Larry Beresford

Patrick Cawley, MD, MBA, MHM, a past president of SHM and a recipient of its prestigious Master of Hospital Medicine award, has been named vice president for clinical operations and executive director of the Medical University Hospital Authority at the Medical University of South Carolina (MUSC) in Charleston.

"What distinguished Dr. Cawley from the rest of the field is his intimate knowledge of MUSC, his medical expertise combined with graduate education in management, and his track record of improving our performance in quality and patient safety," says Raymond S. Greenberg, MD, PhD, and president of MUSC. "Given his familiarity with the issues here, Dr. Cawley can step in quickly to assume his new responsibilities. He's already demonstrating steady and thoughtful leadership."

Dr. Cawley took his first leadership course 15 years ago. That led to other courses on such topics as marketing and finance, and that led to his earning a master’s degree in business administration from the University of Massachusetts at Amherst. "Just like medicine, you never stop learning in business or trying to do things better," he says.

Dr. Cawley says hospitalists have a leg up on other physicians when it comes to moving into hospital administration. "Being a hospitalist allowed me to get into every nook and cranny of this hospital," he says. He advises other hospitalists interested in this path to seek out progressive leadership roles. “Show what you can do,” he says, “and get that management degree.”

As Dr. Cawley's administrative responsibilities continue to expand, the time he spends in clinical practice continues to decrease. Although he plans to give up clinical work for the crucial first six months in his new position, he says he hopes to return to hospitalist practice at least 10% of the time after that.

"Any CEO worth his or her salt goes out to the front lines to see what is happening," Dr. Cawley notes. "As a physician, it is easier to get to those front lines. Once there, you get a feel for how the hospital really runs."

Visit our website for more information about executive leadership positions in hospitals.

Patrick Cawley, MD, MBA, MHM, a past president of SHM and a recipient of its prestigious Master of Hospital Medicine award, has been named vice president for clinical operations and executive director of the Medical University Hospital Authority at the Medical University of South Carolina (MUSC) in Charleston.

"What distinguished Dr. Cawley from the rest of the field is his intimate knowledge of MUSC, his medical expertise combined with graduate education in management, and his track record of improving our performance in quality and patient safety," says Raymond S. Greenberg, MD, PhD, and president of MUSC. "Given his familiarity with the issues here, Dr. Cawley can step in quickly to assume his new responsibilities. He's already demonstrating steady and thoughtful leadership."

Dr. Cawley took his first leadership course 15 years ago. That led to other courses on such topics as marketing and finance, and that led to his earning a master’s degree in business administration from the University of Massachusetts at Amherst. "Just like medicine, you never stop learning in business or trying to do things better," he says.

Dr. Cawley says hospitalists have a leg up on other physicians when it comes to moving into hospital administration. "Being a hospitalist allowed me to get into every nook and cranny of this hospital," he says. He advises other hospitalists interested in this path to seek out progressive leadership roles. “Show what you can do,” he says, “and get that management degree.”

As Dr. Cawley's administrative responsibilities continue to expand, the time he spends in clinical practice continues to decrease. Although he plans to give up clinical work for the crucial first six months in his new position, he says he hopes to return to hospitalist practice at least 10% of the time after that.

"Any CEO worth his or her salt goes out to the front lines to see what is happening," Dr. Cawley notes. "As a physician, it is easier to get to those front lines. Once there, you get a feel for how the hospital really runs."

Visit our website for more information about executive leadership positions in hospitals.

Patrick Cawley, MD, MBA, MHM, a past president of SHM and a recipient of its prestigious Master of Hospital Medicine award, has been named vice president for clinical operations and executive director of the Medical University Hospital Authority at the Medical University of South Carolina (MUSC) in Charleston.

"What distinguished Dr. Cawley from the rest of the field is his intimate knowledge of MUSC, his medical expertise combined with graduate education in management, and his track record of improving our performance in quality and patient safety," says Raymond S. Greenberg, MD, PhD, and president of MUSC. "Given his familiarity with the issues here, Dr. Cawley can step in quickly to assume his new responsibilities. He's already demonstrating steady and thoughtful leadership."

Dr. Cawley took his first leadership course 15 years ago. That led to other courses on such topics as marketing and finance, and that led to his earning a master’s degree in business administration from the University of Massachusetts at Amherst. "Just like medicine, you never stop learning in business or trying to do things better," he says.

Dr. Cawley says hospitalists have a leg up on other physicians when it comes to moving into hospital administration. "Being a hospitalist allowed me to get into every nook and cranny of this hospital," he says. He advises other hospitalists interested in this path to seek out progressive leadership roles. “Show what you can do,” he says, “and get that management degree.”

As Dr. Cawley's administrative responsibilities continue to expand, the time he spends in clinical practice continues to decrease. Although he plans to give up clinical work for the crucial first six months in his new position, he says he hopes to return to hospitalist practice at least 10% of the time after that.

"Any CEO worth his or her salt goes out to the front lines to see what is happening," Dr. Cawley notes. "As a physician, it is easier to get to those front lines. Once there, you get a feel for how the hospital really runs."

Visit our website for more information about executive leadership positions in hospitals.

Research on seriously ill, hospitalized, Medicare-age patients finds that those who received inpatient consultations from a multidisciplinary, palliative-care team (including a physician, nurse, and social worker) had lower 30-day hospital readmission rates.¹ Ten percent of discharged patients who received the palliative-care consult were readmitted within 30 days at an urban HMO medical center in Los Angeles County during the same period, even though they were sicker than the overall discharged population.

Receipt of hospice care or home-based palliative-care services following discharge was also associated with significantly lower rates of readmissions, suggesting opportunities for systemic cost savings from earlier access to longitudinal, or ongoing, palliative-care services, says Susan Enguidanos, MPH, PhD, assistant professor of gerontology at the University of Southern California in Los Angeles. Patients discharged from the hospital without any follow-up care in the home had higher odds of readmission.

“Hospitals and medical centers should seriously consider an inpatient palliative care consultation team for many reasons, mostly arising from findings from other studies that have demonstrated improved quality of life, pain and symptom management, satisfaction with medical care, and other promising outcomes,” Dr. Enguidanos says. “Our study suggests that longitudinal palliative care is also associated with the lower readmission rate.”

References

1. Enguidanos S, Vesper E, Lorenz K. 30-day readmissions among seriously ill older adults. J Palliat Med. 2012;15(12):1356-1361.
2. The Advisory Board Company. Mastering the cardiovascular care continuum: strategies for bridging divides among providers and across time. The Advisory Board Company website. Available at: http://www.advisory.com/Research/Cardiovascular-Roundtable/Studies/2012/Mastering-the-Cardiovascular-Care-Continuum. Accessed Jan. 8, 2013.
3. Misky G, Carlson T, Klem P, et al. Development and implementation of a clinical care pathway for acute VTE reduces hospital utilization and cost at an urban tertiary care center [abstract]. J Hosp Med. 2012;7 Suppl 2:S66-S67.
4. Versel N. Health IT holds key to better care integration. Information Week website. Available at: http://www.informationweek.com/healthcare/interoperability/health-it-holds-key-to-better-care-integ/240012443. Accessed Jan. 8, 2013.
5. Office of Inspector General. Early Assessment Finds That CMS Faces Obstacles in Overseeing the Medicare EHR Incentive Program. Office of Inspector General website. Available at: https://oig.hhs.gov/oei/reports/oei-05-11-00250.asp. Accessed Jan. 8, 2013.

