1. Safety, Quality, and the Pharmacy Practice Model Initiative: Aligning for Success Scott Knoer, M.S., Pharm.D. Chief Pharmacy Officer Cleveland Clinic

2. ObjectivesObjectives Describe metrics and a process that can be used to measure the quality of change that occurred and ensure that a positive change has taken place Describe metrics and a process that can be used to measure the quality of change that occurred and ensure that a positive change has taken place Describe how organizations have implemented safety and quality principles in daily practice Describe how organizations have implemented safety and quality principles in daily practice

3. A Case Study at the Cleveland Clinic Impacting metrics that count Impacting metrics that count - HCAHPS medication scores - HF readmission reduction

4. Insured Payor Mix Note: Based on gross charges. Excludes strategic projects in forecasted period. Detail % Exchange

5. Detail $ Millions Projected Impact of Healthcare Reform

6. HCAHPS Scores Hospital Consumer Assessment of Healthcare Providers & Systems Hospital Consumer Assessment of Healthcare Providers & Systems Measures patients’ perceptions of their hospital experience Measures patients’ perceptions of their hospital experience Tied to hospital reimbursement Tied to hospital reimbursement

7. Why Do HCAHPS Scores Count? Publically reported measures Publically reported measures Beginning this year, government reimbursement is directly tied into HCAHPS Scores Beginning this year, government reimbursement is directly tied into HCAHPS Scores Underperformers will get less money Underperformers will get less money

8. Medication Domain Questions Purpose of new medications explained Purpose of new medications explained Side effects described Side effects described Medication Communication Medication Communication - Composite score based on the percent of patients responding ‘Always’

9. HF Readmissions Unplanned readmissions cost Medicare $17.4 billion a year, and HF is the most frequent reason for rehospitalizations (Jencks et al., 2009). Unplanned readmissions cost Medicare $17.4 billion a year, and HF is the most frequent reason for rehospitalizations (Jencks et al., 2009). Reducing readmission rates has the potential to lead to significant cost savings Reducing readmission rates has the potential to lead to significant cost savings You get paid less if you have high readmissions You get paid less if you have high readmissions http://www.medscape.com/vie warticle/722234

10. Ask 3, Teach 3 Ask 3 Ask 3 Patients will be encouraged to "Ask 3" so they understand the name, purpose and possible side effects of their medications Patients will be encouraged to "Ask 3" so they understand the name, purpose and possible side effects of their medications

11. Ask 3, Teach 3 Teach 3: System wide pharmacy competency Teach 3: System wide pharmacy competency - The name of the medication - Describe the purpose of the medication - Explain possible side effects (Note: It’s important to use the words possible side effects in the conversation)

12. Pharmacy HF Education Every Cleveland Clinic patient discharges with a primary diagnosis for HF receives discharge education from a pharmacist Every Cleveland Clinic patient discharges with a primary diagnosis for HF receives discharge education from a pharmacist System competency System competency

13. Bedside Delivery of Medications Bedside delivery option for discharge Rx for all HF patients Bedside delivery option for discharge Rx for all HF patients - Tech driven literacy survey - iPad education pilots

14. Summary of Projects Patient Experience Patient Experience - Bedside discharge delivery - HF education - Ask 3, teach 3 education

15. Enterprise Medication HCAHPS Scores

16. Enterprise 30-Day HF Readmissions

17. FutureFuture Expand discharge delivery option to all patients Expand discharge delivery option to all patients - Leverage technology iPads iPads Portable credit card readers Portable credit card readers Expand RPh education to selected groups Expand RPh education to selected groups Manage the continuum Manage the continuum

18. `` Every Life Deserves World Class Care