Wikipedia:Tutorial (historical)/Editing/sandbox

Utilization/Governance/Issues/Opportunities

1. Identify the committees/positions responsible for medication utilization and ensure there is a shared vision around the steps outlined in this framework
2. Details: [more details; see CDS guide chapter 1 on stakeholders]; extract details from and reference IOM med safety report: link to report Exec Summary
   • Not just a "pharmacy thing" - requires broad multi-disciplinary team
   • Important role for organizational board of directors and executive leadership: how much time does this topic have on their agenda? How engaged are these groups and their influential leaders?
3. Example: [illustrative successful practice examples from Community]
   • 1/3 of management incentive plan for HealthEast based on quality goals
   • Brigham and Women's: executive rounds, pharmacy
   • St. Raphael: prioritizatio, variance analysis, tracking
   • AJHSP article describing causes of outpatient Rx errors
4. Examine local and national sources of information regarding opportunities to improve medication utilization (see fig 1-6 in HIMSS CDS guide)
   • Local sources: Drug cost data, ... etc.
   • National sources:
     1. ISMP data [link].
     2. reports describing major sources of med errors: Bates et al. Effect of Computerized Physician Order Entry and a Team Intervention on Prevention of Serious Medication Errors
     3. Bobb et al. The epidemiology of prescribing errors: the potential impact of computerized prescriber order entry
     4. use of high-risk medications by pregnant women is not uncommon
     5. New Joint Commission national patient safety goal on reducing patient harm from use of anticoagulant therapy: 2008 hospital safety goals

        Example

        • AVIATOR case example from Memorial Hermann
        • St Raphael KCI example: frequent, hi risk use and identified variances; used CPOE alerts, education to address