Research on seriously ill, hospitalized, Medicare-age patients finds that those who received inpatient consultations from a multidisciplinary, palliative-care team (including a physician, nurse, and social worker) had lower 30-day hospital readmission rates.¹ Ten percent of discharged patients who received the palliative-care consult were readmitted within 30 days at an urban HMO medical center in Los Angeles County during the same period, even though they were sicker than the overall discharged population.

Receipt of hospice care or home-based palliative-care services following discharge was also associated with significantly lower rates of readmissions, suggesting opportunities for systemic cost savings from earlier access to longitudinal, or ongoing, palliative-care services, says Susan Enguidanos, MPH, PhD, assistant professor of gerontology at the University of Southern California in Los Angeles. Patients discharged from the hospital without any follow-up care in the home had higher odds of readmission.

“Hospitals and medical centers should seriously consider an inpatient palliative care consultation team for many reasons, mostly arising from findings from other studies that have demonstrated improved quality of life, pain and symptom management, satisfaction with medical care, and other promising outcomes,” Dr. Enguidanos says. “Our study suggests that longitudinal palliative care is also associated with the lower readmission rate.”

References

1. Enguidanos S, Vesper E, Lorenz K. 30-day readmissions among seriously ill older adults. J Palliat Med. 2012;15(12):1356-1361.
2. The Advisory Board Company. Mastering the cardiovascular care continuum: strategies for bridging divides among providers and across time. The Advisory Board Company website. Available at: http://www.advisory.com/Research/Cardiovascular-Roundtable/Studies/2012/Mastering-the-Cardiovascular-Care-Continuum. Accessed Jan. 8, 2013.
3. Misky G, Carlson T, Klem P, et al. Development and implementation of a clinical care pathway for acute VTE reduces hospital utilization and cost at an urban tertiary care center [abstract]. J Hosp Med. 2012;7 Suppl 2:S66-S67.
4. Versel N. Health IT holds key to better care integration. Information Week website. Available at: http://www.informationweek.com/healthcare/interoperability/health-it-holds-key-to-better-care-integ/240012443. Accessed Jan. 8, 2013.
5. Office of Inspector General. Early Assessment Finds That CMS Faces Obstacles in Overseeing the Medicare EHR Incentive Program. Office of Inspector General website. Available at: https://oig.hhs.gov/oei/reports/oei-05-11-00250.asp. Accessed Jan. 8, 2013.

Research on seriously ill, hospitalized, Medicare-age patients finds that those who received inpatient consultations from a multidisciplinary, palliative-care team (including a physician, nurse, and social worker) had lower 30-day hospital readmission rates.¹ Ten percent of discharged patients who received the palliative-care consult were readmitted within 30 days at an urban HMO medical center in Los Angeles County during the same period, even though they were sicker than the overall discharged population.

Receipt of hospice care or home-based palliative-care services following discharge was also associated with significantly lower rates of readmissions, suggesting opportunities for systemic cost savings from earlier access to longitudinal, or ongoing, palliative-care services, says Susan Enguidanos, MPH, PhD, assistant professor of gerontology at the University of Southern California in Los Angeles. Patients discharged from the hospital without any follow-up care in the home had higher odds of readmission.

“Hospitals and medical centers should seriously consider an inpatient palliative care consultation team for many reasons, mostly arising from findings from other studies that have demonstrated improved quality of life, pain and symptom management, satisfaction with medical care, and other promising outcomes,” Dr. Enguidanos says. “Our study suggests that longitudinal palliative care is also associated with the lower readmission rate.”

References

1. Enguidanos S, Vesper E, Lorenz K. 30-day readmissions among seriously ill older adults. J Palliat Med. 2012;15(12):1356-1361.
2. The Advisory Board Company. Mastering the cardiovascular care continuum: strategies for bridging divides among providers and across time. The Advisory Board Company website. Available at: http://www.advisory.com/Research/Cardiovascular-Roundtable/Studies/2012/Mastering-the-Cardiovascular-Care-Continuum. Accessed Jan. 8, 2013.
3. Misky G, Carlson T, Klem P, et al. Development and implementation of a clinical care pathway for acute VTE reduces hospital utilization and cost at an urban tertiary care center [abstract]. J Hosp Med. 2012;7 Suppl 2:S66-S67.
4. Versel N. Health IT holds key to better care integration. Information Week website. Available at: http://www.informationweek.com/healthcare/interoperability/health-it-holds-key-to-better-care-integ/240012443. Accessed Jan. 8, 2013.
5. Office of Inspector General. Early Assessment Finds That CMS Faces Obstacles in Overseeing the Medicare EHR Incentive Program. Office of Inspector General website. Available at: https://oig.hhs.gov/oei/reports/oei-05-11-00250.asp. Accessed Jan. 8, 2013.

Data reported at the American Heart Association’s scientific sessions in Los Angeles in November suggest that when a cardiologist, rather than a hospitalist, is the attending physician for a hospitalized heart failure patient, readmission is less likely. Casey M. Lawler, MD, FACC, a cardiologist at the Minneapolis Heart Institute, says her center began establishing protocols to improve heart failure readmissions rates five years ago, after determining that many patients did not understand their diagnosis or treatment. “Thus, we became much more involved in post-discharge care,” including the phoning of discharged patients and follow-up with primary-care providers.

When the heart failure patients’ attending physicians were cardiologists, their readmission rate was 16%, versus 27.1% with hospitalists, even though their severity of illness was higher. Length of stay was similar for both groups and total mean costs were higher for the patients managed by cardiologists. “Although these results reveal that specialists have a positive impact on readmission rates, an overhaul to an entire healthcare system’s treatment of [heart failure] patients—from admission to post-discharge follow-up—is required to truly impact preventable readmissions,” Dr. Lawler asserted.

In the Minneapolis study, 65% of the 2,300 heart failure patients were managed by hospitalists, and 35% by cardiologists. A recent national survey of advanced heart failure programs found that cardiologists managed the care of acute HF patients more than 60 percent of the time.²

References

1. Enguidanos S, Vesper E, Lorenz K. 30-day readmissions among seriously ill older adults. J Palliat Med. 2012;15(12):1356-1361.
2. The Advisory Board Company. Mastering the cardiovascular care continuum: strategies for bridging divides among providers and across time. The Advisory Board Company website. Available at: http://www.advisory.com/Research/Cardiovascular-Roundtable/Studies/2012/Mastering-the-Cardiovascular-Care-Continuum. Accessed Jan. 8, 2013.
3. Misky G, Carlson T, Klem P, et al. Development and implementation of a clinical care pathway for acute VTE reduces hospital utilization and cost at an urban tertiary care center [abstract]. J Hosp Med. 2012;7 Suppl 2:S66-S67.
4. Versel N. Health IT holds key to better care integration. Information Week website. Available at: http://www.informationweek.com/healthcare/interoperability/health-it-holds-key-to-better-care-integ/240012443. Accessed Jan. 8, 2013.
5. Office of Inspector General. Early Assessment Finds That CMS Faces Obstacles in Overseeing the Medicare EHR Incentive Program. Office of Inspector General website. Available at: https://oig.hhs.gov/oei/reports/oei-05-11-00250.asp. Accessed Jan. 8, 2013.

Data reported at the American Heart Association’s scientific sessions in Los Angeles in November suggest that when a cardiologist, rather than a hospitalist, is the attending physician for a hospitalized heart failure patient, readmission is less likely. Casey M. Lawler, MD, FACC, a cardiologist at the Minneapolis Heart Institute, says her center began establishing protocols to improve heart failure readmissions rates five years ago, after determining that many patients did not understand their diagnosis or treatment. “Thus, we became much more involved in post-discharge care,” including the phoning of discharged patients and follow-up with primary-care providers.

