Hospital Pharmacy in Canada Report Data Trends New Frontline Staff Surveys Your Suggestions Kevin Hall B. Sc. Pharm., Pharm. D., FCSHP Clinical Associate Professor Faculty of Pharmacy and Pharmaceutical Sciences University of Alberta Chuck Wilgosh B. Sc. Pharm., MBA Pharmacy Practice Consultant

Objectives To review and briefly discuss trends in the responses to a number of selected questions that have appeared in the Hospital Pharmacy in Canada Report. To briefly review and discuss the front-line staff (pharmacists and technicians) surveys that were included in the 2011/12 HPC Report. To obtain feedback from the conference attendees concerning possible additions or deletions of survey questions.

IV admixture to 90% or more of beds

Types of Drug Distribution Systems

Automated Dispensing Cabinet Adoption

Implementation of CPOEs

Technician checking Unit Dose trays

Trends in Pharmacist Activities

Uses of Barcoding in Hospital Pharmacy (Base: all respondents)

North American Health-System / Hospital Pharmacists Initiative (ASHP, CSHP, APES, etc.) Started in early 2000s, first version posted on ASHP’s Web site in June 2001 Strategic vision and action plan with 36 goals in 6 domains Goals and objectives were based on available evidence and were considered achievable by 2015 Baselines established and targets created

CSHP 2015 Progress – 10 to 12 years later Medication Reconciliation “In 100% of hospitals and related healthcare settings, pharmacists will ensure that medication reconciliation occurs during transfers across the continuum of care.” Target: 100% of hospitals On admission: On Transfer: On Discharge % 41% 36% % 47% 44%

CSHP 2015 Progress – 10 to 12 years later Monitoring of complex and high risk regimens “The medication therapy of 100% of inpatients with complex and high risk medication regimens will be monitored by a pharmacist” Target: 100% of hospitals Results 2010 Survey: 5% Results 2012 Survey 10%

CSHP 2015 Progress – 10 to 12 years later Monitoring of complex and high risk regimens “75% of hospital inpatients discharged with complex and high-risk medication regimens will receive medication counselling managed by a pharmacist.” Target: 75% Results 2008 Survey: 3% Results 2010 Survey: 2% Results 2012 Survey 2%

CSHP 2015 Progress – 10 to 12 years later Ensuring appropriate therapy on discharge “90% of hospital pharmacies will participate in ensuring that patients hospitalized for an acute MI will receive an ACE inhibitor at discharge.” Target: 90% Results 2008 Survey: 53% Results 2010 Survey: 59% Results 2012 Survey 58%

CSHP 2015 Progress – 10 to 12 years later Ensuring appropriate therapy on discharge “90% of hospital pharmacies will participate in ensuring that patients hospitalized for an acute MI will receive a beta blocker at discharge.” Target: 90% Results 2008 Survey: 52% Results 2010 Survey: 59% Results 2012 Survey 59%

CSHP 2015 Progress – 10 to 12 years later Ensuring safety of medication use “80% of hospital pharmacies will conduct an annual assessment of the processes used for compounding sterile medications.” Target: 80% Results 2008 Survey: 24% Results 2010 Survey: 29% Results 2012 Survey 48%

CSHP 2015 Progress – 10 to 12 years later Applying technology to improve medication safety “75% of hospitals will use machine-readable coding to verify medications before dispensing pharmacies will conduct an annual assessment of the processes used for compounding sterile medications.” Target: 75% Results 2008 Survey: 13% Results 2010 Survey: 17% Results 2012 Survey 20%

CSHP 2015 Progress – 10 to 12 years later Applying technology to improve medication safety “For routine medication prescribing for inpatients, 75%of hospitals will use CPOE systems that include clinical decision support.” Target: 75% Results 2008 Survey: 7% Results 2010 Survey: 6% Results 2012 Survey 9%

So why do changes occur so slowly ?

Frontline technician survey

Your Suggestions

Technician certification and regulation: 1)Has your department held informational sessions with its pharmacy technicians to explain what technician certification and technician regulation are, the status of pharmacy technician certification/regulation across Canada, and the personal implications that this may have for you?  no  yes