Contribution of Hospital Pharmacy Residents to Resolution of Drug Therapy

Problems for Patients: RES-DTP Study

Manish KhullarRichard SlavikSean Gorman

Nicole BruchetSarah Murray

Brett HamiltonDawn Dalen

Victoria Slavik

Background

• Priority disease states account for a significant number of ED visits, hospital admissions, prolonged lengths of stay and increased costs

• RCTs have shown that pharmacists providing proactive, evidence-based activities to resolve DTPs for patients with priority disease states can improve the overall quality of drug therapy, and reduce ED visits, readmissions, costs

Background

• To promote clinical pharmacist continuous professional development (CPD), disease state education modules (DSEMs) for priority disease states were implemented at IH in 2009

• DSEMs improve the knowledge, skills, abilities, competence, and confidence of pharmacists and improve accepted process of care measures (DTPs, DSEM DTPs and DSEM KPIs)

Background

• Pharmacist-resolved DTPs is the primary clinical performance indicator at IH and part of the recommended bundle of Canadian clinical pharmacy key performance indicators (cpKPIs)

• From Aug 1/2012 to July 31/2013, IH pharmacists resolved 27, 564 DTPs, of which 10, 911 (40%) were DSEM DTPs, and 7834 (28%) DSEM KPIs

Rationale

• Providing evidence-based clinical activities and resolving DTPs is a major goal for professional development during the IH Pharmacy Practice Residency Program

• Limited observational data and a systematic review suggest that U.S. entry to practice PharmD students and residents may contribute to “clinical activities” or “clinical interventions” during experiential rotations

• There are no data on the contribution of Canadian pharmacy practice residents to clinical activities or resolved DTPs during their experiential rotations

Rationale

• At IH, a recently completed study on perceived benefits and barriers to residency precepting identified discordance in the perception of resident contributions to DTP resolution

• Current preceptors vs non-preceptors, and staff pharmacists vs managers were more likely to state that pharmacy residents contribute to DTP resolution for patients

• There are currently no data on resolution of DTPs by IH pharmacy residents

Purpose and Objectives

• Purpose:• To describe the contribution of hospital pharmacy

residents to clinical pharmacy care using accepted process of care measures, and capture resident perceptions of DTP tracking

• Primary Objective:• To determine the number of DTPs resolved by IH

pharmacy residents

Secondary Objectives

• To determine the number of DSEM DTPs resolved by IH pharmacy residents

• To determine the number of KPIs resolved by IH pharmacy residents

• To determine the number of DTPs, DSEM DTPs, and DSEM KPIs resolved by IH pharmacy residents over time

• To collect focus group feedback on perceptions of DTP tracking from IH pharmacy residents

Significance

• Will help quantify contribution of IH pharmacy residents to evidence-based clinical activities and resolved DTPs, and identify if training procedures need to be modified to promote real world contribution of IH pharmacy residents

• Relevance to Canadian hospital pharmacy residency programs

Methods

• Design • Prospective, observational, one group study to

determine the contribution of hospital pharmacy residents to clinical process of care measures

• Setting• Kelowna General Hospital (KGH), Royal Inland Hospital

(RIH), Penticton Regional Hospital (PRH), East Kootenay Regional Hospital (EKH) and Kootenay Lake Hospital from July 29, 2013 to June 13, 2014

Methods

• Inclusion Criteria• DTP Tracker data collated from all IH hospital pharmacy

residents after the completion of the first 4 week patient care rotation (ie. Internal Medicine rotation) will be included

• Exclusion Criteria• DTP Tracker data that is un-interpretable due to

manipulation of standard pull-down field options, free text options, or incomplete entry of resolved DTPs will be excluded

Methods

• Primary Outcomes:• Number of DTPs resolved by IH pharmacy residents

• Secondary Outcomes:• Number of DSEM DTPs resolved by IH pharmacy

residents• Number of DSEM DTPs and DSEM KPIs resolved by IH

pharmacy residents• Number of DTPs, DSEM DTPs, and DSEM KPIs resolved by

IH pharmacy residents over time• Focus group feedback on perceptions of DTP tracking

from IH pharmacy residents

QUESTIONS?