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Jewish Healthcare Foundation

Plans Announced for Pharmacy Pilot Program

April 25, 2007

The Jewish Healthcare Foundation (JHF) in conjunction with the Pittsburgh Regional Health Initiative (PRHI) plans to launch a pilot program to expand the role of pharmacists in supervising medications for chronically ill patients in hospitals and nursing homes and in post-discharge follow-up. The goal is to improve the safety and efficacy of treatment while potentially reducing the costs.

Up to six institutionally-based Southwestern pharmacists will be selected for the Pharmacy Agents for Change program. They will design and conduct demonstration projects to better manage multiple medications, educate patients and consult on the choice and administration of medications.

The pharmacists will be given training in process engineering and work redesign principles to be applied in the demonstrations. PRHI will provide the training through its Perfecting Patient CareSM University and also will support the projects with on-site coaching.

JHF's board recently approved $210,000 in funding to provide stipends, training and other support for the two-year program. Requests for project proposals are scheduled for release June 1 with a submission deadline of Aug. 1

The program is expected to build on findings of a 1999 study that JHF funded to see if patients with multiple medical conditions would benefit from the intervention of hospital pharmacists. Conducted by researchers at the University of Pittsburgh Center for Research on Health Care, the study concluded that patients often were able to take fewer medications when pharmacists reviewed their regimens and that the administration of the medicines often could be streamlined.

Hospitalized patients who suffer from multiple chronic diseases, such as diabetes, high blood pressure and congestive heart failure, often receive prescriptions from multiple physicians and sometimes don't realize that new prescriptions are supposed to replace ones they already are taking. Sometimes, patients receive duplicative medications with different names. Lack of coordination between physicians can result in medication conflicts. In addition, pharmacists sometimes find that patients might be better served with different drug choices.

Across the country, there is growing interest in involving pharmacists more in clinical decision-making and patient education. Numerous pilot programs have been started, including a highly publicized one in Ashville, NC, which sponsors have credited with significant improvements in health outcomes and decreases in lost work days, and the Living My LifeTM self-management program for diabetics that the Pittsburgh Business Group developed using the Ashville model.

"We believe there is an expanded role for pharmacists to play, but reimbursements in health care have not been structured to support it," said Karen Wolk Feinstein, PhD, President and Chief Executive Officer of JHF and PRHI. "In addition to documenting improvements in patient outcomes and their financial impact, we'll be using this program to investigate what kinds of payment changes might be needed."

The Pharmacy Agents for Change is the latest in a series of professional development programs and demonstrations that JHF began in 2001 to bring process engineering principles, systems thinking and other quality improvement tools into the hands of the region's healthcare professionals. Those who are trained are linked in learning networks to further develop and spread understanding of these methods. In conjunction with PRHI, JHF launched quality improvement fellowships for Physician Champions and Nurse Navigators in late 2005. Late last year, JHF and its other operating affiliate, Health Careers Futures, began a fellowship program to help librarians become more acquainted with resources for researching consumer health questions. In conjunction with HCF, the Foundation also sponsors fellowships in patient safety and medical ethics for graduate students pursuing health care-related degrees.

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