Clinical pharmacy. Bienvenue Welkom Wellcome Willkommen

Transcription

1 Clinical pharmacy Bienvenue Welkom Wellcome Willkommen

2 Introduction The National Pilot Project DEVELOPMENT OF THE APPLICATION INTEGRATED AND THE EVALUATION OF CLINICAL PHARMACY INTO THE HOSPITAL 1 st of July 2014 Structural financing of the clinical pharmacy in the hospitals

3 The goals of the government to optimize the pharmaceutical care and the care implying of the medical devices; to promote clinical pharmacy for safety and rational pharmaceutical care; to set up good practices and to implement improvements; to promote the electronic prescription; to support the seamless pharmaceutical care, in particular medication reconciliation, the transmission of information at the time of the exit of the patient; to develop and support the essential conditions with the optimization of the pharmaceutical care: o proposals for an adaptation of the legislative framework, o development of indicators of output to index the evolutions, o support for the development of authentic data banks for the drugs

4 Clinicamp III

5 Aim of the day Talk with each other about clinical pharmacy Share tools and strategies Help new starting hospitals Today = Working day = Workshops = Active Participation

6 Menu Some history of development of clinical pharmacy in hospitals sponsored by the federal government What s all about hospital pharmacy, clinical pharmacy, pharmaceutical care in relation to public financing? Program of the Clinicamp III

7 History Since the years 70 in USA and UK Years 80 : first training courses in clinical pharmacy in Belgium 2003 : Wilmotte L, Hecq JD : analyse de conditions d implémentation de la pharmacie clinique dans la formation des pharmaciens hospitaliers belges, Pharmakon 2003;35: (4) : Fellowship Clinical Pharmacy KUL (1 year) Precursory projects, especially in the university hospitals 2005 : Certificat universitaire UCL en Pharmacie clinique 2006 : Postgraduate Clinical Pharmacy KUL (2 years) July 2007: financing / SPF: 20 ETP in 27 hospitals July 2010: 27 accepted additional projects

8 July 2014: 0,25 ETP/200 beds (general hospitals & academics) The positive tests of the application of clinical pharmacy and its impact on the quality of the care convinced the authorities to widen this support with the whole of the general hospitals of Belgium. The financing is envisaged in the B5 part of the Budget of Financial means. This governmental support of the pharmaceutical care directed towards the patient would become first world.

9 Pharmakon 2003 ;35:( 4):10 16

10 Hospital pharmacy Clinical pharmacy Pharmaceutical care What s all about? It s about drug therapy for patients It s about pharmaceutical care giving

11 Hospital pharmacy Preparation of pharmaceutical care giving Pharmaceutical care giving for the individual patient Follow-up of pharmaceutical care giving To be ready when the patient arrives The patient is there The patient is gone

12 Preparation of pharmaceutical care giving Pharmacy & Therapeutics committee CPOE development and implementation Cooperation with physicians and nurses o Guidelines for drug therapy and drug administration o Care pathways Databases: development and maintenance Purchasing and inventory

13 Pharmaceutical care giving for the individual patient Medication history of the patient upon arriving at the hospital Evaluation medical prescription Preparation of the drug MULTIDISCIPLINARITY Distribution of the drug Administration of the drug Registration of the administration of the drug Billing of the drug Counseling of the patient at discharge

14 Follow-up of pharmaceutical care giving Analysis of past drug therapies in relation of the guidelines (DUE, ) Was everything going well with the drug therapies? (DRP, ) Analysis of past drug therapies in relation to the drug budget

15 What s all about pharmaceutical care in relation to public financing? The hospital pharmacist is taking care and/or coordinate for the patient: o Medication history of the patient upon arriving at the hospital o Evaluation medical prescription o Counseling of the patient at discharge Patient oriented seamless care (community <-> hospital) Transmural care giving

16 How to do this? Development of applied pharmaco-therapeutic knowledge and experience To be on the wards together with physicians and nurses To prove the added-value of the pharmacist in drug therapy

17 Pharmaco-therapeutic knowledge? Pharmacology Pathophysiology Chemistry + Patient Acquiring Pharmaco-therapeutic Knowledge Bedside

18 Being bedside What s also important? Communication with care givers (physicians, nurses, ) Communication with patients and relatives Always the right advice Documentation of the added value To be familiar with sales techniques

