014 Annual Report
DEACONESS FAMILY PHARMACYLOCATIONSDeaconess HospitalMonday – Friday, 0700 to 1900Saturday, 0900 to 1400
Remote Point of Sale LocationsGateway Hours same as Deaconess Hospital location
The Women’s Hospital Monday – Friday, 0900 to 1400
DFP Staff• Four technicians – Three dedicated
to DFP and one rotates between inpatient and outpatient
• Four trained pharmacists, two dedicated to outpatient and two rotate between inpatient and outpatient
• One pharmacist with immunization training
2013–2014 Accomplishments by Deaconess FIRST Pillars
Fantastic People• Carrie Morton invited as an expert
speaker on a series of webinars on Specialty Pharmacy and ACOs hosted by Avalere, Armada and Specialty Pharmacy Association of America
Increasing Quality• Installed the ScriptPro/2000 robot
• Assigned a designated person in the Family Pharmacy to review the discharge hospice list to remove patients from system thereby decreasing possibility of re-filling expired patients Rx’s
• Tweaked ordering system to better manage inventory of very expensive specialty medications
Resulting in Growth• Added TWH and THH beneficiary
groups
• Analyzed growth potential for adding second location
Superior Service• Piloted discharge prescriptions to
bedside service
Outpatient Services
FY2013/14 Prescription volume 91,886Discharge prescriptions (excluding case mgmt. prescriptions)
7,807
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2013–2014 Annual Report | DEACONESS PHARMACY DEPARTMENT
2013–2014 Accomplishments by Deaconess FIRST PillarsIncreasing Quality• Developed program to address
adherence for new expensive hepatitis C treatments
• Redesigned health plan steering committee to include members from TWH and THH
• Quarterly review of opportunity assessment with the Advisory Board
Resulting in Growth• Added TWH and THH beneficiary
groups
Top Financial Performance• Adjusted copay structure to align
with national benchmarks
• Adjusted formulary by removing items, changing tiers, or requiring a prior authorization or step therapy
PHARMACY BENEFIT MANAGEMENT
The pharmacy team performs monthly analysis on drug cost, plan spend and
rebate information provided by our transparent pharmacy benefit manager, Envision RXOptions. The pharmacy department plays a role in guiding and developing changes to the employee health plan through the Health Plan Steering Committee.
The pharmacy team advises the Health Plan Steering Committee on matters of formulary management, benefit decisions and copay structure to ensure cost effective and quality medication choices.
Population Served• Health plan beneficiaries of:
o Deaconess Hospitalo The Women’s Hospitalo The Heart Hospital
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DEACONESS PHARMACY DEPARTMENT | 2013–2014 Annual Report
MEDICATION THERAPY MANAGEMENT CLINIC
2013–2014 Accomplishments by Deaconess FIRST Pillars
In the Deaconess Medication Therapy Management Clinic (MTM), pharmacists meet
with patients with chronic diseases to ensure medication adherence and improve outcomes.
LocationsOperates in the Deaconess Anticoagulation Clinic with shared resources such as rooms and medical office assistants at DH, DGH and DC Downtown.
Population ServedFY2013/14 Number of visits 755
MTM P&T-Approved Protocols• Asthma • COPD• Diabetes• Heart Failure• Hepatitis C
• Hyperlipidemia• Hypertension• Medication
Therapy Review• Smoking Cessation
MTM staff• 100% pharmacists are board-certified
pharmacotherapy specialists
• Four of five pharmacists residency trained
• Dr. Fredrick Wallisch, MD–Medical Director
Types of MTM Interventions Completed
Referral Type
Increasing Quality• Average improvement
of diabetic patients’ hemoglobin A1C was 0.62
• For hypertensive patients, systolic blood pressure decreased by 12.2, and diastolic blood pressure decreased by 6.8 on average
• Review Humana risk shared contract beneficiary discharge list for recommendations to be sent to their physician
Resulting in Growth• Implemented asthma
wellness protocol for Deaconess health plan beneficiaries
• Developed process for TWH and THH health plan beneficiaries to meet with MTM when needed
• Developed hepatitis C protocol to improved adherence with expensive medication therapies
Superior Service• Offer late
appointments one day a week
• Adjusted location of appointments to meet patient demand
Top Financial Performance• Completed 284 cost-
focused interventions
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DEACONESS PHARMACY DEPARTMENT | 2013–2014 Annual Report
DEACONESS ANTICOAGULATION CLINICS
At the Deaconess Anticoagulation Clinic (DAC), patients on warfarin
are monitored via a fingerstick, series of questions and medication adjustment per P&T protocol to ensure they stay within appropriate range for their indication.
