Multidisciplinary team for enhancing care for patients with acute myocardial infarction or heart failure

Coons, James C.; Fera, Toni

doi:10.2146/ajhp060281

Cited by 23 publications

(16 citation statements)

References 15 publications

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“…As adherence to performance measures begins to affect reimbursement, institutions use clinical pathways and guideline‐based order sets. Pathways developed and implemented by multidisciplinary teams, including physicians, nonphysician providers, nurses, and pharmacists, have been shown to improve adherence to performance measures, medication safety, and outcomes . Clinical pharmacists can provide recommendations about drug dosing and monitoring parameters built into the order set, and implementation strategies.…”

Section: Clinical Pharmacist Roles Across the Continuum Of Heart Failmentioning

confidence: 99%

Clinical Pharmacy Services in Heart Failure: An Opinion Paper from the Heart Failure Society of America and American College of Clinical Pharmacy Cardiology Practice and Research Network

et al. 2013

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Heart failure (HF) care takes place in multiple settings, with a variety of providers, and generally involves patients who have multiple comorbidities. This situation is a "perfect storm" of factors that predispose patients to medication errors. The goals of this paper are to outline potential roles for clinical pharmacists in a multidisciplinary HF team, to document outcomes associated with interventions by clinical pharmacists, to recommend minimum training for clinical pharmacists engaged in HF care, and to suggest financial strategies to support clinical pharmacy services within a multidisciplinary team. As patients transition from inpatient to outpatient settings and between multiple caregivers, pharmacists can positively affect medication reconciliation and education, assure consistency in management that results in improvements in patient satisfaction and medication adherence, and reduce medication errors. For mechanical circulatory support and heart transplant teams, the Centers for Medicare and Medicaid Services considers the participation of a transplant pharmacology expert (e.g., clinical pharmacist) to be a requirement for accreditation, given the highly specialized and complex drug regimens used. Although reports of outcomes from pharmacist interventions have been mixed owing to differences in study design, benefits such as increased use of evidence-based therapies, decreases in HF hospitalizations and emergency department visits, and decreases in all-cause readmissions have been demonstrated. Clinical pharmacists participating in HF or heart transplant teams should have completed specialized postdoctoral training in the form of residencies and/or fellowships in cardiovascular and/or transplant pharmacotherapy, and board certification is recommended. Financial mechanisms to support pharmacist participation in the HF teams are variable. Positive outcomes associated with clinical pharmacist activities support the value of making this resource available to HF teams.

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Section: Clinical Pharmacist Roles Across the Continuum Of Heart Failmentioning

confidence: 99%

Clinical Pharmacy Services in Heart Failure: An Opinion Paper from the Heart Failure Society of America and American College of Clinical Pharmacy Cardiology Practice and Research Network

et al. 2013

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“…These fi ndings are similar to a study in which compliance with discharge instructions remained lower than anticipated because of documentation issues within the medication reconciliation process. 4 Changes in the discharge medication transcription process at our institution are currently in process to address this systematic problem.…”

Section: Discussionmentioning

confidence: 99%

Pharmacist Involvement at Discharge with the Joint Commission Heart Failure Core Measure: Challenges and Lessons Learned

et al. 2014

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“…A single study found that a multidisciplinary team that included pharmacists may improve Joint Commission core measures for hospitalized patients with HF. 14 Due to documentation issues related to medication reconciliation, the percentage of discharge instructions remained lower than anticipated. 14 Warden et al 15 found that pharmacist involvement in medication reconciliation and discharge counseling for HF patients was associated with a significant increase in adherence to Joint Commission discharge instructions (83% vs 100%, p = 0.007).…”

Section: Introductionmentioning

confidence: 94%

The impact of a Continuum of Care Resident Pharmacist on heart failure readmissions and discharge instructions at a community hospital

Truong

Backes

2015

SAGE Open Medicine

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Purpose:To examine the impact of a Continuum of Care Resident Pharmacist on (1) heart failure 30-day hospital readmissions and (2) compliance with Joint Commission Heart Failure core measure 1 at a community hospital.Methods:The Continuum of Care Network led by a Continuum of Care Resident Pharmacist was established in August 2011. The Continuum of Care Resident Pharmacist followed Continuum of Care Network patients and retrospectively collected data from August 2011 to December 2012. Thirty-day readmission rates for Continuum of Care Network heart failure patients versus non-Continuum of Care Network heart failure patients were compared and analyzed. Joint Commission Heart Failure core measure 1 compliance rates were retrospectively collected from January 2011 and compared to data after establishment of the Continuum of Care Network.Results:In all, 162 Continuum of Care Network patients and 470 non-Continuum of Care Network patients were discharged with a diagnosis of heart failure from August 2011 to December 2012. Continuum of Care Network heart failure patients had a lower 30-day all-cause readmission rate compared to non-Continuum of Care Network heart failure patients (12% versus 24%, respectively; p = 0.005). In addition, Heart Failure core measure 1 compliance rates improved from the 80th percentile to the 90th percentile after implementation of the Continuum of Care Network (p = 0.004). The top three interventions performed by the Continuum of Care Resident Pharmacist were discharge counseling (74.1%), providing a MedActionPlan™ (68.5%), and resolving medication reconciliation discrepancies (64.8%).Conclusion:The study findings suggest that a Continuum of Care Resident Pharmacist contributed to lowered heart failure readmission rates and improved Heart Failure core measure 1 compliance rates. Future randomized, controlled trials are needed to confirm these findings.

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Multidisciplinary team for enhancing care for patients with acute myocardial infarction or heart failure

Abstract: A multidisciplinary team that included pharmacists improved JCAHO core measures for hospitalized patients with MI or HF.

Cited by 23 publications

References 15 publications

Clinical Pharmacy Services in Heart Failure: An Opinion Paper from the Heart Failure Society of America and American College of Clinical Pharmacy Cardiology Practice and Research Network

Clinical Pharmacy Services in Heart Failure: An Opinion Paper from the Heart Failure Society of America and American College of Clinical Pharmacy Cardiology Practice and Research Network

Pharmacist Involvement at Discharge with the Joint Commission Heart Failure Core Measure: Challenges and Lessons Learned

The impact of a Continuum of Care Resident Pharmacist on heart failure readmissions and discharge instructions at a community hospital

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