When the heart failure patients’ attending physicians were cardiologists, their readmission rate was 16%, versus 27.1% with hospitalists, even though their severity of illness was higher. Length of stay was similar for both groups and total mean costs were higher for the patients managed by cardiologists. “Although these results reveal that specialists have a positive impact on readmission rates, an overhaul to an entire healthcare system’s treatment of [heart failure] patients—from admission to post-discharge follow-up—is required to truly impact preventable readmissions,” Dr. Lawler asserted.

In the Minneapolis study, 65% of the 2,300 heart failure patients were managed by hospitalists, and 35% by cardiologists. A recent national survey of advanced heart failure programs found that cardiologists managed the care of acute HF patients more than 60 percent of the time.²

References

1. Enguidanos S, Vesper E, Lorenz K. 30-day readmissions among seriously ill older adults. J Palliat Med. 2012;15(12):1356-1361.
2. The Advisory Board Company. Mastering the cardiovascular care continuum: strategies for bridging divides among providers and across time. The Advisory Board Company website. Available at: http://www.advisory.com/Research/Cardiovascular-Roundtable/Studies/2012/Mastering-the-Cardiovascular-Care-Continuum. Accessed Jan. 8, 2013.
3. Misky G, Carlson T, Klem P, et al. Development and implementation of a clinical care pathway for acute VTE reduces hospital utilization and cost at an urban tertiary care center [abstract]. J Hosp Med. 2012;7 Suppl 2:S66-S67.
4. Versel N. Health IT holds key to better care integration. Information Week website. Available at: http://www.informationweek.com/healthcare/interoperability/health-it-holds-key-to-better-care-integ/240012443. Accessed Jan. 8, 2013.
5. Office of Inspector General. Early Assessment Finds That CMS Faces Obstacles in Overseeing the Medicare EHR Incentive Program. Office of Inspector General website. Available at: https://oig.hhs.gov/oei/reports/oei-05-11-00250.asp. Accessed Jan. 8, 2013.

Data reported at the American Heart Association’s scientific sessions in Los Angeles in November suggest that when a cardiologist, rather than a hospitalist, is the attending physician for a hospitalized heart failure patient, readmission is less likely. Casey M. Lawler, MD, FACC, a cardiologist at the Minneapolis Heart Institute, says her center began establishing protocols to improve heart failure readmissions rates five years ago, after determining that many patients did not understand their diagnosis or treatment. “Thus, we became much more involved in post-discharge care,” including the phoning of discharged patients and follow-up with primary-care providers.

When the heart failure patients’ attending physicians were cardiologists, their readmission rate was 16%, versus 27.1% with hospitalists, even though their severity of illness was higher. Length of stay was similar for both groups and total mean costs were higher for the patients managed by cardiologists. “Although these results reveal that specialists have a positive impact on readmission rates, an overhaul to an entire healthcare system’s treatment of [heart failure] patients—from admission to post-discharge follow-up—is required to truly impact preventable readmissions,” Dr. Lawler asserted.

In the Minneapolis study, 65% of the 2,300 heart failure patients were managed by hospitalists, and 35% by cardiologists. A recent national survey of advanced heart failure programs found that cardiologists managed the care of acute HF patients more than 60 percent of the time.²

References

1. Enguidanos S, Vesper E, Lorenz K. 30-day readmissions among seriously ill older adults. J Palliat Med. 2012;15(12):1356-1361.
2. The Advisory Board Company. Mastering the cardiovascular care continuum: strategies for bridging divides among providers and across time. The Advisory Board Company website. Available at: http://www.advisory.com/Research/Cardiovascular-Roundtable/Studies/2012/Mastering-the-Cardiovascular-Care-Continuum. Accessed Jan. 8, 2013.
3. Misky G, Carlson T, Klem P, et al. Development and implementation of a clinical care pathway for acute VTE reduces hospital utilization and cost at an urban tertiary care center [abstract]. J Hosp Med. 2012;7 Suppl 2:S66-S67.
4. Versel N. Health IT holds key to better care integration. Information Week website. Available at: http://www.informationweek.com/healthcare/interoperability/health-it-holds-key-to-better-care-integ/240012443. Accessed Jan. 8, 2013.
5. Office of Inspector General. Early Assessment Finds That CMS Faces Obstacles in Overseeing the Medicare EHR Incentive Program. Office of Inspector General website. Available at: https://oig.hhs.gov/oei/reports/oei-05-11-00250.asp. Accessed Jan. 8, 2013.

A poster presented at HM12 in San Diego last April describes a standardized, systematic, multidisciplinary clinical pathway for treating acute VTE (venous thromboembolism) in an urban hospital serving a high proportion of the uninsured.³ Implementing the pathway in February 2011 “dramatically reduced hospital utilization and cost, particularly among uninsured patients,” who were previously shown to have increased length of stay, cost, and emergency department recidivism, says lead author Gregory Misky, MD, a hospitalist at the University of Colorado Denver.

The pathway—which aimed to standardize all VTE care from hospital presentation to post-discharge follow-up—contained multiple components, including education for staff, enhanced communication processes, written order sets, and a series of formal and informal meetings held with community providers, such as the clinics where these patients get their follow-up primary care. Dr. Misky collaborated with his university’s anticoagulation clinic to help identify primary-care physicians and clinics and arrange follow-up outpatient appointments much sooner than the patients could have obtained by themselves.

The prospective study compared 135 VTE patients presenting to the emergency department or admitted to a medicine service and receiving care under the pathway, compared with 234 VTE patients prior to its introduction. Length of stay dropped to 2.5 days from 4.2, and for uninsured patients it dropped even more, to 2.2 days from 5.5.

Dr. Misky says the data gathered since the San Diego conference “continue to show good results in resource utilization, particularly for the uninsured, with emergency department visits and readmissions slashed.” Readmissions have dropped to 5.2% from 9.8%—and to 3.5% from 11.6% for uninsured VTE patients. He suggests that the clinical pathway approach likely has implications for other diseases as well.

References

1. Enguidanos S, Vesper E, Lorenz K. 30-day readmissions among seriously ill older adults. J Palliat Med. 2012;15(12):1356-1361.
2. The Advisory Board Company. Mastering the cardiovascular care continuum: strategies for bridging divides among providers and across time. The Advisory Board Company website. Available at: http://www.advisory.com/Research/Cardiovascular-Roundtable/Studies/2012/Mastering-the-Cardiovascular-Care-Continuum. Accessed Jan. 8, 2013.
3. Misky G, Carlson T, Klem P, et al. Development and implementation of a clinical care pathway for acute VTE reduces hospital utilization and cost at an urban tertiary care center [abstract]. J Hosp Med. 2012;7 Suppl 2:S66-S67.
4. Versel N. Health IT holds key to better care integration. Information Week website. Available at: http://www.informationweek.com/healthcare/interoperability/health-it-holds-key-to-better-care-integ/240012443. Accessed Jan. 8, 2013.
5. Office of Inspector General. Early Assessment Finds That CMS Faces Obstacles in Overseeing the Medicare EHR Incentive Program. Office of Inspector General website. Available at: https://oig.hhs.gov/oei/reports/oei-05-11-00250.asp. Accessed Jan. 8, 2013.

A poster presented at HM12 in San Diego last April describes a standardized, systematic, multidisciplinary clinical pathway for treating acute VTE (venous thromboembolism) in an urban hospital serving a high proportion of the uninsured.³ Implementing the pathway in February 2011 “dramatically reduced hospital utilization and cost, particularly among uninsured patients,” who were previously shown to have increased length of stay, cost, and emergency department recidivism, says lead author Gregory Misky, MD, a hospitalist at the University of Colorado Denver.

