The integration of quality assessment and a patient-specific intervention/outcomes program.

The clinical intervention program in place at the University of Iowa Hospitals and Clinics is based on the pharmacist's evaluation of the patient, the disease state, and the appropriateness of the selected therapy. The system was developed so that all pharmacists within our institution: staff pharmacists, clinical pharmacy specialists, clinical pharmacists, and pharmacy residents can easily and efficiently document all interactions with other health care providers. The recent introduction of the Medication Use Indicators process by the Joint Commission has provided many pharmacy departments with a series of outcome measurements which may prove useful in their attempts to maximize contributions to the medication use process. In this article, we describe how our department has begun to utilize the Joint Commission indicator data by integrating information from them into the daily practices of our staff, and how our department has utilized a formal interventions and outcomes program to evaluate such efforts.

Locally derived clinical practice guidelines using a decision analysis model.

As health-care providers continually are faced with the need to identify the most cost-effective modalities when initiating therapy among many therapeutic options, standardized clinical guidelines become the foundation for decision making. This article discusses how decision analysis can be useful in the formulation of locally derived clinical practice guidelines. The following is an example of using decision analysis to evaluate data gathered within the institution, supplemented by peer-reviewed literature, to choose the most cost-effective agent in the treatment of chemotherapy-induced nausea and vomiting at the authors' institution.

Increased adverse drug reaction reporting through wall-mounted ADR reporting cards.

To increase adverse drug reaction reporting, the Pharmacy Department Quality Assessment and Improvement Committee at the University of Iowa Hospitals and Clinics created an abbreviated wall-mounted adverse drug reaction card on "tear-off" pads. This report discusses strategies the Committee identified in order to attain its goal.