Pharmacist medication assessments in a surgical preadmission clinic.

BACKGROUND: In the hospital setting, postoperative admission is a key vulnerable moment when patients are at increased risk of medication discrepancies. This study measures the reduction of medication discrepancies associated with a combined intervention of structured pharmacist medication history interviews with assessments in a surgical preadmission clinic and a postoperative medication order form. METHODS: In the Surgical Pharmacist in Preadmission Clinic Evaluation (SPPACE) study, patients who had a preadmission clinic appointment before undergoing surgical procedures were eligible for inclusion. Patients were excluded if they were scheduled for discharge the same day as their surgery. Eligible patients were randomly assigned to the intervention arm (structured pharmacist medication history interview with assessment and generation of a postoperative medication order form) or to the standard care arm (nurse-conducted medication histories and surgeon-generated medication orders). The primary end point was the number of patients with at least 1 postoperative medication discrepancy related to home medications. RESULTS: Between April 19, 2005, and June 3, 2005, a total of 464 patients were enrolled in the study, of which 227 and 237 patients were randomized to the intervention and standard care arms, respectively. In the intervention arm, 41 (20.3%) of 202 patients had at least 1 postoperative medication discrepancy related to home medications, compared with 86 (40.2%) of 214 patients in the standard care arm (P<.001). In the intervention arm, 26 (12.9%) of 202 patients had at least 1 postoperative medication discrepancy with the potential to cause possible or probable harm, compared with 64 (29.9%) of 214 patients in the standard care arm (P<.001). These were mostly omissions of reordering home medications. CONCLUSION: A combined intervention of pharmacist medication assessments and a postoperative medication order form can reduce postoperative medication discrepancies related to home medications.

Using a course pilot in the development of an online problem-based learning (PBL) therapeutics course in a post-professional PharmD program.

BACKGROUND AND PURPOSE: To assess whether the traditional problem-based learning (PBL) process can be replicated in an online environment, and to identify any barriers and facilitators to learning using a course pilot. EDUCATIONAL ACTIVITY AND SETTING: Eight alumni and one experienced tutor participated in a two-week simulated PBL course comprised of two three-hour synchronous online tutorials. Blackboard Collaborate® software was used to permit audio and visual interaction. The PBL tutorials were recorded and observed by the researchers. Participants completed satisfaction surveys after the pilot, and were invited to take part in a focus group to debrief about their experience. FINDINGS: Once the steep learning curve with the technology was overcome, the quality of the PBL process was similar in the online course as it was in the face-to-face course. Several key factors for success were identified through analysis of the videotaped sessions, and interviews with the participants in the course pilot. SUMMARY: Conducting a course pilot study demonstrated that an online PBL course is feasible, and identified some considerations to facilitate success.

Evaluation of a Unique Interprofessional Education Program Involving Medical and Pharmacy Students.

Objective. To measure changes in interprofessional competencies among pharmacy and medical students following a half-day event focusing on interprofessional learning. Methods. There were 118 pharmacy students and 28 medical students who participated in the Healthcare Interprofessional Education Day (HIPED) which consisted of three stations (communication, patient interviewing, and prescribing) in which pharmacy and medical students had to work collaboratively. The standardized Interprofessional Collaborative Competency Attainment Survey (ICCAS) was used to evaluate the effectiveness of the program. Results. There were 133 surveys completed for a response rate of 91%. All 20 items measured by the ICCAS showed a significant improvement. The strongest effect sizes were in the collaboration, roles & responsibilities, and collaborative practice/family-centered approach categories. The least robust effects were in the conflict management/resolution category. Conclusion. The HIPED activity was an effective IPE experience. The strong and consistent improvement in all ICCAS scores suggest a framework for pharmacy and medical school training to move from siloed educational experiences to synergistic learning opportunities.