The pathway—which aimed to standardize all VTE care from hospital presentation to post-discharge follow-up—contained multiple components, including education for staff, enhanced communication processes, written order sets, and a series of formal and informal meetings held with community providers, such as the clinics where these patients get their follow-up primary care. Dr. Misky collaborated with his university’s anticoagulation clinic to help identify primary-care physicians and clinics and arrange follow-up outpatient appointments much sooner than the patients could have obtained by themselves.

The prospective study compared 135 VTE patients presenting to the emergency department or admitted to a medicine service and receiving care under the pathway, compared with 234 VTE patients prior to its introduction. Length of stay dropped to 2.5 days from 4.2, and for uninsured patients it dropped even more, to 2.2 days from 5.5.

Dr. Misky says the data gathered since the San Diego conference “continue to show good results in resource utilization, particularly for the uninsured, with emergency department visits and readmissions slashed.” Readmissions have dropped to 5.2% from 9.8%—and to 3.5% from 11.6% for uninsured VTE patients. He suggests that the clinical pathway approach likely has implications for other diseases as well.

References

1. Enguidanos S, Vesper E, Lorenz K. 30-day readmissions among seriously ill older adults. J Palliat Med. 2012;15(12):1356-1361.
2. The Advisory Board Company. Mastering the cardiovascular care continuum: strategies for bridging divides among providers and across time. The Advisory Board Company website. Available at: http://www.advisory.com/Research/Cardiovascular-Roundtable/Studies/2012/Mastering-the-Cardiovascular-Care-Continuum. Accessed Jan. 8, 2013.
3. Misky G, Carlson T, Klem P, et al. Development and implementation of a clinical care pathway for acute VTE reduces hospital utilization and cost at an urban tertiary care center [abstract]. J Hosp Med. 2012;7 Suppl 2:S66-S67.
4. Versel N. Health IT holds key to better care integration. Information Week website. Available at: http://www.informationweek.com/healthcare/interoperability/health-it-holds-key-to-better-care-integ/240012443. Accessed Jan. 8, 2013.
5. Office of Inspector General. Early Assessment Finds That CMS Faces Obstacles in Overseeing the Medicare EHR Incentive Program. Office of Inspector General website. Available at: https://oig.hhs.gov/oei/reports/oei-05-11-00250.asp. Accessed Jan. 8, 2013.

A poster presented at HM12 in San Diego last April describes a standardized, systematic, multidisciplinary clinical pathway for treating acute VTE (venous thromboembolism) in an urban hospital serving a high proportion of the uninsured.³ Implementing the pathway in February 2011 “dramatically reduced hospital utilization and cost, particularly among uninsured patients,” who were previously shown to have increased length of stay, cost, and emergency department recidivism, says lead author Gregory Misky, MD, a hospitalist at the University of Colorado Denver.

The pathway—which aimed to standardize all VTE care from hospital presentation to post-discharge follow-up—contained multiple components, including education for staff, enhanced communication processes, written order sets, and a series of formal and informal meetings held with community providers, such as the clinics where these patients get their follow-up primary care. Dr. Misky collaborated with his university’s anticoagulation clinic to help identify primary-care physicians and clinics and arrange follow-up outpatient appointments much sooner than the patients could have obtained by themselves.

The prospective study compared 135 VTE patients presenting to the emergency department or admitted to a medicine service and receiving care under the pathway, compared with 234 VTE patients prior to its introduction. Length of stay dropped to 2.5 days from 4.2, and for uninsured patients it dropped even more, to 2.2 days from 5.5.

Dr. Misky says the data gathered since the San Diego conference “continue to show good results in resource utilization, particularly for the uninsured, with emergency department visits and readmissions slashed.” Readmissions have dropped to 5.2% from 9.8%—and to 3.5% from 11.6% for uninsured VTE patients. He suggests that the clinical pathway approach likely has implications for other diseases as well.

References

1. Enguidanos S, Vesper E, Lorenz K. 30-day readmissions among seriously ill older adults. J Palliat Med. 2012;15(12):1356-1361.
2. The Advisory Board Company. Mastering the cardiovascular care continuum: strategies for bridging divides among providers and across time. The Advisory Board Company website. Available at: http://www.advisory.com/Research/Cardiovascular-Roundtable/Studies/2012/Mastering-the-Cardiovascular-Care-Continuum. Accessed Jan. 8, 2013.
3. Misky G, Carlson T, Klem P, et al. Development and implementation of a clinical care pathway for acute VTE reduces hospital utilization and cost at an urban tertiary care center [abstract]. J Hosp Med. 2012;7 Suppl 2:S66-S67.
4. Versel N. Health IT holds key to better care integration. Information Week website. Available at: http://www.informationweek.com/healthcare/interoperability/health-it-holds-key-to-better-care-integ/240012443. Accessed Jan. 8, 2013.
5. Office of Inspector General. Early Assessment Finds That CMS Faces Obstacles in Overseeing the Medicare EHR Incentive Program. Office of Inspector General website. Available at: https://oig.hhs.gov/oei/reports/oei-05-11-00250.asp. Accessed Jan. 8, 2013.

David Lawrence, MD, retired head of the Kaiser Foundation health plan, says in a recent Information Week article that it will be “nearly impossible” to achieve the goals of healthcare integration without the connectivity of a well-designed health IT system.⁴ Dr. Lawrence was a member of a committee that authored the recent report Order from Chaos: Accelerating Care Integration for the Lucian Leape Institute at the National Patient Care Safety Foundation. Failures of coordination most often happen during the crucial information transfers that happen during care transitions, but there has not been enough attention to how important information technology could be to these transfers, Dr. Lawrence told the magazine. “It’s the really complex stuff where this becomes particularly critical,” he said.

The federal Office of Inspector General (OIG) took the Centers for Medicare & Medicaid Services (CMS) to task in a November report for not having adequate oversight or safeguards for its EHR meaningful-use program.⁵ As a result, OIG described Medicare as “vulnerable” to fraud and abuse of incentive payments made to hospitals and health professionals, according to OIG. OIG recommends that CMS request and review supporting documentation for selected providers and issue guidance with specific examples of appropriate documentation. As of September 2012, CMS had paid out $4 billion in meaningful-use incentives to 1,400 hospitals and 82,000 professionals.

References

1. Enguidanos S, Vesper E, Lorenz K. 30-day readmissions among seriously ill older adults. J Palliat Med. 2012;15(12):1356-1361.
2. The Advisory Board Company. Mastering the cardiovascular care continuum: strategies for bridging divides among providers and across time. The Advisory Board Company website. Available at: http://www.advisory.com/Research/Cardiovascular-Roundtable/Studies/2012/Mastering-the-Cardiovascular-Care-Continuum. Accessed Jan. 8, 2013.
3. Misky G, Carlson T, Klem P, et al. Development and implementation of a clinical care pathway for acute VTE reduces hospital utilization and cost at an urban tertiary care center [abstract]. J Hosp Med. 2012;7 Suppl 2:S66-S67.
4. Versel N. Health IT holds key to better care integration. Information Week website. Available at: http://www.informationweek.com/healthcare/interoperability/health-it-holds-key-to-better-care-integ/240012443. Accessed Jan. 8, 2013.
5. Office of Inspector General. Early Assessment Finds That CMS Faces Obstacles in Overseeing the Medicare EHR Incentive Program. Office of Inspector General website. Available at: https://oig.hhs.gov/oei/reports/oei-05-11-00250.asp. Accessed Jan. 8, 2013.