19 Public financing of clinical pharmacy in hospitals Why the Belgian government is financing clinical pharmacy? o Desires excellent and affordable drug therapy for their citizens in hospitals o Convinced about added-value of hospital pharmacists in drug therapies Is this amount of money enough? No, but a starting point

20 What can we do with this money? Financing hospital pharmacist(s) or others in case of making free hospital pharmacist time Development pharmaco-therapeutic knowledge and experience Transfer this knowledge and experience where possible to o Hospital pharmacists in and outside the pharmacy o Pharmacy technicians o Physicians o Nurses

21 Input of hospital pharmacists Reengineering the hospital pharmacy activities to make time free for clinical activities The right person on the right place Limited resources: Number of hospital pharmacist in a hospital is limited related to the number of patients Risk analysis and management Change of mentality Hospital pharmacist is not the supplier of drugs Hospital pharmacists is the provider of drug therapy

22 Input of hospital pharmacists Coming out of the hospital pharmacy Participating meetings showing the added-value of hospital/clinical pharmacy If possible or desirable or in case of opportunity taking the lead in drug therapy matters Presentations Publications Research

23 Input of hospital pharmacists Development of clinical pharmaceutical knowledge and experience bedside supports Activities in the pharmacy: drug chart review, preparations ready-to-administer, Activities in : o preparation of therapies: P&T committee, CPOE support o follow-up of therapies: evaluation incidents, budget,

24 There is no time to develop clinical pharmacy activities in the hospital? Yes, but In more than 50 hospitals clinical pharmacy has been started During the national assembly of hospital pharmacy associations more and more abstracts are presented We see an increasing number of presentations on the post university education and training days We can read scientific contributions in national and international journals So,

25 Public financing of clinical pharmacy in hospitals Financing means getting value for money Follow-up by government with: o Yearly reports o Indicators o Self-evaluation Yearly Clinicamp Feedback by government based on follow-up information

26 Public financing of clinical pharmacy in hospitals More is coming from the Belgian government for hospital pharmacy o Creation of hospital pharmacy team o The recruitment process for a hospital pharmacist has been started Mission With a multidisciplinary, skilled and motivated team, we contribute to a health policy based on information and expert advice to achieve financially and geographically accessible to everyone a continuum of quality care

27 Ultimate goal Development of clinical pharmacy activities in hospitals in a cooperation between hospital pharmacists and Belgian government Belgian government Hospital pharmacy team Network Pharmacy & Therapeutics committees

