MS-TRIP 2: Disseminating the PPRNet Model for Improving Medication Safety

Transcription

1 MS-TRIP 2: Disseminating the PPRNet Model for Improving Medication Safety Andrea Wessell, PharmD Lynne Nemeth, PhD, RN AHRQ Grant Number 1 R18HS019593

2 AGENDA 1:45pm-2:15pm MS-TRIP 2 Project summary Andrea Wessell 2:15pm-3:00pm 3:00pm-3:15pm Best Practice panel Toolkit review Break MS-TRIP 2 practices 3:30pm-4:00pm Discussion and Dissemination of MS-TRIP 2 Best Practices across PPRNet PPRNet Practices August 23-25, 2012 PPRNet 2012

3 WORKSHOP AFTERNOON GOALS Summarize lessons learned during final year of MS-TRIP 2 Share best practice approaches to med safety Gather feedback on the PPRNet Medication Safety Toolkit Disseminate best practices across PPRNet August 23-25, 2012 PPRNet 2012

4 THE PROBLEM Prescribing and monitoring errors cause preventable harm in primary care patients Most safety innovations and investments have focused on inpatient settings Real world safety laboratories are needed to test and model improvement August 23-25, 2012 PPRNet 2012 JAMA 2011; 306 (22):

5 THE OPPORTUNITY First MS-TRIP project resulted in: A set of prescribing and monitoring error indicators Practice strategies used to improve med safety Modest improvements in indicator set after a 2-year PPRNet intervention Quality and Safety in Healthcare 2010;19(5):1-5. Journal of Patient Safety 2010;6(4): American Journal of Medical Quality 2012; doi: / August 23-25, 2012 PPRNet 2012

6 MS-TRIP 2 PROJECT GOALS Disseminate PPRNet Medication Safety Improvement Model to 60 PPRNet practices Develop a Med Safety toolkit August 23-25, 2012 PPRNet 2012

7 MS-TRIP 22 PRACTICES IN ATTENDANCE PANELS Advanced Health Care Alpha Medical Center Andrew Murry, MD Burke Primary Care Byron Center Family Medicine Chatuge Family Practice Cookeville Primary Care Assocs Cowherd Family Medical Center Dekalb Health Medical Group Fulton Family Health Assocs Hilliard Family Medicine Diana Lozano, MD Mililani Family Practice NE Iowa Family Practice Center New London Family Practice Kelly K. Omalia, MD Ripon Family Physicians The Internal Medicine and Pediatric Clinic of New Albany August 23-25, 2012 PPRNet 2012

8 PPRNET MEDICATION SAFETY IMPROVEMENT MODEL Safety approaches and practice strategies to: Develop practice culture of medication safety Assure the accuracy of each patient s med list Integrate EHR decision support features Implement a practice protocol for med refills Design and execute case management for patients who meet criteria for preventable med errors August 23-25, 2012 PPRNet 2012

9 Quarterly Reports Avoiding potentially inappropriate therapy Avoiding potentially inappropriate dosages Avoiding potential drug-drug interactions MS-TRIP 2 INTERVENTIONS Avoiding potential drug-disease interactions Monitoring of potential adverse events

10 MS-TRIP REPORTS

11 MS-TRIP REPORTS

12 MS-TRIP REPORTS

13 Network Meetings MS-TRIP 2 INTERVENTIONS

14 MS-TRIP 2 ACTIVITIES MS-TRIP 2 INTERVENTIONS Webinars Quarterly to coincide with reports PRN for individual practices

15 MS-TRIP 2 ACTIVITIES MS-TRIP 2 INTERVENTIONS Site Visits Large practices or those new to PPRNet research

16 MEDICATION SAFETY TOOLKIT help local health care organizations meet the challenge of implementing safe practice interventions to improve patient safety

17 TOOLKIT COMPONENTS Description of the safety problem Key components of the MS-TRIP 2 intervention Practice tools developed during project (ie, templates, handouts, posters, etc.) Case studies to highlight best practices

18 TOOLKIT COMPONENTS PRNet/research/mstrip2home

19 TOOLKIT COMPONENTS August 23-25, 2012 PPRNet PRNet/research/mstrip2home

20 LESSONS LEARNED Overall, findings corroborated key strategies in MS improvement model Specific lessons will be highlighted during panel discussion Relevant toolkit components will be displayed for feedback

21 MS-TRIP 2 Lessons Learned: Best Practice Approaches to Medication Safety PPRNet, 2010

22 LESSONS LEARNED Develop a practice culture of medication safety Deliver medication safety education and reminders to patients consistently across the practice Use MS-TRIP reports to evaluate performance over time and guide improvement plans

23 BYRON CENTER FAMILY PRACTICE

24 MEDICATION SAFETY TOOLKIT

25 LESSONS LEARNED Assure the accuracy of each patient s med list Process adapted to meet practice needs and workflow Greater attention to having patients bring medications to visits Best approach to sharing med list at the end of visit seems to be a work in progress

26 MEDICATION SAFETY TOOLKIT

27 MEDICATION SAFETY TOOLKIT

28 LESSONS LEARNED Integrate EHR decision support features into routine practice Dose advisor and HM medication templates were new to many practices Note templates were often edited to reinforce MS-TRIP measures

29 MEDICATION SAFETY TOOLKIT

30 LESSONS LEARNED Implement a practice protocol for med refills Many practices worked on a more consistent approach o Staff education o Schedule refills according to monitoring requirements/prompts in HM o Use HM as a standing order

31 MEDICATION SAFETY TOOLKIT

32 LESSONS LEARNED Design and execute case management for patients who meet criteria for potential errors Use reports to identify patients o Start with measures below median performance o Provider/nursing team prioritize measures and decide what works best messaging, flags on med lists, direct patient outreach Use reports to develop tracking system for patients on warfarin

33 PPRNET MEDICATION SAFETY IMPROVEMENT MODEL Safety approaches and practice strategies to: Develop practice culture of medication safety Assure the accuracy of each patient s med list Integrate EHR decision support features Implement a practice protocol for med refills Design and execute case management for patients who meet criteria for preventable med errors August 23-25, 2012 PPRNet 2012

34 How confident are you that your current medication safety plans will be sustained in your practice a year from now? What med safety strategies have become a stable part of practice life? August 23-25, 2012 PPRNet 2012

35 BREAK August 23-25, 2012 PPRNet

36 Additional Discussion and Dissemination of MS-TRIP 2 Best Practices across PPRNet August 23-25, 2012 PPRNet

37 PPRNET MEDICATION SAFETY IMPROVEMENT MODEL Safety approaches and practice strategies to: Develop practice culture of medication safety Assure the accuracy of each patient s med list Integrate EHR decision support features Implement a practice protocol for med refills Design and execute case management for patients who meet criteria for preventable med errors August 23-25, 2012 PPRNet 2012

38 What MS-TRIP best practices are feasible for you to implement? August 23-25, 2012 PPRNet 2012

39 AGENDA 4:30pm-5:30pm PPRNet Fun Run and Walk Meet in Lobby 6:30pm-7:30pm PPRNet Reception and Best Practice Awards Stono Ballroom August 23-25, 2012 PPRNet 2012