David Lawrence, MD, retired head of the Kaiser Foundation health plan, says in a recent Information Week article that it will be “nearly impossible” to achieve the goals of healthcare integration without the connectivity of a well-designed health IT system.⁴ Dr. Lawrence was a member of a committee that authored the recent report Order from Chaos: Accelerating Care Integration for the Lucian Leape Institute at the National Patient Care Safety Foundation. Failures of coordination most often happen during the crucial information transfers that happen during care transitions, but there has not been enough attention to how important information technology could be to these transfers, Dr. Lawrence told the magazine. “It’s the really complex stuff where this becomes particularly critical,” he said.

The federal Office of Inspector General (OIG) took the Centers for Medicare & Medicaid Services (CMS) to task in a November report for not having adequate oversight or safeguards for its EHR meaningful-use program.⁵ As a result, OIG described Medicare as “vulnerable” to fraud and abuse of incentive payments made to hospitals and health professionals, according to OIG. OIG recommends that CMS request and review supporting documentation for selected providers and issue guidance with specific examples of appropriate documentation. As of September 2012, CMS had paid out $4 billion in meaningful-use incentives to 1,400 hospitals and 82,000 professionals.

References

1. Enguidanos S, Vesper E, Lorenz K. 30-day readmissions among seriously ill older adults. J Palliat Med. 2012;15(12):1356-1361.
2. The Advisory Board Company. Mastering the cardiovascular care continuum: strategies for bridging divides among providers and across time. The Advisory Board Company website. Available at: http://www.advisory.com/Research/Cardiovascular-Roundtable/Studies/2012/Mastering-the-Cardiovascular-Care-Continuum. Accessed Jan. 8, 2013.
3. Misky G, Carlson T, Klem P, et al. Development and implementation of a clinical care pathway for acute VTE reduces hospital utilization and cost at an urban tertiary care center [abstract]. J Hosp Med. 2012;7 Suppl 2:S66-S67.
4. Versel N. Health IT holds key to better care integration. Information Week website. Available at: http://www.informationweek.com/healthcare/interoperability/health-it-holds-key-to-better-care-integ/240012443. Accessed Jan. 8, 2013.
5. Office of Inspector General. Early Assessment Finds That CMS Faces Obstacles in Overseeing the Medicare EHR Incentive Program. Office of Inspector General website. Available at: https://oig.hhs.gov/oei/reports/oei-05-11-00250.asp. Accessed Jan. 8, 2013.

David Lawrence, MD, retired head of the Kaiser Foundation health plan, says in a recent Information Week article that it will be “nearly impossible” to achieve the goals of healthcare integration without the connectivity of a well-designed health IT system.⁴ Dr. Lawrence was a member of a committee that authored the recent report Order from Chaos: Accelerating Care Integration for the Lucian Leape Institute at the National Patient Care Safety Foundation. Failures of coordination most often happen during the crucial information transfers that happen during care transitions, but there has not been enough attention to how important information technology could be to these transfers, Dr. Lawrence told the magazine. “It’s the really complex stuff where this becomes particularly critical,” he said.

The federal Office of Inspector General (OIG) took the Centers for Medicare & Medicaid Services (CMS) to task in a November report for not having adequate oversight or safeguards for its EHR meaningful-use program.⁵ As a result, OIG described Medicare as “vulnerable” to fraud and abuse of incentive payments made to hospitals and health professionals, according to OIG. OIG recommends that CMS request and review supporting documentation for selected providers and issue guidance with specific examples of appropriate documentation. As of September 2012, CMS had paid out $4 billion in meaningful-use incentives to 1,400 hospitals and 82,000 professionals.

References

1. Enguidanos S, Vesper E, Lorenz K. 30-day readmissions among seriously ill older adults. J Palliat Med. 2012;15(12):1356-1361.
2. The Advisory Board Company. Mastering the cardiovascular care continuum: strategies for bridging divides among providers and across time. The Advisory Board Company website. Available at: http://www.advisory.com/Research/Cardiovascular-Roundtable/Studies/2012/Mastering-the-Cardiovascular-Care-Continuum. Accessed Jan. 8, 2013.
3. Misky G, Carlson T, Klem P, et al. Development and implementation of a clinical care pathway for acute VTE reduces hospital utilization and cost at an urban tertiary care center [abstract]. J Hosp Med. 2012;7 Suppl 2:S66-S67.
4. Versel N. Health IT holds key to better care integration. Information Week website. Available at: http://www.informationweek.com/healthcare/interoperability/health-it-holds-key-to-better-care-integ/240012443. Accessed Jan. 8, 2013.
5. Office of Inspector General. Early Assessment Finds That CMS Faces Obstacles in Overseeing the Medicare EHR Incentive Program. Office of Inspector General website. Available at: https://oig.hhs.gov/oei/reports/oei-05-11-00250.asp. Accessed Jan. 8, 2013.

Number of meals served annually to patients, visitors, and staff by 155 leading U.S. hospitals, which are adopting new standards and criteria for nutritional care at their facilities in order to promote healthier meal options for patients and in their cafeterias. These hospitals belong to the Healthier Hospitals initiative.

(healthierhospitals.org/) led by the Partnership for a Healthier America, a group working to end childhood obesity. Among its goals are to increase the proportion of fruits and vegetables in hospitals’ food purchasing, to remove deep fat-fried products by the end of 2015, and to take advantage of the buying power and community influence hospitals can leverage to increase demand for healthier food.

1. Enguidanos S, Vesper E, Lorenz K. 30-day readmissions among seriously ill older adults. J Palliat Med. 2012;15(12):1356-1361.
2. The Advisory Board Company. Mastering the cardiovascular care continuum: strategies for bridging divides among providers and across time. The Advisory Board Company website. Available at: http://www.advisory.com/Research/Cardiovascular-Roundtable/Studies/2012/Mastering-the-Cardiovascular-Care-Continuum. Accessed Jan. 8, 2013.
3. Misky G, Carlson T, Klem P, et al. Development and implementation of a clinical care pathway for acute VTE reduces hospital utilization and cost at an urban tertiary care center [abstract]. J Hosp Med. 2012;7 Suppl 2:S66-S67.
4. Versel N. Health IT holds key to better care integration. Information Week website. Available at: http://www.informationweek.com/healthcare/interoperability/health-it-holds-key-to-better-care-integ/240012443. Accessed Jan. 8, 2013.
5. Office of Inspector General. Early Assessment Finds That CMS Faces Obstacles in Overseeing the Medicare EHR Incentive Program. Office of Inspector General website. Available at: https://oig.hhs.gov/oei/reports/oei-05-11-00250.asp. Accessed Jan. 8, 2013.

Number of meals served annually to patients, visitors, and staff by 155 leading U.S. hospitals, which are adopting new standards and criteria for nutritional care at their facilities in order to promote healthier meal options for patients and in their cafeterias. These hospitals belong to the Healthier Hospitals initiative.

(healthierhospitals.org/) led by the Partnership for a Healthier America, a group working to end childhood obesity. Among its goals are to increase the proportion of fruits and vegetables in hospitals’ food purchasing, to remove deep fat-fried products by the end of 2015, and to take advantage of the buying power and community influence hospitals can leverage to increase demand for healthier food.