28 Program of THE day Time Zalen/Salles CLINICAMP III 13/06/2014 W. Vandersteen R. Magritte B J. Ensor C. Permeke B C. Permeke A Pater Damiaan Onthaal Accueil Plenary session Introductie tot de structurele fase van de toepassing klinische farmacie - Introduction à la phase structurelle de l'application de la pharmacie clinique L. Willems - JD Hecq SESSIONS : number of participants limited/session session 1 session 2 session 3 session 4 session 5 session Documenteren van een klinisch Meerwaarde van klinische farmacie Medicatiehistoriek bij opname Medicatiehistoriek bij ontslag Medicatiebegeleiding bij oncologische Medication Review farmaceutisch advies in het door rapportering patienten patiëntendossier Documenter un avis cliniquepharmaceutique dans le dossier du par le rapportage l'admission auprès de patients oncologique Importance de la pharmacie clinique Historique de la médication à Historique de la médication à la sortie Accompagnement de la médication Revue de la médication patient Anne Spinewine (CHU Dinant-Godinne) Elke Detroy (Jessaziekenhuis) Rachel Pham (HIS Buxelles) Karolien Walgraeve (UZ Leuven) France Duvivier (CHPLT) Annemie Somers (UZ Gent) Katrien Blauwhoff (AZ St. Nikolaas) Christine Danguy (CHU Charleroi - A. Stéphane Steurbaut (UZ Brussel) Angela Passanisi (CHBAH) Tine Hendrickx (AZ ST Lucas, Gent) Fanny Vaillant (Clin.Univ. St Luc, Bxl) Vésale) session 7 session 8 session 9 session 10 session 11 session 12 Organisatie van klinische farmacie: Prospectief kostenbesparende Multidisciplinaire opvolging van antiinfectieuze Ziekenhuisbrede acties met focus op Life long learning met betrekking tot Kennis- en kundeoverdracht aan data en hoe deze aanwenden bij een klinische-farmaceutische acties en middelen individuele patiënt klinische farmacie artsen, verpleegkundigen en overleg campagnes apothekerassistenten Organisation de la pharmacie clinique: Suivi mulitidisciplinaire de Actions au niveau de l'hôpital avec Apprentissage permanent en ce qui Transmission des connaissances et données et comment s'en servir lors Actions prospectives avantageuses médicaments anti-infectieux focues sur le patient individuel concerne la pharmacie clinique compétences aux médecins, infirmiers d'une concertation pharmaco-cliniques et campagnes et assistants en pharmacie Different workshops Jean-Daniel Hecq (CHU Dinant- Isabelle Glorieux (GZA Ziekenhuizen) Godinne) Michele Catry (AZ St. Lucas, Gent) Ludo Willems (UZ Leuven) Olivier Tassin (GHdCharleroi) SESSIONS : number of participants limited/session Paul Tulkens (UCL) Astrid Van Regemortel (ZNA) Thierry Van Hees (ULG, Liège) Sara Mertens (UZ Gent) Sabine Deryckere (UZ Gent) Audrey Vervacke (Hôpital Erasme) Sabrina Dewinter (UZ Leuven) Celine Van Wetter (GHdCharleroi) WALKING DINNER - Clinigalery session 1 session 2 session 3 session 4 session 5 session 6 Documenteren van een klinisch Meerwaarde van klinische farmacie Medicatiehistoriek bij opname Medicatiehistoriek bij ontslag Medicatiebegeleiding bij oncologische Medication Review farmaceutisch advies in het door rapportering patienten patiëntendossier Documenter un avis cliniquepharmaceutique Importance de la pharmacie clinique Historique de la médication à Historique de la médication à la sortie Accompagnement de la médication Revue de la médication dans le dossier du par le rapportage l'admission auprès de patients oncologique patient Celine Micchel (CHU Dinant-Godinne) Elke Detroy (Jessaziekenhuis) Rachel Pham (HIS Buxelles) Karolien Walgraeve (UZ Leuven) France Duvivier (CHPLT) Annemie Somers (UZ Gent) Katrien Blauwhoff (AZ St. Nikolaas) Christine Danguy (CHU Charleroi - A. Stéphane Steurbaut (UZ Brussel) Angela Passanisi (CHBAH) Tine Hendrickx (AZ ST Lucas, Gent) Fanny Vaillant (Clin.Univ. St Luc, Bxl) Vésale) session 7 session 8 session 9 session 10 session 11 session 12 Organisatie van klinische farmacie: Prospectief kostenbesparende Multidisciplinaire opvolging van antiinfectieuze Ziekenhuisbrede acties met focus op Life long learning met betrekking tot Kennis- en kundeoverdracht aan data en hoe deze aanwenden bij een klinische-farmaceutische acties en middelen individuele patiënt klinische farmacie artsen, verpleegkundigen en overleg campagnes apothekerassistenten Organisation de la pharmacie clinique: Suivi mulitidisciplinaire de Actions au niveau de l'hôpital avec Apprentissage permanent en ce qui Transmission des connaissances et données et comment s'en servir lors Actions prospectives avantageuses médicaments anti-infectieux focues sur le patient individuel concerne la pharmacie clinique dcompétences aux médecins, d'une concertation pharmaco-cliniques et campagnes infirmiers et assistants en pharmacie Jean-Daniel Hecq (CHU Dinant- Isabelle Glorieux (GZA Ziekenhuizen) Paul Tulkens (UCL) Astrid Van Regemortel (ZNA) Thierry Van Hees (ULG, Liège) Sara Mertens (UZ Gent) Godinne) Michele Catry (AZ St. Lucas, Gent) Sabine Deryckere (UZ Gent) Audrey Vervacke (Hôpital Erasme) Sabrina Dewinter (UZ Leuven) Celine Van Wetter (GHdCharleroi) Ludo Willems (UZ Leuven) Olivier Tassin (GHdCharleroi) Plenary session Conclusions and closing speech L. Willems - JD Hecq - C. Decoster RECEPTION and have a chat