Locations• Deaconess Hospital• Deaconess Gateway Hospital• Deaconess Clinic Downtown• Deaconess Clinic North Park
Population ServedFY2013/14 Number of visits 31,692Number of new patients 565
2013–2014 Accomplishments by Deaconess FIRST Pillars
DAC Staff• Dr. William Hardesty, MD—
Medical Director
• DAC clinicians with advanced credentials:
Increasing Quality• Maintained percentage of INRs in range
above national benchmark of 65% with year-end average of 72.5%
• Developed a process with lab to alert the DAC clinician for high INRs
• Improved reporting capabilities on elevated INR values to report higher values
• Begin review of INRs greater than six with staff education when opportunities for improvement are identified
• Infection control and HFAP review of cleaning procedures and staff education
• DAC bridge therapy protocol updated
• Updated the no show and termination policies
Resulting in Growth• Provided warfarin education
to the Deaconess Clinic nurse coaches
• Developed process to monitor DAC patients admitted to the hospital for post-discharge follow up
Superior Service• Deaconess Anticoagulation Clinic
patient satisfaction fiscal year average was 96.2, exceeding outpatient satisfaction target of 94.7
• Staff education by Patient Experience Officer to improve patient satisfaction scores
• Revised protocols for manage-ment of “snow bird” patients
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2013–2014 Annual Report | DEACONESS PHARMACY DEPARTMENT
There is a dedicated pharmacy team experienced with high risk drugs
and oncology treatments serving the patients in the Deaconess infusion centers. Pharmacists work closely with the nurses and physicians in oncology and the infusion centers to ensure safe, effective treatment is delivered to these patients.
This team also works closely with the Medication Assistance Program and the pre-cert departments to ensure
2013–2014 Accomplishments by Deaconess FIRST Pillars
DEACONESS OUTPATIENT INFUSION SERVICES
Outpatient Infusion Volume
medications are covered by their insurance and patients receive financial help when needed.
LocationsThe three infusion centers at Deaconess are primarily serviced by the pharmacy satellites located at:
• Chancellor Center for Oncology
• Deaconess Clinic Downtown
Increasing Quality• Revised infusion records for chemo
and non-chemo outpatient infusions to improve billing accuracy
• Conducted a ChemoGLO Wipe Study at the Chancellor Center and Deaconess Clinic Infusion Center to monitor environmental exposure with common antineoplastic agents
• Rituximab DUE and benchmarking
• Tysabri® certified infusion sites
Resulting in Growth• HIPEC and hazardous drugs in
operating room process developed
Top Financial Performance• Implemented review of all drug waste
and inclusion on bill (JW modifier, Medicare requirement)
• Completed audit of infusion center charts and requested 100% review of charges prior to billing
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DEACONESS PHARMACY DEPARTMENT | 2013–2014 Annual Report
DEACONESS HOME CARE PHARMACY SERVICES
There is a dedicated pharmacy team experienced with home care and
hospice that serves the patients of Deaconess Home Medical Equipment.
LocationsDeaconess Home Medical Equipment – Deaconess Hospital Campus
DHME Staff• Four trained pharmacists
• Two trained technicians
2013–2014 Accomplishments by Deaconess FIRST Pillars
Increasing Quality• Average INR in range was 60.4%
Resulting in Growth• Worked to transition services to
Deaconess VNA Plus
Superior Service• Addressed 873 INR lab values to
ensure appropriate anticoagulation therapy
Top Financial Performance• Completed audit of medication
billing units
DHME Orders Dispensed
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2013–2014 Annual Report | DEACONESS PHARMACY DEPARTMENT
The Mission of MAPMedication Assistance program (MAP) works through a variety of public and private services that can help patients get their medications at no cost or a reduced cost when help is needed.