1. Enguidanos S, Vesper E, Lorenz K. 30-day readmissions among seriously ill older adults. J Palliat Med. 2012;15(12):1356-1361.
2. The Advisory Board Company. Mastering the cardiovascular care continuum: strategies for bridging divides among providers and across time. The Advisory Board Company website. Available at: http://www.advisory.com/Research/Cardiovascular-Roundtable/Studies/2012/Mastering-the-Cardiovascular-Care-Continuum. Accessed Jan. 8, 2013.
3. Misky G, Carlson T, Klem P, et al. Development and implementation of a clinical care pathway for acute VTE reduces hospital utilization and cost at an urban tertiary care center [abstract]. J Hosp Med. 2012;7 Suppl 2:S66-S67.
4. Versel N. Health IT holds key to better care integration. Information Week website. Available at: http://www.informationweek.com/healthcare/interoperability/health-it-holds-key-to-better-care-integ/240012443. Accessed Jan. 8, 2013.
5. Office of Inspector General. Early Assessment Finds That CMS Faces Obstacles in Overseeing the Medicare EHR Incentive Program. Office of Inspector General website. Available at: https://oig.hhs.gov/oei/reports/oei-05-11-00250.asp. Accessed Jan. 8, 2013.

Number of meals served annually to patients, visitors, and staff by 155 leading U.S. hospitals, which are adopting new standards and criteria for nutritional care at their facilities in order to promote healthier meal options for patients and in their cafeterias. These hospitals belong to the Healthier Hospitals initiative.

(healthierhospitals.org/) led by the Partnership for a Healthier America, a group working to end childhood obesity. Among its goals are to increase the proportion of fruits and vegetables in hospitals’ food purchasing, to remove deep fat-fried products by the end of 2015, and to take advantage of the buying power and community influence hospitals can leverage to increase demand for healthier food.

1. Enguidanos S, Vesper E, Lorenz K. 30-day readmissions among seriously ill older adults. J Palliat Med. 2012;15(12):1356-1361.
2. The Advisory Board Company. Mastering the cardiovascular care continuum: strategies for bridging divides among providers and across time. The Advisory Board Company website. Available at: http://www.advisory.com/Research/Cardiovascular-Roundtable/Studies/2012/Mastering-the-Cardiovascular-Care-Continuum. Accessed Jan. 8, 2013.
3. Misky G, Carlson T, Klem P, et al. Development and implementation of a clinical care pathway for acute VTE reduces hospital utilization and cost at an urban tertiary care center [abstract]. J Hosp Med. 2012;7 Suppl 2:S66-S67.
4. Versel N. Health IT holds key to better care integration. Information Week website. Available at: http://www.informationweek.com/healthcare/interoperability/health-it-holds-key-to-better-care-integ/240012443. Accessed Jan. 8, 2013.
5. Office of Inspector General. Early Assessment Finds That CMS Faces Obstacles in Overseeing the Medicare EHR Incentive Program. Office of Inspector General website. Available at: https://oig.hhs.gov/oei/reports/oei-05-11-00250.asp. Accessed Jan. 8, 2013.

A healthy collaboration between hospitalists and pharmacists can generate cost savings and promote positive outcomes, such as preventing adverse drug events and improving care transitions, says Jonathan Edwards, PharmD, BCPS, a clinical pharmacy specialist at Huntsville Hospital in Alabama.

At the 2012 national conference of the American College of Clinical Pharmacy in Hollywood, Fla., Edwards presented a poster that detailed the effectiveness of such interdisciplinary collaboration at Huntsville Hospital, where pharmacists and physicians developed six order sets, a collaborative practice, and a patient interaction program from November 2011 to February 2012. During the study period, researchers documented a total cost savings of $9,825 resulting from 156 patient interventions.

Edwards’ collaborative study at Huntsville started with two physicians who had launched a service teaching hospitalists what pharmacists do, and how they could help in their efforts.

“We got together and developed an order set for treating acute alcohol withdrawal. That went well, so we did five more order sets,” Edwards says. “Then we thought: What if pharmacists got more involved by meeting directly with patients in the hospital to optimize their medication management and help them reach their goals for treatment? We now evaluate patients on the hospitalist service in three units.”

For Edwards, key factors that make the hospitalist-pharmacist relationship work include communicating the pharmacist’s availability to help with the hospitalist’s patients, identifying the physician’s openness to help, and clarifying how the physician prefers to be contacted.

Last October, the American Society of Health-System Pharmacists (ASHP) and the American Pharmacists Association (APhA) recognized eight care-transitions programs for best practices that improved patient outcomes and reduced hospital readmissions as part of the Medication Management in Care Transitions (MMCT) Project.

“The MMCT project highlights the valuable role pharmacists can play in addressing medication-related problems that can lead to hospital readmissions,” APhA chief executive officer Thomas E. Menighan, BSPharm, MBA, ScD (Hon), FAPhA, said in a news release. “By putting together these best practices, our goal is to provide a model for better coordination of care and better connectivity between pharmacists and healthcare providers in different practice settings that leads to improved patient health.”

Visit our website for more information about maximizing patient care through pharmacist-hospitalist collaboration.

Larry Beresford is a freelance writer in Oakland, Calif.

Articles first published in the Jan. 16, 2013, edition of The Hospitalist eWire.

A healthy collaboration between hospitalists and pharmacists can generate cost savings and promote positive outcomes, such as preventing adverse drug events and improving care transitions, says Jonathan Edwards, PharmD, BCPS, a clinical pharmacy specialist at Huntsville Hospital in Alabama.

At the 2012 national conference of the American College of Clinical Pharmacy in Hollywood, Fla., Edwards presented a poster that detailed the effectiveness of such interdisciplinary collaboration at Huntsville Hospital, where pharmacists and physicians developed six order sets, a collaborative practice, and a patient interaction program from November 2011 to February 2012. During the study period, researchers documented a total cost savings of $9,825 resulting from 156 patient interventions.

Edwards’ collaborative study at Huntsville started with two physicians who had launched a service teaching hospitalists what pharmacists do, and how they could help in their efforts.

“We got together and developed an order set for treating acute alcohol withdrawal. That went well, so we did five more order sets,” Edwards says. “Then we thought: What if pharmacists got more involved by meeting directly with patients in the hospital to optimize their medication management and help them reach their goals for treatment? We now evaluate patients on the hospitalist service in three units.”

For Edwards, key factors that make the hospitalist-pharmacist relationship work include communicating the pharmacist’s availability to help with the hospitalist’s patients, identifying the physician’s openness to help, and clarifying how the physician prefers to be contacted.

Last October, the American Society of Health-System Pharmacists (ASHP) and the American Pharmacists Association (APhA) recognized eight care-transitions programs for best practices that improved patient outcomes and reduced hospital readmissions as part of the Medication Management in Care Transitions (MMCT) Project.

“The MMCT project highlights the valuable role pharmacists can play in addressing medication-related problems that can lead to hospital readmissions,” APhA chief executive officer Thomas E. Menighan, BSPharm, MBA, ScD (Hon), FAPhA, said in a news release. “By putting together these best practices, our goal is to provide a model for better coordination of care and better connectivity between pharmacists and healthcare providers in different practice settings that leads to improved patient health.”

Visit our website for more information about maximizing patient care through pharmacist-hospitalist collaboration.

Larry Beresford is a freelance writer in Oakland, Calif.

Articles first published in the Jan. 16, 2013, edition of The Hospitalist eWire.

A healthy collaboration between hospitalists and pharmacists can generate cost savings and promote positive outcomes, such as preventing adverse drug events and improving care transitions, says Jonathan Edwards, PharmD, BCPS, a clinical pharmacy specialist at Huntsville Hospital in Alabama.

At the 2012 national conference of the American College of Clinical Pharmacy in Hollywood, Fla., Edwards presented a poster that detailed the effectiveness of such interdisciplinary collaboration at Huntsville Hospital, where pharmacists and physicians developed six order sets, a collaborative practice, and a patient interaction program from November 2011 to February 2012. During the study period, researchers documented a total cost savings of $9,825 resulting from 156 patient interventions.

