Optimal Prescribing Update and Support (OPUS)Prototype Session 2

March 7, 2012

Session OpeningDr. Keith White, MD

OPUS takes off and flies

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Session Opening (15 min) Report out by Practices (75 min) Break (15 min) Feedback on Materials (30 min) Facilitation Skills (60 min) Lunch (60 min) Break out: Presentations Skills, MOA (60 min) Break (30 min) Training Video Discussion (30 min) Engagement Strategy (30 min) Evaluation (15 min) Closing Remarks (15 min)

Agenda

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“What’s In It For Me?” (WIIFM) ––> What was “it” for you?

Action Period Report Results

Report Out by Practices

Out of 8 physicians who reported…

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906 patients were identified

How Many Patients were Identified?

Statins PPIs

Patient Lists

63 137

EMR 334 372

Total 397 509

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5 GPs reviewed patient charts before visit

4 GPs called in patients to discuss medications

4 GPs flagged charts to identify patients who required medication reviews on next visit

Over half of patients were caught at their next regular visit

Action Period Activities

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GPs had discussions about medication changes with 181 patients

GPs changed medication in over 54 patients

GPs succeeded in tapering or stopping medications in over

45 patients

What happened?

PPIs Statins

156 125

PPIs Statins

35+ 19

PPIs Statins

26+ 19

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Give a brief overview of what you did in the action period:

› What went well?

› What did not?

› How did MOAs help?

› Suggestions for improvements for your colleagues?

Summary Reports from tables:

› Top 2-3 highlights of the action period.

› Top 2-3 barriers.

› Most common MOA supporting roles.

› Suggestions for future action periods.

Table Discussions

BREAK

(15 minutes)

Feedback on Materials

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What worked well?

What didn't work at all?

What needs to be revised? How should it be revised?

What is missing or what would make things make things run more smoothly?

Discussion questions

Facilitation Skills

Helen Roberts, Clippe Communications helenvr@dccnet.com

604 788 9886

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To help you feel comfortable as a facilitator

To clarify the role of the pharmacy support

Purpose

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The earlier the better

WIIFM - What's In It For Me

Open ended questions

Teaching attitude is different than teaching a skill !

Principle #1: Engage them

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Your Brain on Questions

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Engage them with questions

Review purpose and agenda

Your role: Share your story – what you liked

What’s in it for them

Recap

Agenda

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Tell them what you are going to tell them

Then tell them

Then tell them what you told them

Principle #2

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Put questions back to the group

Lean into your partner for help

Principle #3: You never need to have all the answers

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7 + 2 Chunk your information

Attitudes are contagious

Principle #4 and 5

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Presentation Skills – plenary

MOAs – Beijing Room, Second Floor

Break out sessions

LUNCH

(60 minutes)

BREAK

(15 minutes)

Training Video DiscussionMalcolm Maclure and Alan Cassels

http://www.web.uvic.ca/~studies/

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Recruit GPs

Rehearse your presentation

Replace or supplement Academic Detailer

Reminders for Action Periods

Additional drugs classes. e4PROS project.

Uses of Videos

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“What’s In It For Me?”

Special Authority Pre-Approval: other drug class?

Other motivators to engage GPs

e4PROS project: e-Education for Prescribing Review Enabling remote GPs to participate Option to extend OPUS to other drug classes

Engagement Strategy

Evaluation

Marcus Hollander, PhD &Helena Kadlec, PhD

March 7, 2012

Hollander Analytical Services Ltd.308 -895 Fort StreetVictoria, BC V8W 1H7

Tel: (250) 384-2776Fax: (250) 389-0105E-Mail: marcus@hollanderanalytical.com helena@hollanderanalytical.com

Our Evaluation Approach (Adapted to the Quarterly Learning Session model)

FinalizeModule Content

Everyone in attendance:Session #1 Survey

Everyone in attendance:Session #2 Survey

Action PeriodSession #1

Prototyping a PSP Learning Module

Session #2

** TODAY **

Regional Roll-out

Report to PSPReport to PSP

Findings from Session 1

• Prototype Session 1 (Nov 2011) 23 participants who completed the survey (11 GPs, 3 MOAs, 6

Academic Detailers, 3 PSP RSTs) response rate = 87%

• Make-up session (Jan 2012) 8 participants completed the survey (7 GPs and 1 Pharmacist)

Number and Percentage of Participants Rating their Understanding of Each Topic as “Very Good” or “Good”

Topic

Prototype Session 1

Make-up session

N % N %

The overall aims of the OPUS learning session. 12/13 92.3 7 / 8 87.5

Information contained in an EQIP report. 12/13 92.3 4 / 6 66.7

Special Authority Pre-approval Agreement. 9/13 69.3 2 / 6 33.3

The model for improvement employed by PSP. 12/13 92.3 7 / 8 87.5

Your role in the OPUS initiative. 10/13 76.9 4 / 7 57.1

Your goals and expectations for the action period. 10/13 76.9 5 / 8 62.5

Your plans for change during the action period. 9/11 81.8 4 / 7 57.1

How to engage the local community pharmacist in patients’ care.

3/13 23.1 2 / 8 25.0

How the new information/handouts will be used in the GP’s practice.

6/12 50.0 5 / 7 71.4

How you will self-audit charts during the action period. 9/13 69.2 4 / 7 57.1

How you will monitor changes during the action period. 11/13 84.6 4 / 8 50.0

Overall level of preparedness for the action period. 9/12 75.0 5 / 8 62.5

Session 1(Nov 2011)

Make-up(Jan 2012)

The review of my personal EQIP portrait prior to the learning session, was: helpful to me. . . . . . . . . . . . . . . . . . . . . surprising to me. . . . . . . . . . . . . . . . . . uncomfortable for me . . . . . . . . . . . . . .

8 (100%)5 (62.5%)1 (12.5%)

3 (100%)1 (33.3%)

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The discussion of the data limitation (as influenced by a GP’s approach to MSP coding) was helpful to me.

9 (90.0%) 3 (75.0%)

My understanding of my prescribing patterns was improved by attending the session.

7 (70.0%) 4 (80.0%)

After attending the session, I understand how I can improve my patient lists

7 (70.0%) 4 (57.1%)

After attending the session, I feel more comfortable with collabo-rating with the community pharmacist in caring for my patients.

2 (20.0%) 1 (14.3%)

After attending the session, I feel more comfortable discussing changes in prescriptions with my patients, with regard to: a) Antihypertensives

b) Statins c) Proton Pump Inhibitors d) Anticoagulants

9 (90.0%)10 (100%)10 (100%)4 (44.4%)

--7 (100%)7 (100%)

--

Number and % of GPs who Agreed or Strongly Agreed

The Evaluation Today

• Please complete the survey at the end of today’s session

• We appreciate your time and input into this process

Closing Comments

Dr. Keith White, MD

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Presentation to GPSC of OPUS prototype results

Data strategy approval

e-Education for Prescribing Review & Online Support (e4PROS)

Additional drugs classes may be explored

Evaluation of the provincial OPUS

Next Steps