Patient Safety Content in the COP Curriculum COP

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Patient Safety Content in the COP Curriculum

Patient Safety Content in the COP Curriculum

COP Departments – Teaching Mission Medical Chemistry (Medicinal Chemistry Foundations I &II, Nucleotides, Pharmacodynamics

COP Departments – Teaching Mission Medical Chemistry (Medicinal Chemistry Foundations I &II, Nucleotides, Pharmacodynamics (Physiological Basis of Disease I&II, Microbiological Basis for Therapy, Pharmacological Basis of Therapeutics I&II) Pharmaceutics (Dosage Forms I&II, Dose Optimization I&II, Dosage Forms and Contemporary Practice, Clinical Biochemistry, Herbal Medicines) Pharmaceutical Outcomes and Policy (Quantitative Methods, Introduction to Pharmacy Health Care, Professional Communications, Evidence-based Pharmacy, Legal and Organizational Medicine Use, Pharmacoeconomics) Pharmacy Practice (Practicum I-IV, Drug Therapy Monitoring, Pharmacotherapy I-VI, Pharmaceutical Skills Lab I&II) Total: 146 credits (including 8 elective credits)

INTRODUCTION TO PHARMACISTS, PHARMACEUTICALS AND THE HEALTHCARE SYSTEM This course introduces the pharmacy student

INTRODUCTION TO PHARMACISTS, PHARMACEUTICALS AND THE HEALTHCARE SYSTEM This course introduces the pharmacy student to the relationships of patients, pharmacists, and other health care professionals with the institutions that control medication use; tools and attitudes necessary to provide patient care; the concepts of health and illness, and patient behavior; legal issues of pharmacy practice; how health care systems, of which pharmacy is a part, seek to meet the goals of equitable access, reasonable cost, and high quality. These areas of knowledge are essential to understanding pharmacy practice, and will guide the student throughout their curriculum towards the goal of becoming a practicing pharmacist. Delivery: Lectures, Text Book: Mc. Carthy RL & Schafermeyer KW. (2007). Introduction to Health Care Delivery: A Primer for Pharmacists, Cases, Group Discussions Assessment: Cases (group work, essay); Multiple-choice

LEGAL AND ORGANIZATIONAL ENVIRONMENT OF MEDICINES USE This course describes the governmental framework within

LEGAL AND ORGANIZATIONAL ENVIRONMENT OF MEDICINES USE This course describes the governmental framework within which pharmacy is practiced. The legal and ethical basis of pharmacy practice is emphasized. Best pharmacy practices and managed care approaches are presented and discussed.

EVIDENCE-BASED PHARMACY – OBJECTIVES Methods for evaluation and improvement of drug therapy outcomes including

EVIDENCE-BASED PHARMACY – OBJECTIVES Methods for evaluation and improvement of drug therapy outcomes including critical appraisal of drug and clinical service literature, and quality assessment and improvement techniques with special focus on patient and medication safety Find and evaluate published medical literature for clinical decisionmaking, understand scientific reasoning and the research process Describe how clinical findings are summarized in evidence reports Describe current evidence on the assessment and improvement of patient safety, the epidemiology of medication errors & ADEs Devise ways to assess the quality of pharmacotherapy in pharmacy practice and its effect on patient outcomes and health care cost. Identify options for change in practice that are feasible and effective Describe how to design, establish, and evaluate quality improvement programs.