Edwards’ collaborative study at Huntsville started with two physicians who had launched a service teaching hospitalists what pharmacists do, and how they could help in their efforts.

“We got together and developed an order set for treating acute alcohol withdrawal. That went well, so we did five more order sets,” Edwards says. “Then we thought: What if pharmacists got more involved by meeting directly with patients in the hospital to optimize their medication management and help them reach their goals for treatment? We now evaluate patients on the hospitalist service in three units.”

For Edwards, key factors that make the hospitalist-pharmacist relationship work include communicating the pharmacist’s availability to help with the hospitalist’s patients, identifying the physician’s openness to help, and clarifying how the physician prefers to be contacted.

Last October, the American Society of Health-System Pharmacists (ASHP) and the American Pharmacists Association (APhA) recognized eight care-transitions programs for best practices that improved patient outcomes and reduced hospital readmissions as part of the Medication Management in Care Transitions (MMCT) Project.

“The MMCT project highlights the valuable role pharmacists can play in addressing medication-related problems that can lead to hospital readmissions,” APhA chief executive officer Thomas E. Menighan, BSPharm, MBA, ScD (Hon), FAPhA, said in a news release. “By putting together these best practices, our goal is to provide a model for better coordination of care and better connectivity between pharmacists and healthcare providers in different practice settings that leads to improved patient health.”

Visit our website for more information about maximizing patient care through pharmacist-hospitalist collaboration.

Larry Beresford is a freelance writer in Oakland, Calif.

Articles first published in the Jan. 16, 2013, edition of The Hospitalist eWire.

A healthy collaboration between hospitalists and pharmacists can generate cost savings and promote positive outcomes, such as preventing adverse drug events and improving care transitions, says Jonathan Edwards, PharmD, BCPS, a clinical pharmacy specialist at Huntsville Hospital in Alabama.

At the 2012 national conference of the American College of Clinical Pharmacy in Hollywood, Fla., Edwards presented a poster that detailed the effectiveness of such interdisciplinary collaboration at Huntsville Hospital, where pharmacists and physicians developed six order sets, a collaborative practice, and a patient interaction program from November 2011 to February 2012. During the study period, researchers documented a total cost savings of $9,825 resulting from 156 patient interventions.

Edwards’ collaborative study at Huntsville started with two physicians who had launched a service teaching hospitalists what pharmacists do, and how they could help in their efforts.

“We got together and developed an order set for treating acute alcohol withdrawal. That went well, so we did five more order sets,” Edwards says. “Then we thought: What if pharmacists got more involved by meeting directly with patients in the hospital to optimize their medication management and help them reach their goals for treatment? We now evaluate patients on the hospitalist service in three units.”

For Edwards, key factors that make the hospitalist-pharmacist relationship work include communicating the pharmacist’s availability to help with the hospitalist’s patients, identifying the physician’s openness to help, and clarifying how the physician prefers to be contacted.

Last October, the American Society of Health-System Pharmacists (ASHP) and the American Pharmacists Association (APhA) recognized eight care-transitions programs for best practices that improved patient outcomes and reduced hospital readmissions as part of the Medication Management in Care Transitions (MMCT) Project.

“The MMCT project highlights the valuable role pharmacists can play in addressing medication-related problems that can lead to hospital readmissions,” APhA chief executive officer Thomas E. Menighan, BSPharm, MBA, ScD (Hon), FAPhA, said in a news release. “By putting together these best practices, our goal is to provide a model for better coordination of care and better connectivity between pharmacists and healthcare providers in different practice settings that leads to improved patient health.”

Visit our website for more information about maximizing patient care through pharmacist-hospitalist collaboration.

A healthy collaboration between hospitalists and pharmacists can generate cost savings and promote positive outcomes, such as preventing adverse drug events and improving care transitions, says Jonathan Edwards, PharmD, BCPS, a clinical pharmacy specialist at Huntsville Hospital in Alabama.

At the 2012 national conference of the American College of Clinical Pharmacy in Hollywood, Fla., Edwards presented a poster that detailed the effectiveness of such interdisciplinary collaboration at Huntsville Hospital, where pharmacists and physicians developed six order sets, a collaborative practice, and a patient interaction program from November 2011 to February 2012. During the study period, researchers documented a total cost savings of $9,825 resulting from 156 patient interventions.

Edwards’ collaborative study at Huntsville started with two physicians who had launched a service teaching hospitalists what pharmacists do, and how they could help in their efforts.

“We got together and developed an order set for treating acute alcohol withdrawal. That went well, so we did five more order sets,” Edwards says. “Then we thought: What if pharmacists got more involved by meeting directly with patients in the hospital to optimize their medication management and help them reach their goals for treatment? We now evaluate patients on the hospitalist service in three units.”

For Edwards, key factors that make the hospitalist-pharmacist relationship work include communicating the pharmacist’s availability to help with the hospitalist’s patients, identifying the physician’s openness to help, and clarifying how the physician prefers to be contacted.

Last October, the American Society of Health-System Pharmacists (ASHP) and the American Pharmacists Association (APhA) recognized eight care-transitions programs for best practices that improved patient outcomes and reduced hospital readmissions as part of the Medication Management in Care Transitions (MMCT) Project.

“The MMCT project highlights the valuable role pharmacists can play in addressing medication-related problems that can lead to hospital readmissions,” APhA chief executive officer Thomas E. Menighan, BSPharm, MBA, ScD (Hon), FAPhA, said in a news release. “By putting together these best practices, our goal is to provide a model for better coordination of care and better connectivity between pharmacists and healthcare providers in different practice settings that leads to improved patient health.”

Visit our website for more information about maximizing patient care through pharmacist-hospitalist collaboration.

A healthy collaboration between hospitalists and pharmacists can generate cost savings and promote positive outcomes, such as preventing adverse drug events and improving care transitions, says Jonathan Edwards, PharmD, BCPS, a clinical pharmacy specialist at Huntsville Hospital in Alabama.

At the 2012 national conference of the American College of Clinical Pharmacy in Hollywood, Fla., Edwards presented a poster that detailed the effectiveness of such interdisciplinary collaboration at Huntsville Hospital, where pharmacists and physicians developed six order sets, a collaborative practice, and a patient interaction program from November 2011 to February 2012. During the study period, researchers documented a total cost savings of $9,825 resulting from 156 patient interventions.

Edwards’ collaborative study at Huntsville started with two physicians who had launched a service teaching hospitalists what pharmacists do, and how they could help in their efforts.

“We got together and developed an order set for treating acute alcohol withdrawal. That went well, so we did five more order sets,” Edwards says. “Then we thought: What if pharmacists got more involved by meeting directly with patients in the hospital to optimize their medication management and help them reach their goals for treatment? We now evaluate patients on the hospitalist service in three units.”

For Edwards, key factors that make the hospitalist-pharmacist relationship work include communicating the pharmacist’s availability to help with the hospitalist’s patients, identifying the physician’s openness to help, and clarifying how the physician prefers to be contacted.

Last October, the American Society of Health-System Pharmacists (ASHP) and the American Pharmacists Association (APhA) recognized eight care-transitions programs for best practices that improved patient outcomes and reduced hospital readmissions as part of the Medication Management in Care Transitions (MMCT) Project.

“The MMCT project highlights the valuable role pharmacists can play in addressing medication-related problems that can lead to hospital readmissions,” APhA chief executive officer Thomas E. Menighan, BSPharm, MBA, ScD (Hon), FAPhA, said in a news release. “By putting together these best practices, our goal is to provide a model for better coordination of care and better connectivity between pharmacists and healthcare providers in different practice settings that leads to improved patient health.”