Locations• Deaconess Hospital
• Deaconess Clinic Downtown
Population Served• Patients without prescription
insurance coverage
• Patients with low income based on government guidelines
• Patients underinsured with high copays or deductibles
• Patients must have a valid prescription and physician
MAP Representatives• Six pharmacy technicians working
under pharmacist supervision.
2013–2014 Accomplishments by Deaconess FIRST Pillars
Fantastic People• Two new pharmacy technicians
trained in MAP
Increasing Quality• Updated MAP website to include
more medication assistance resources including links to $4 lists at outside pharmacies.
• Evaluated alternative software programs
Resulting in Growth• Ended the fiscal year with 1,737
active patients
Superior Service• Educated all new Deaconess Clinic
nurse coaches on MAP
Top Financial Performance• Coordinated $4,462,725 (average
wholesale price) worth of home medications for patients who received them free of charge.
• Coordinated $504,102 (Deaconess cost) worth of drug replaced to Deaconess mostly for outpatient infusions.
• Coordinated foundation assistance from multiple disease state foundations that equated to $227,553 that was applied toward medication bills.
MEDICATION ASSISTANCE PROGRAM
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DEACONESS PHARMACY DEPARTMENT | 2013–2014 Annual Report
Pharmacy Support for Deaconess Health System
2013–2014 Accomplishments by Deaconess FIRST Pillars
Fantastic People• Three individuals completed
Novation training
Increasing Quality• Programmed Novation reports to
be reviewed monthly
Resulting in Growth• Evaluated and selected new
wholesaler
Superior Service• Minimized impact of drug
shortages by ordering direct, anticipating purchases, changing operational processes, and substitution of different formulations
Top Financial Performance• Negotiated flu vaccine contract
• Completed 5 bulk buy purchases
• Implemented multiple initiatives in conjunction with Midwest Purchasing Coalition
PURCHASINGServes patients of• Deaconess Hospital
• Deaconess Cross Pointe
• Deaconess Gateway Hospital
• The Heart Hospital at Deaconess Gateway
• Deaconess Clinic
Formulary Additions• denosumab (Prolia®)
• valrubicin (Valstar®)
• tbo-filgrastim (Granix®)
• pertuzumab (Perjeta®)
• vortioxetine (Brintellix®)
DRUG SPENDING BY THERAPEUTIC CLASS
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2013–2014 Annual Report | DEACONESS PHARMACY DEPARTMENT
DHS TOP 20 DRUG SPENDGeneric Name Brand Name Therapeutic Class
Infliximab Remicade Disease modifying antirheumatic agent
Rituximab Rituxan Antineoplastic
Pegfilgrastim Neulasta Hematopoetic
Bevacizumab Avastin Antineoplastic
Trastuzumab Herceptin Antineoplastic
Immune Globulin Gamma Privigen Immune Serum
Pemetrexed Disodium Alimta Antineoplastic agent
Pneumoc 13-val conj-dip
Prevnar 13 Vaccine
Denosumab Prolia/Xgeva Antineoplastic
Alteplase Activase/Cathflo Thrombolytic
Ertapenem sodium Invanz Antibiotic/Carbapenem
Daptomycin Cubicin Antibiotic
Bendamustine Hcl Treanda Antineoplastic agent
Regadenoson Lexiscan Adenosine Receptor Agonist
Enoxaparin sodium Lovenox Anticoagulant
Albumin human Buminate Blood modifier agent
Octreotide acetate Sandostatin Endocrine-Metabolic Agent
Bivalirudin Angiomax Direct Thombin Inhibitor
Darbepoetin alfa Aranesp Hematopoetic
Azacitidine Vidaza Antineoplastic agent
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DEACONESS PHARMACY DEPARTMENT | 2013–2014 Annual Report
PHARMACY INFORMATICS TEAM
2013–2014 Accomplishments by Deaconess FIRST Pillars
Fantastic People• One pharmacist retired
• Presented at Epic User Group Meeting
Increasing Quality• Numerous updates to Epic to
improve safety of medications
• Negotiated and completed robot overhaul
• Completed EPIC build for ambulatory and emergency department preference list
• Meaningful use grouper validation
Resulting in Growth• Reviewed and began build for
Epic 2014 upgrade and TWH implementation
Superior Service• IT pharmacy support located in the
pharmacy department
Top Financial Performance• Completed investigation on two
RAC audits
The informatics team within the pharmacy department is responsible
for automation, database management and Willow, the medication management application of Epic.