EBP – COURSE PHILOSOPHY IOM report on reinventing the healthcare system: Consequent application of

EBP – COURSE PHILOSOPHY IOM report on reinventing the healthcare system: Consequent application of evidence to healthcare delivery Full adoption of quality improvement through IT and systems that reward quality Transition from individual to population-based care Students don't appreciate patient safety issues They don't feel responsible Students love to be smart and to be drug experts

COURSE STRUCTURE 4 campuses, 300+ students Lectures (online; 3/week) Discussion groups (6 groups, weekly,

COURSE STRUCTURE 4 campuses, 300+ students Lectures (online; 3/week) Discussion groups (6 groups, weekly, 2 hours, with polling tools) Quizzes (weekly, online or via "clickers") Midterm (4 hours, article critique) Final project ( groups of 5, QI project, background paper, formal presentation with external judges)

EBP – COURSE CONTENT Critical literature appraisal will address the following issues Introduction to

EBP – COURSE CONTENT Critical literature appraisal will address the following issues Introduction to evidence-based medicine Retrieval methods for primary medical literature, drug references and other evidence sources Methods for the critical literature appraisal Study types and their relevance to study validity and application in practice Interpretation of epidemiologic measures of frequency and risk Threats to validity (confounding, bias, random error), hypothesis testing and scientific reasoning Methods and resources for evidence summaries (meta-analysis, evidence reports, clinical guidelines)

EBP – CONTENT II Quality assessment and improvement Definitions and elements of quality; quality

EBP – CONTENT II Quality assessment and improvement Definitions and elements of quality; quality deficits in healthcare Means to measure quality and current applications; selection of highpriority areas for QI Methods to explore and explain variation in quality, benchmarking Selection of QI strategies and plans for implementation & evaluation Patient and drug safety Review of drug safety information, methodological issues related to pharmacovigilance and post-marketing studies Epidemiology of patient safety and medication errors, ascertainment and analysis of medication error data Examples of medication safety initiatives

INTERVIEW AND DATA ENTRY FORM http: //www. cop. ufl. edu/safezone/ned/formg en/5213 b. htm Patient

INTERVIEW AND DATA ENTRY FORM http: //www. cop. ufl. edu/safezone/ned/formg en/5213 b. htm Patient demographics Diabetes Outcomes (labs, complications, healthcare utilization) Diabetes care (prevention, drug therapy, monitoring) Diabetes-related quality of life Diabetes Knowledge

Hba 1 c, % Hb. A 1 c <=7 >7 Total Count Column %

Hba 1 c, % Hb. A 1 c <=7 >7 Total Count Column % valuehba 1 c, % Missing 23 19. 0% 98 81. 0% 121 100. 0% Patient DM Knowledge summary score >= 10 < 10 LDL <100 25 41. 7% 35 58. 3% 60 100. 0% BMI N Mean >= 29. 00 < 29. 00 156 115 8. 254 8. 097 Std. Error Deviation Mean 1. 962. 157 1. 833. 171 Total >=100 20 21. 7% 72 78. 3% 92 100. 0% 68 24. 9% 205 75. 1% 273 100. 0% N Mean Std. Deviation Std. Error Mean 121 152 7. 901 8. 402 1. 861 1. 912 . 169. 155

FINAL PROJECT Problem statement Selection of a QI target Selection of process and outcomes

FINAL PROJECT Problem statement Selection of a QI target Selection of process and outcomes measures Selection / development of intervention Study design, statistics Study significance

FAMOUS STUDENT AND INSTRUCTOR QUOTES Thus, there is a great capacity to reduce morbidity

FAMOUS STUDENT AND INSTRUCTOR QUOTES Thus, there is a great capacity to reduce morbidity and morality with the use of ACE-I. Recall bias is unpredictable because there were 19 countries participating and it is hard to figure out whethere were cases more likely to think harder about whether exposed. The strength of an RCT is that subjects are human. “Randomization levels the playing field and blinding keeps the game fair. ” “The causal association is temporarily seen in the study. ” “The authors of the study except of the two associated with Merck were wellpositioned and educated. ” “Attrition bias was minimized by adding more subjects to the study after drop out. ” The dose in the placebo group was not mentioned. “The control group received a fair fight. ” Efficient use of highlighter Study subjects are human and random. ” “Attrition was slightly similar. ” “The bias renders the findings reconsiderable. ” All the authors appear wellpositioned to conduct the study, but they were all from different countries and I wonder how well they were able to communicate with each other.

almut@cop. ufl. edu

almut@cop. ufl. edu