optimal prescribing update and support (opus) prototype session 2 march 7, 2012
TRANSCRIPT
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Optimal Prescribing Update and Support (OPUS)Prototype Session 2
March 7, 2012
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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
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Report Out by Practices
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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
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BREAK
(15 minutes)
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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
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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
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LUNCH
(60 minutes)
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BREAK
(15 minutes)
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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
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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: [email protected] [email protected]
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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
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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)
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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
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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%)
0
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
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The Evaluation Today
• Please complete the survey at the end of today’s session
• We appreciate your time and input into this process
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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