Visit our website for more information about maximizing patient care through pharmacist-hospitalist collaboration.

A quality-improvement (QI) project to give high-risk patients ready access to prescribed medications at the time of hospital discharge achieved an 86% success rate, according to an abstract poster presented at HM12 in San Diego last April.¹

Lead author Elizabeth Le, MD, then a resident at the University of California at San Francisco Medical Center (UCSF) and now a practicing hospitalist at the Veterans Administration Medical Center in Palo Alto, Calif., says the multidisciplinary “brown bag medications” project involved training house staff to recognize patients at risk. Staff meetings and rounds were used to identify appropriate candidates—those with limited mobility or cognitive issues, lacking insurance coverage or financial resources, a history of medication noncompliance, or leaving the hospital against medical advice—as well as those prescribed medications with a greater urgency for administration on schedule, such as anticoagulants or antibiotics.

About one-quarter of patients on the unit where this approach was first tested were found to need the service, which involved faxing prescriptions to an outpatient pharmacy across the street from the hospital for either pick-up by the family or delivery to the patient’s hospital room. For those with financial impediments, hospital social workers and case managers explored other options, including the social work department’s discretionary use fund, to pay for the drugs.

Dr. Le believes the project could be replicated in other facilities that lack access to in-house pharmacy services at discharge. She recommends involving social workers and case managers in the planning.

At UCSF, recent EHR implementation has automated the ordering of medications, but the challenge of recognizing who could benefit from extra help in obtaining their discharge medications remains a critical issue for hospitals trying to bring readmissions under control.

For more information about the brown bag medications program, contact Dr. Le at [email protected].

References

1. Le L, Kynoch E, Monetta C, et al. Brown bag medications: Development and implementation of a program to provide discharge medications [abstract]. J Hosp Med. 2012;7 Suppl 2:S103.

A quality-improvement (QI) project to give high-risk patients ready access to prescribed medications at the time of hospital discharge achieved an 86% success rate, according to an abstract poster presented at HM12 in San Diego last April.¹

Lead author Elizabeth Le, MD, then a resident at the University of California at San Francisco Medical Center (UCSF) and now a practicing hospitalist at the Veterans Administration Medical Center in Palo Alto, Calif., says the multidisciplinary “brown bag medications” project involved training house staff to recognize patients at risk. Staff meetings and rounds were used to identify appropriate candidates—those with limited mobility or cognitive issues, lacking insurance coverage or financial resources, a history of medication noncompliance, or leaving the hospital against medical advice—as well as those prescribed medications with a greater urgency for administration on schedule, such as anticoagulants or antibiotics.

About one-quarter of patients on the unit where this approach was first tested were found to need the service, which involved faxing prescriptions to an outpatient pharmacy across the street from the hospital for either pick-up by the family or delivery to the patient’s hospital room. For those with financial impediments, hospital social workers and case managers explored other options, including the social work department’s discretionary use fund, to pay for the drugs.

Dr. Le believes the project could be replicated in other facilities that lack access to in-house pharmacy services at discharge. She recommends involving social workers and case managers in the planning.

At UCSF, recent EHR implementation has automated the ordering of medications, but the challenge of recognizing who could benefit from extra help in obtaining their discharge medications remains a critical issue for hospitals trying to bring readmissions under control.

For more information about the brown bag medications program, contact Dr. Le at [email protected].

References

1. Le L, Kynoch E, Monetta C, et al. Brown bag medications: Development and implementation of a program to provide discharge medications [abstract]. J Hosp Med. 2012;7 Suppl 2:S103.

A quality-improvement (QI) project to give high-risk patients ready access to prescribed medications at the time of hospital discharge achieved an 86% success rate, according to an abstract poster presented at HM12 in San Diego last April.¹

Lead author Elizabeth Le, MD, then a resident at the University of California at San Francisco Medical Center (UCSF) and now a practicing hospitalist at the Veterans Administration Medical Center in Palo Alto, Calif., says the multidisciplinary “brown bag medications” project involved training house staff to recognize patients at risk. Staff meetings and rounds were used to identify appropriate candidates—those with limited mobility or cognitive issues, lacking insurance coverage or financial resources, a history of medication noncompliance, or leaving the hospital against medical advice—as well as those prescribed medications with a greater urgency for administration on schedule, such as anticoagulants or antibiotics.

About one-quarter of patients on the unit where this approach was first tested were found to need the service, which involved faxing prescriptions to an outpatient pharmacy across the street from the hospital for either pick-up by the family or delivery to the patient’s hospital room. For those with financial impediments, hospital social workers and case managers explored other options, including the social work department’s discretionary use fund, to pay for the drugs.

Dr. Le believes the project could be replicated in other facilities that lack access to in-house pharmacy services at discharge. She recommends involving social workers and case managers in the planning.

At UCSF, recent EHR implementation has automated the ordering of medications, but the challenge of recognizing who could benefit from extra help in obtaining their discharge medications remains a critical issue for hospitals trying to bring readmissions under control.

For more information about the brown bag medications program, contact Dr. Le at [email protected].

References

1. Le L, Kynoch E, Monetta C, et al. Brown bag medications: Development and implementation of a program to provide discharge medications [abstract]. J Hosp Med. 2012;7 Suppl 2:S103.

Reduction in bloodstream infection rates resulting from a simple intervention: bathing all ICU patients daily with antimicrobial chlorhexidine soap rather than the widely mandated practice of screening ICU patients to determine which ones harbor methicillin-resistant Staphylococcus aureus (MRSA) and then implementing an MRSA treatment protocol for them.

According to data on 75,000 patients at hospitals in 16 states presented in October at the Infectious Diseases Society of America annual meeting, there also was a 37% reduction in patients with MRSA.

Lead researcher Susan Huang, MD, an infectious-disease specialist at the University of California at Irvine, says the results show the benefits of this preventive approach, which included applying an antibiotic ointment to the patient’s nasal passage, and could make ICU screening for drug-resistant organisms, such as MRSA, unnecessary.

Reduction in bloodstream infection rates resulting from a simple intervention: bathing all ICU patients daily with antimicrobial chlorhexidine soap rather than the widely mandated practice of screening ICU patients to determine which ones harbor methicillin-resistant Staphylococcus aureus (MRSA) and then implementing an MRSA treatment protocol for them.

According to data on 75,000 patients at hospitals in 16 states presented in October at the Infectious Diseases Society of America annual meeting, there also was a 37% reduction in patients with MRSA.

Lead researcher Susan Huang, MD, an infectious-disease specialist at the University of California at Irvine, says the results show the benefits of this preventive approach, which included applying an antibiotic ointment to the patient’s nasal passage, and could make ICU screening for drug-resistant organisms, such as MRSA, unnecessary.

Reduction in bloodstream infection rates resulting from a simple intervention: bathing all ICU patients daily with antimicrobial chlorhexidine soap rather than the widely mandated practice of screening ICU patients to determine which ones harbor methicillin-resistant Staphylococcus aureus (MRSA) and then implementing an MRSA treatment protocol for them.

According to data on 75,000 patients at hospitals in 16 states presented in October at the Infectious Diseases Society of America annual meeting, there also was a 37% reduction in patients with MRSA.

Lead researcher Susan Huang, MD, an infectious-disease specialist at the University of California at Irvine, says the results show the benefits of this preventive approach, which included applying an antibiotic ointment to the patient’s nasal passage, and could make ICU screening for drug-resistant organisms, such as MRSA, unnecessary.