Under the direction of the pharmacy implementation supervisor, all build, maintenance and validation to ensure proper ordering, charging and automated clinical decision making are completed across the system and multiple campuses.
Pharmacy Informatics Team:• Three pharmacists
• Two technical analysts
Automation Supported• Aesynt™ Robot-Rx®
• Aesynt™ Unit Dose Packager and Overwrapper
• Baxter ABACUS™ Calculation Software
• Baxter DoseEdge™ Pharmacy Workflow Manager
• Baxter EXACTAMIX™ Automated Compounder
• CareFusion Pharmogistics® Carousel and Inventory Management Software
• Omnicell® automated dispensing cabinets
• ScriptPro® SP 200 Robot
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DEACONESS PHARMACY DEPARTMENT | 2013–2014 Annual Report
2013–2014 Resident• Jessica Stansbury
o Graduated from Purdue Universityo Residency Project: Implementation of
a Pharmacist in a Physician’s Office
2014–2015 Resident• Morgan Labhart
o Graduated from Appalachian College of Pharmacy
o Residency Project: Preparation for URAC Specialty Pharmacy Accreditation – A Gap Analysis
Where are our residents now?• 4—Clinical
pharmacists at Deaconess
• 1—South Bend, IN• 3—St. Louis, MO• 1—Cleveland, OH
• 1—Indianapolis• 1—Springfield, IL• 1—Vincennes, IN• 1—Washington
State• 1—Arizona
• 1—South Dakota
DEACONESS PHARMACY RESIDENCY PROGRAMThe pharmacy residency was originally accredited by ASHP in 2006 and was renewed in 2013. The residency started in July 2006 and has successfully graduated a total of 15 residents who have met the goals of the program by working in academia or as clinical pharmacists in a variety of settings.
Education and Training
Residency PreceptorsNew Preceptors in 2014: 4
Total Residency Preceptors: 20
Preceptor Requirements:
• One year of experience following an ASHP-accredited residency program
• Three years of experience if a residency program was not completed
• Must be a model practitioner and contribute to pharmacy knowledge
Residency Rotations Offered• Administrative• Advanced
General Medicine• Anticoagulation
Clinic – longitudinal rotation
• Cardiology• Critical Care• Drug Information• Emergency Room• Family Medicine –
longitudinal rotation
• General Medicine• Geriatrics• Infectious Disease• Medication
Therapy Management – longitudinal rotation
• Nephrology• NICU• Nutrition• Oncology• Orientation/
staffing• Pediatrics• Surgery
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DEACONESS PHARMACY DEPARTMENT | 2013–2014 Annual Report
DEACONESS PHARMACY STUDENT PROGRAMEducation and TrainingDeaconess Health System provides training for pharmacy students on both IPPE and APPE rotations. During the 2013–2014 year, students from Butler University, Purdue University, St. Louis College of Pharmacy, Southern Illinois University–Edwardsville, and Creighton were taught by Deaconess pharmacists.
Pharmacy Rotations Offered • IPPE Rotation - Hospital Operations
• APPE Rotationso General
Medicineo Anticoagulationo Nutritiono Surgeryo Home Care/
Hospice
o Oncologyo Pediatricso Emergency
Medicineo Family
Medicine Clinic
Student PreceptorsNew Preceptors in 2013–2014: 2
Total Student Preceptors: 9
One pharmacist oversees the coordination of all students rotations and serves as the Butler University College of Pharmacy Regional Coordinator.
2013–2014 Students• Forty student rotations were completed
• Five schools were served
2013–2014 Student Projects• All pharmacy students help with
admission medication reconciliation
• Updating anticoagulation reference
• Clarifying admission medication reconciliation steps for all students
• Tube feedings for certain medications
Student rotations = great recruiting39.7% of current pharmacists completed pharmacy rotations at Deaconess as students
Paid Summer StudentsA limited number of students work as technicians during peak vacation season and gain experience. Summer students also work on projects and help with regulatory requirements. FY13/14 projects included:
• Analyzed pain data to help HCAHPS pain team and address narcotic adverse events
• Developed and implemented discharge-medications-to-bedside program
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