CSHP Can YOU hit the Target? Carolyn Bornstein BScPhm, ACPR, FCSHP CSHP President, Vision Liaison November 17, 2007

CSHP 2015 – Can YOU Hit the Target? OB AGM – Nov 17, 2007 CSHP MISSION CSHP is the national voice of pharmacists committed to the advancement of safe, effective medication use and patient care in hospitals and related healthcare settings

CSHP 2015 – Can YOU Hit the Target? OB AGM – Nov 17, 2007 CSHP VISION 2010  A dynamic Society  The Influential Voice for Hospital Pharmacy  Inspiring Practice Excellence  Fostering Leadership and Professional Growth

CSHP 2015 – Can YOU Hit the Target? OB AGM – Nov 17, 2007 VISION 2010 – Four Pillars Advocacy CMA, SOP, Global, PR, Blueprint, CPSI Organizational Effectiveness Communication, branches, succession Members and Membership Services E-commerce, PSNs, online education, PLI Practice Excellence through CSHP 2015

CSHP 2015 – Can YOU Hit the Target? OB AGM – Nov 17, 2007 STRATEGIC OBJECTIVE CSHP will improve patient medication outcomes and safety by advancing practice excellence through CSHP 2015

CSHP 2015 – Can YOU Hit the Target? OB AGM – Nov 17, 2007 What is CSHP 2015? Adaptation of ASHP’s 2015 Initiative Patterned after Healthy People Goals and related objectives (34) Pharmacy practice excellence in hospitals and related healthcare settings in 2015 A Vision - The Future of Hospital Pharmacy Practice in Canada A patient-centred tool A Quality Initiative

CSHP 2015 – Can YOU Hit the Target? OB AGM – Nov 17, 2007 SIX GOALS OF CSHP Making medication use effective in hospitals 2. Making medication use effective in non- hospital settings 3. Making medication use scientific 4. Making medication use safe wrt systems 5. Making medication use safe wrt technology 6. Making meaningful contributions to public health

CSHP 2015 – Can YOU Hit the Target? OB AGM – Nov 17, 2007 SIX GOALS OF CSHP 2015 “Effective” medication use 1.Increase the extent to which pharmacists help individual hospital inpatients achieve the best use of medications 2.Increase the extent to which pharmacists help individual non-hospitalized patients achieve the best use of medication

CSHP 2015 – Can YOU Hit the Target? OB AGM – Nov 17, 2007 GOALS Continued “Scientific” medication use 3.Increase the extent to which hospital and related healthcare setting pharmacists actively apply evidence- based methods to the improvement of medication therapy

CSHP 2015 – Can YOU Hit the Target? OB AGM – Nov 17, 2007 GOALS Continued 4.Increase the extent to which pharmacy departments in hospitals and related healthcare settings have a significant role in improving the safety of medication use. 5.Increase the extent to which hospitals and related healthcare settings apply technology effectively to improve the safety of medication use “Safe” medication use

CSHP 2015 – Can YOU Hit the Target? OB AGM – Nov 17, 2007 GOALS Continued 6.Increase the extent to which pharmacy departments in hospitals and related healthcare settings engage in public health initiatives on behalf of their communities “Community” health

CSHP 2015 – Can YOU Hit the Target? OB AGM – Nov 17, 2007 OBJECTIVES – Support Goals Improve medication outcomes patient safety pharmacy practice excellence Measurable targets Based on: What will make the most difference to the patient? What will convey the positive contributions of the pharmacist? Can change as best practice changes or evolves

CSHP 2015 – Can YOU Hit the Target? OB AGM – Nov 17, 2007 OBJECTIVES APPLY TO ALL TYPES OF: PATIENTS - Inpatients, outpatients, community members PHARMACISTS - generalists, specialists, and managers PRACTICE SETTINGS – hospital, clinics, primary care, LTCF, community

CSHP 2015 – Can YOU Hit the Target? OB AGM – Nov 17, 2007 Please REMEMBER…. ALL OBJECTIVES won’t apply to everyone, But there is … SOMETHING FOR EVERYONE! They include measurable targets to monitor progress

CSHP 2015 – Can YOU Hit the Target? OB AGM – Nov 17, 2007 MEASURABLE TARGETS BASELINES required Where are we now? TARGETS Aspirations, challenges, NOT standards Where we want to be in 2015! May change once baseline determined

CSHP 2015 – Can YOU Hit the Target? OB AGM – Nov 17, 2007 Some Objectives – Goal 1 Objective 1.3 In 90% of hospitals, pharmacists will have organizational authority to manage medication therapy in collaboration with other members of the health-care team Objective % of hospital inpatients discharged with complex and high-risk medication regimens will receive medication counselling managed by a pharmacist Objective % of recently hospitalized patients or their caregivers will recall speaking with a pharmacist while in the hospital

CSHP 2015 – Can YOU Hit the Target? OB AGM – Nov 17, 2007 Some Objectives – Goal 2 Objective 2.2 In 95% of ambulatory and specialized care clinics, pharmacists will counsel clinic patients with complex and high-risk medication regimens Objective 2.3 In 85% of home care services, pharmacists will have organizational authority to manage medication therapy in collaboration with other members of the healthcare team Objective 2.4 In 65% of long-term care facilities, pharmacists will have organizational authority to manage medication therapy in collaboration with other members of the healthcare team

