CSHP 2015 - Can YOU hit the Target?

Carolyn Bornstein BScPhm, ACPR, FCSHP

CSHP President, Vision Liaison

November 17, 2007

CSHP 2015 – Can YOU Hit the Target?

OB AGM – Nov 17, 2007

CSHP MISSION

CSHP is the national voice of pharmacists committed to the advancement of safe, effective medication use and patient care in hospitals and related healthcare settings

CSHP 2015 – Can YOU Hit the Target?

OB AGM – Nov 17, 2007

CSHP VISION 2010

A dynamic Society The Influential Voice for Hospital

Pharmacy Inspiring Practice Excellence Fostering Leadership and

Professional Growth

CSHP 2015 – Can YOU Hit the Target?

OB AGM – Nov 17, 2007

VISION 2010 – Four Pillars

Advocacy CMA, SOP, Global, PR, Blueprint, CPSI

Organizational EffectivenessCommunication, branches, succession

Members and Membership ServicesE-commerce, PSNs, online education, PLI

Practice Excellence through CSHP 2015

CSHP 2015 – Can YOU Hit the Target?

OB AGM – Nov 17, 2007

STRATEGIC OBJECTIVE

CSHP will improve patient medication outcomes and safety by advancing practice excellence through CSHP 2015

CSHP 2015 – Can YOU Hit the Target?

OB AGM – Nov 17, 2007

What is CSHP 2015?

Adaptation of ASHP’s 2015 Initiative Patterned after Healthy People 2010 6 Goals and related objectives (34) Pharmacy practice excellence in hospitals and

related healthcare settings in 2015 A Vision - The Future of Hospital Pharmacy

Practice in Canada A patient-centred tool A Quality Initiative

CSHP 2015 – Can YOU Hit the Target?

OB AGM – Nov 17, 2007

SIX GOALS OF CSHP 2015

1. Making medication use effective in hospitals

2. Making medication use effective in non-hospital settings

3. Making medication use scientific

4. Making medication use safe wrt systems

5. Making medication use safe wrt technology

6. Making meaningful contributions to public health

CSHP 2015 – Can YOU Hit the Target?

OB AGM – Nov 17, 2007

SIX GOALS OF CSHP 2015

“Effective” medication use

1. Increase the extent to which pharmacists help individual hospital inpatients achieve the best use of medications

2. Increase the extent to which pharmacists help individual non-hospitalized patients achieve the best use of medication

CSHP 2015 – Can YOU Hit the Target?

OB AGM – Nov 17, 2007

GOALS Continued

“Scientific” medication use

3. Increase the extent to which hospital and related healthcare setting pharmacists actively apply evidence-based methods to the improvement of medication therapy

CSHP 2015 – Can YOU Hit the Target?

OB AGM – Nov 17, 2007

GOALS Continued

4. Increase the extent to which pharmacy departments in hospitals and related healthcare settings have a significant role in improving the safety of medication use.

5. Increase the extent to which hospitals and related healthcare settings apply technology effectively to improve the safety of medication use

“Safe” medication use

CSHP 2015 – Can YOU Hit the Target?

OB AGM – Nov 17, 2007

GOALS Continued

6. Increase the extent to which pharmacy departments in hospitals and related healthcare settings engage in public health initiatives on behalf of their communities

“Community” health

CSHP 2015 – Can YOU Hit the Target?

OB AGM – Nov 17, 2007

OBJECTIVES – Support Goals

Improve medication outcomes patient safety pharmacy practice excellence

Measurable targets Based on:

What will make the most difference to the patient? What will convey the positive contributions of the

pharmacist? Can change as best practice changes or evolves

CSHP 2015 – Can YOU Hit the Target?

OB AGM – Nov 17, 2007

OBJECTIVES

APPLY TO ALL TYPES OF:

PATIENTS - Inpatients, outpatients, community members

PHARMACISTS - generalists, specialists, and managers

PRACTICE SETTINGS – hospital, clinics, primary care, LTCF, community

CSHP 2015 – Can YOU Hit the Target?

OB AGM – Nov 17, 2007

Please REMEMBER….

ALL OBJECTIVES won’t apply to everyone,

But there is … SOMETHING FOR EVERYONE!

They include measurable targets to monitor progress

CSHP 2015 – Can YOU Hit the Target?

OB AGM – Nov 17, 2007

MEASURABLE TARGETS

BASELINES required Where are we now?

TARGETS Aspirations, challenges, NOT standardsWhere we want to be in 2015! May change once baseline determined

CSHP 2015 – Can YOU Hit the Target?

OB AGM – Nov 17, 2007

Some Objectives – Goal 1

Objective 1.3In 90% of hospitals, pharmacists will have organizational authority to manage medication therapy in collaboration with other members of the health-care team

Objective 1.475% of hospital inpatients discharged with complex and high-risk medication regimens will receive medication counselling managed by a pharmacist

Objective 1.550% of recently hospitalized patients or their caregivers will recall speaking with a pharmacist while in the hospital

CSHP 2015 – Can YOU Hit the Target?

OB AGM – Nov 17, 2007

Some Objectives – Goal 2

Objective 2.2In 95% of ambulatory and specialized care clinics, pharmacists will counsel clinic patients with complex and high-risk medication regimens

Objective 2.3In 85% of home care services, pharmacists will have organizational authority to manage medication therapy in collaboration with other members of the healthcare team

Objective 2.4In 65% of long-term care facilities, pharmacists will have organizational authority to manage medication therapy in collaboration with other members of the healthcare team

CSHP 2015 – Can YOU Hit the Target?

