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Success Stories
A CPA SUCCESS STORY:
COOLEY DICKINSON HOSPITAL
The Client
Cooley Dickinson Hospital (www.cooley-dickinson.org) is a 142-bed acute care hospital providing patient-centered healthcare services at a main campus in Northampton, Massachusetts, and at satellite facilities in Amherst, Easthampton, Florence, Hadley, South Deerfield and Worthington. At Cooley Dickinson, 400 affiliated physicians and over 1,700 employees work collaboratively to provide the highest quality of care.
The Situation
One of the difficulties for small- to medium-size hospitals is maintaining expertise in all areas of service. This can be particularly difficult in the complicated area of pharmaceutical care. Most patients served by hospitals are exposed to drug therapy for diagnosis, prophylaxis or treatment. With the increasing cost, regulatory compliance and clinical impact of drug therapy, Cooley-Dickinson was having difficulty keeping pace with the rapid changes in medication management and turned to CPA for assistance.
Our Solution
After an initial intensive efficiency evaluation, CPA defined a plan to improve the quality of pharmaceutical care from inventory management to quality clinical program implementation. While the analysis was enlightening, the difficulty is always in the implementation of the changes. It was clear that a more hands-on approach to pharmacy management was required in order to help Cooley-Dickinson address its various needs. To execute the needed changes, CPA partnered with Cooley-Dickinson in May of 2009 and provided expertise with a Director of Pharmacy, temporary pharmacist informaticist and medication quality improvement and risk reduction specialists. The main areas of contribution of the partnered approach included:
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Identifying and implementing a strategic plan
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Identifying and correcting programming deficiencies in the Eclipsys CPOE system.
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Standardizing order sets
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Assisting anesthesiologists on documenting narcotic use in the OR
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Programming smart pumps to assure accuracy and reduce risk
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Establishing a state-of-the art formulary review and approval process
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Targeting high-cost drug usage
Results
With access to timely implementation and experienced professionals from CPA, goals were achieved in a matter of months and continue today. The successes include:
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Savings of over $200,000 documented in the first 12 months, not including medication error avoidance and subsequent morbidity costs.
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Recent Joint Commission Survey resulted in no medication-related deficiencies
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Eclipsys CPOE dictionary build is corrected, resulting in more accurate and efficient medication order and administration
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Maintained regulatory standards
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Incorporated evidence-based medicine (EBM) in formulary review process
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Smart pump implementation was successful
A CPA SUCCESS STORY:
MAJOR NATIONAL HEALTHCARE BENEFIT PLAN ORGANIZATION
The Client
The Organization helps to coordinate care for millions of Federal employees, retirees and their families around the country.
The Situation
The Organization is charged with the task of establishing nationwide benefits parameters; in that context, it is the responsibility of the Organization's P&T Committee to make decisions about which drugs are covered for the benefit of federal recipients. Doing this effectively requires that the P&T Committee be current on all the latest information regarding drug efficacies, costs, interactions and so on. For help, they turned many years ago to Clinical Pharmacy Associates.
Our Solution
On a quarterly basis, CPA provides a comprehensive compendium of information to the Organization's P&T Committee concerning such topics as new drug evaluations, new drug classifications and safety-related drug labeling changes. To obtain the information, CPA associates monitor a wide array of data sources on a continuous basis. It is presented in person to the P&T Committee by CPA Co-founder Dr. Chris Keeys, who functions as an integral member of the P&T Committee, helping them make efficacious decisions about which drugs to include and not to include on the Federal recipients plans.
Results
The Organization has long recognized that one of CPA's strengths is the fact that it is an independent organization and has no affiliations with drug manufacturers. As the Executive Director for Pharmacy Programs at the Organization says, "With CPA, I know we're going to get independent, fact-based medication reports. I don't have to worry that there's any bias in them."
A CPA SUCCESS STORY:
DIMENSIONS HEALTHCARE SYSTEM
The Client
Formed in 1982, Dimensions Healthcare System (www.dimensionhealth.org) is an integrated, not-for-profit healthcare system serving residents of Prince George's County, Maryland and the surrounding area. Dimensions and its member institutions and affiliated organizations provide comprehensive quality healthcare services ranging from prenatal care to behavioral healthcare to rehabilitation services. Member institutions include three Hospital Centers and two Specialty Hospital and Nursing Centers.
The Situation
Dimensions and the member institutions face the daunting responsibility of serving the highest share of uninsured, underinsured and Medicaid patients of any hospital system in Maryland. Efficient management of the full scope of pharmacy operations is an essential element to the financial as well as their patient care mission for the people of Prince Georges County.
Our Solution
Clinical Pharmacy Associates has provided high quality pharmacy services to Dimensions' member institutions in all facets of pharmacy, clinical and management operations for over 10 years. Our approach has been to adapt to the changing requirements of the member institutions and, more recently, provide system-wide recommendations on management and best practice. Recommendations have been developed and implemented in all areas of CPA's offerings.
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CPA OnSite
- Directors, clinical pharmacists, quality improvements specialists, staff pharmacist and technicians are deployed to meet the changing needs in the member institutions. Our associates bring outside, high level expertise but operate in a seamless manner with their colleagues, the employees of the hospital.
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CPA Advisors
- The depth of CPA's skills and expertise comes into play on projects and key strategic initiatives. Consultants are utilized to bring high level input and action for projects including major pharmacy information systems implementations.
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CPA Analytics
- Under the direction of CPA lead associates, committee-ready analytics are brought to bear to improve the effectiveness of the Hospitals' P&T Committees .
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CPA MedNovations
- After-hours virtual pharmacy provides the same high quality order review and entry all night that is provided in-house during the day.
Results
Effective deployment of all of the resources of Clinical Pharmacy Associates provides Dimensions with many benefits. High-level management of the pharmacy practices of Dimensions has been essential to the primary mission of providing high quality healthcare.
The impact of the actions and direction of CPA in collaboration with the health system generates results that more than pay for the cost to Dimensions.
Examples of some of the cost savings include:
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Redirection of the utilization for the newer cardiac drug, nesiritide (Natrecor®), based on comparative effectiveness and patient specific parameters resulted in an annual savings of $295,000.
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Application of an early version of the Antibiotic stewardship program identified and addressed the inappropriate use of the newer, broad spectrum antibiotic tigecycline (Tygicil®) and resulted in an annual savings of $210,816.
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Establishment of an after-hours (virtual) telepharmacy service resulted in an annual savings of over $150,000 measured against the cost of staffing in-house.
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