CSHP 2015 – Can YOU Hit the Target? OB AGM – Nov 17, 2007 Some Objectives – Goal 3 Objective 3.2 In 100% of hospital and related healthcare settings, pharmacists will be actively involved in the development and implementation of all evidence-based therapeutic protocols involving medication use Objective % of hospital pharmacies will participate in ensuring that patients hospitalized for an acute myocardial infarction will receive lipid-lowering therapy at discharge

CSHP 2015 – Can YOU Hit the Target? OB AGM – Nov 17, 2007 Some Objectives – Goal 4 Objective % of hospitals and related healthcare settings will have an organizational program, with appropriate pharmacy involvement, to achieve significant annual, documented improvement in the safety of all steps in medication use Objective % of hospitals have at least 95% of routine medication orders reviewed for appropriateness by a pharmacist before administration of the first dose

CSHP 2015 – Can YOU Hit the Target? OB AGM – Nov 17, 2007 Some Objectives – Goal 5 Objective 5.3 For routine medication prescribing for inpatients, 75% of hospitals will use computerized prescriber order entry systems with clinical decision support Objective 5.5 In 75% of hospitals and related healthcare settings, pharmacists will use medication- relevant portions of patients’ electronic medical records for managing patients’ medication therapy

CSHP 2015 – Can YOU Hit the Target? OB AGM – Nov 17, 2007 Some Objectives – Goal 6 Objective % of hospital pharmacies will participate in ensuring that high risk patients in hospitals and related healthcare settings receive vaccinations for influenza and pneumococcus Objective % of hospital pharmacies will participate in ensuring that hospitalized patients who smoke receive smoking-cessation counselling

CSHP 2015 – Can YOU Hit the Target? OB AGM – Nov 17, 2007 CSHP 2015 vs ASHP 2015 Same Goals Objectives – from 31 to 34 Split one objective re: MI and CHF patients into 2 separate objectives HbA1c testing be done “at least” annually NEW: pharmacist reviewing medication orders in the Emergency Department within 24 hours NEW: computerized pharmacist order entry system with clinical decision support NEW: unit dose systems Deleted immunization initiatives in communities by hospital pharmacies Target % patients vs % hospitals

CSHP 2015 – Can YOU Hit the Target? OB AGM – Nov 17, 2007 CSHP 2015 DEFINITIONS Hospital (vs health-system) adapted from the Canada Health Act definition Complex and High Risk Medications ISMP and institutional specific lists/definitions Managing vs monitoring Medication counselling Routine medication orders Community Health Initiatives

CSHP 2015 – Can YOU Hit the Target? OB AGM – Nov 17, 2007 Where’s the EVIDENCE? ASHP 2015 Crosswalk (on their website) Links to literature supporting role of pharmacist, best practice guidelines, outcome measures A Canadian version would link to National and Provincial Health Priorities of other organizations (eg. ISMP, CMA, CPSI, etc.) CSHP is considering a Canadian crosswalk

CSHP 2015 – Can YOU Hit the Target? OB AGM – Nov 17, 2007 Where do YOU start? CSHP 2015 on CSHP website ( CSHP 2015 self-assessment tool (website) Review 2015 presentations (website) Review the objectives wrt your practice setting Engage colleagues and/or your department Use self-assessment tool to identify priorities Choose one or more objectives! Multiple applications…..

CSHP 2015 – Can YOU Hit the Target? OB AGM – Nov 17, 2007 How to Incorporate CSHP 2015 Strategic plan A new pharmacist service A residency project Program improvement project Patient safety initiative Research project Use your imagination……..

CSHP 2015 – Can YOU Hit the Target? OB AGM – Nov 17, 2007 HOW You can hit the Target Select your objective Action plan – NO roadmaps! Measure Baseline (Don’t forget!!) Monitor progress Evaluate Give yourself time (8 years if necessary!) SHARE YOUR SUCCESS!!!

CSHP 2015 – Can YOU Hit the Target? OB AGM – Nov 17, 2007 Strategic Plan for CSHP 2015 Official launch at PPC 2008 Commitment – individual and institution Project leader and steering committee Lilly Hospital Pharmacy Survey Share members’ success stories Ongoing relationship with ASHP for advice and to share our progress, challenges, successes in Canada

CSHP 2015 – Can YOU Hit the Target? OB AGM – Nov 17, 2007 TO RECAP, CSHP 2015 is… 1.A vision of pharmacy practice excellence 2.A patient centered tool to improve medication safety and outcomes 3.A living, breathing document 4.Susceptible to change/updating as practice standards are redefined 5.Applicable to various areas of pharmacy practice

CSHP 2015 – Can YOU Hit the Target? OB AGM – Nov 17, 2007 And Don’t forget when you…. Hit the Target.. Share your success story… Succeed we ALL succeed! Improve patient care, everyone benefits Finish, choose another objective

CSHP 2015 – Can YOU Hit the Target? OB AGM – Nov 17, 2007 So get out there and.. Just DO it! Because… You CAN hit the TARGET!