OB AGM – Nov 17, 2007

Some Objectives – Goal 3

Objective 3.2In 100% of hospital and related healthcare settings, pharmacists will be actively involved in the development and implementation of all evidence-based therapeutic protocols involving medication use

Objective 3.790% of hospital pharmacies will participate in ensuring that patients hospitalized for an acute myocardial infarction will receive lipid-lowering therapy at discharge

CSHP 2015 – Can YOU Hit the Target?

OB AGM – Nov 17, 2007

Some Objectives – Goal 4

Objective 4.190% of hospitals and related healthcare settings will have an organizational program, with appropriate pharmacy involvement, to achieve significant annual, documented improvement in the safety of all steps in medication use

Objective 4.380% of hospitals have at least 95% of routine medication orders reviewed for appropriateness by a pharmacist before administration of the first dose

CSHP 2015 – Can YOU Hit the Target?

OB AGM – Nov 17, 2007

Some Objectives – Goal 5

Objective 5.3 For routine medication prescribing for

inpatients, 75% of hospitals will use computerized prescriber order entry systems with clinical decision support

Objective 5.5 In 75% of hospitals and related healthcare

settings, pharmacists will use medication-relevant portions of patients’ electronic medical records for managing patients’ medication therapy

CSHP 2015 – Can YOU Hit the Target?

OB AGM – Nov 17, 2007

Some Objectives – Goal 6

Objective 6.2 85% of hospital pharmacies will participate in

ensuring that high risk patients in hospitals and related healthcare settings receive vaccinations for influenza and pneumococcus

Objective 6.3 80% of hospital pharmacies will participate in

ensuring that hospitalized patients who smoke receive smoking-cessation counselling

CSHP 2015 – Can YOU Hit the Target?

OB AGM – Nov 17, 2007

CSHP 2015 vs ASHP 2015

Same GoalsObjectives – from 31 to 34

Split one objective re: MI and CHF patients into 2 separate objectives

HbA1c testing be done “at least” annually NEW: pharmacist reviewing medication orders

in the Emergency Department within 24 hours NEW: computerized pharmacist order entry

system with clinical decision support NEW: unit dose systems Deleted immunization initiatives in

communities by hospital pharmacies Target % patients vs % hospitals

CSHP 2015 – Can YOU Hit the Target?

OB AGM – Nov 17, 2007

CSHP 2015 DEFINITIONS

Hospital (vs health-system)adapted from the Canada Health Act definition

Complex and High Risk Medications ISMP and institutional specific lists/definitions

Managing vs monitoringMedication counsellingRoutine medication ordersCommunity Health Initiatives

CSHP 2015 – Can YOU Hit the Target?

OB AGM – Nov 17, 2007

Where’s the EVIDENCE?

ASHP 2015 Crosswalk (on their website)Links to literature supporting role of

pharmacist, best practice guidelines, outcome measures

A Canadian version would link to National and Provincial Health Priorities of other organizations (eg. ISMP, CMA, CPSI, etc.)

CSHP is considering a Canadian crosswalk

CSHP 2015 – Can YOU Hit the Target?

OB AGM – Nov 17, 2007

Where do YOU start?

CSHP 2015 on CSHP website (www.cshp.ca) CSHP 2015 self-assessment tool (website) Review 2015 presentations (website) Review the objectives wrt your practice setting Engage colleagues and/or your department Use self-assessment tool to identify priorities Choose one or more objectives! Multiple applications…..

CSHP 2015 – Can YOU Hit the Target?

OB AGM – Nov 17, 2007

How to Incorporate CSHP 2015

Strategic planA new pharmacist serviceA residency projectProgram improvement projectPatient safety initiativeResearch projectUse your imagination……..

CSHP 2015 – Can YOU Hit the Target?

OB AGM – Nov 17, 2007

HOW You can hit the Target

Select your objectiveAction plan – NO roadmaps!Measure Baseline (Don’t forget!!)Monitor progressEvaluateGive yourself time (8 years if necessary!)SHARE YOUR SUCCESS!!!

CSHP 2015 – Can YOU Hit the Target?

OB AGM – Nov 17, 2007

Strategic Plan for CSHP 2015

Official launch at PPC 2008Commitment – individual and institutionProject leader and steering committeeLilly Hospital Pharmacy SurveyShare members’ success storiesOngoing relationship with ASHP for

advice and to share our progress, challenges, successes in Canada

CSHP 2015 – Can YOU Hit the Target?

OB AGM – Nov 17, 2007

TO RECAP, CSHP 2015 is…

1. A vision of pharmacy practice excellence

2. A patient centered tool to improve medication safety and outcomes

3. A living, breathing document4. Susceptible to change/updating as

practice standards are redefined5. Applicable to various areas of

pharmacy practice

CSHP 2015 – Can YOU Hit the Target?

OB AGM – Nov 17, 2007

And Don’t forget when you….

Hit the Target..Share your success story…Succeed we ALL succeed!Improve patient care, everyone

benefitsFinish, choose another objective

CSHP 2015 – Can YOU Hit the Target?

OB AGM – Nov 17, 2007

So get out there and..

Just DO it!Because…

You CAN hit the TARGET!