29 10h00 Session/Sessie 1 Salle/Zaal W. Vandersteen Documenter un avis clinique-pharmaceutique dans le dossier de patient Documenteren van een klinisch farmaceutische advies in het patiëntendossier Anne Spinewine CHU Dinant-Godinne & Celine Michel - CHU Dinant-Godinne Katrien Blauwhoff (AZ St Nikolaas)

30 10h00 Session / Sessie 2 Salle/Zaal R Magritte Démontrer la plus-value d une pharmacie clinique par le rapportage à la direction de l hôpital (et aux prestataires de soins concernés) Aantonen van de meerwaarde van klinische farmacie door rapportering aan de directie van het ziekenhuis (alsook aan de betrokken zorgverstrekkers) Elke Detroy (Jessaziekenhuis) Christine Danguy (CHU Charleroi-A. Vésale)

31 10h00 Session / Sessie 3 Salle/Zaal J. Ensor Historique de la médication à l admission Medicatiehistoriek bij opname Stéphane Steurbaut (UZ Brussel) Rachel Pham (HIS Bruxelles)

32 10h00 Session / Sessie 4 Salle/Zaal C Permeke B Historique de la médication à la sortie Medicatiehistoriek bij ontslag Angela Passanisi (CH Bois de l Abbaye et de l Hesbaye) Karolien Walgraeve (UZ Leuven)

33 10h00 Session / Sessie 5 Salle/Zaal C. Permeke A Accompagnement de la médication auprès de patients oncologiques Medicatiebegeleiding bij oncologische patiënten France Duvivier (CHPLT, Verviers) Tine Hendrickx (AZ ST Lucas, Gent)

34 10h00 Session / Sessie 6 Salle/Zaal Pater Damiaan Revue de la médication Medication Review Annemie Somers (UZ Gent) Fanny Vaillant (Clin. Univ. St Luc Bruxelles)

35 11h00 Session/Sessie 7 Salle/Zaal W. Vandersteen Organisation de la pharmacie clinique : données et comment s en servir lors d une concertation Organisatie van klinische farmacie: data en hoe deze aanwenden bij een overleg L. Willems (UZ leuven) JD. Hecq (CHU Dinant Godinne)

36 11h00 Session/Sessie 8 Salle/Zaal R. Magritte Actions prospectives avantageuses en matière de clinique pharmaceutique et campagnes (utilisation rationnelle des médicaments) Prospectief kostenbesparende klinisch-farmaceutische acties en campagnes(rationeel gebruik van geneesmiddelen) Isabelle Glorieux GZA Ziekenhuizen) &Michele Catry (AZ St Lucas, Gent) Olivier Tassin

37 11h00 Session/Sessie 9 Salle/Zaal J. Ensor Suivi multidisciplinaire de médicaments anti-infectieux Multidisciplinaire opvolging van anti-infectieuze middelen P. Tulkens (UCL) Sabine Deryckere (UZ GENT)

38 11h00 Session/Sessie 10 Salle/Zaal C. Permeke B Actions au niveau de l hôpital avec focus sur le patient individuel Ziekenhuisbrede acties met focus op individuele patiënt Astrid Van Regemortel (ZNA) Audrey Vervacke (Hôpital Erasme)

39 11h00 Session/Sessie 11 Salle/Zaal C. Permeke A Apprentissage permanent (life long learning) en ce qui concerne la pharmacie clinique Life long learning met betrekking tot klinische farmacie Sabrina Dewinter (UZ Leuven) Thierry Van Hees (ULG Liège)

40 11h00 Session/Sessie 12 Salle/Zaal Pater Damiaan Transmission des connaissances et des compétences aux médecins, aux infirmiers et aux assistants en pharmacie Kennis- en kunde-overdracht aan artsen, verpleegkundigen en apothekersassistenten Sarah Mertens (UZ Gent) Celine Van Wetter (Grand Hôpital de Charleroi)

41 12h00 Walking dinner Clinigalery

42 13h00 Reprise des 12 sessions selon le même schéma. Herhaling van de 12 sessies volgens hetzelfde schema.

43 15h15 Conclusions et clôture / Conclusies en slotwoord 15h45 Drink / Drink

44 Let s work now together