Which hematology/oncology patients are high priority for ambulatory clinical pharmacist review? A three-round Delphi survey by the National Comprehensive Cancer Network.

INTRODUCTION: Prioritization and acuity tools have been leveraged to facilitate targeted and efficient clinical pharmacist interventions. However, there is a lack of established pharmacy-specific acuity factors in the ambulatory hematology/oncology setting. Therefore, National Comprehensive Cancer Network's Pharmacy Directors Forum conducted a survey to establish consensus on acuity factors associated with hematology/oncology patients that are high priority for ambulatory clinical pharmacist review. METHODS: A three-round electronic Delphi survey was conducted. During the first round, respondents were asked an open-ended question to suggest acuity factors based on their expert opinion. Respondents were then asked in the second round to agree or disagree with the compiled acuity factors, in which those with ≥75% agreement were included in the third round. The final consensus was defined as a mean score ≥3.33 on a modified 4-point Likert scale (4 = strongly agree, 1 = strongly disagree) during the third round. RESULTS: A total of 124 hematology/oncology clinical pharmacists completed the first round of the Delphi survey (invitation response rate, 36.7%), of which 103 completed the second round (response rate, 83.1%) and 84 the third round (response rate, 67.7%). A final consensus was achieved for 18 acuity factors. Acuity factors were identified in the following themes: antineoplastic regimen characteristics, drug interactions, organ dysfunction, pharmacogenomics, recent discharge, laboratory parameters, and treatment-related toxicities. CONCLUSIONS: This Delphi panel of 124 clinical pharmacists achieved consensus on 18 acuity factors that would identify a hematology/oncology patient as a high priority for ambulatory clinical pharmacist review. The research team envisions incorporating these acuity factors into a pharmacy-specific electronic scoring tool.

Evaluation of the frequency of dispensing electronically discontinued medications and associated outcomes.

OBJECTIVES: To determine if outpatient pharmacies of an academic medical center inadvertently dispense discontinued medications and, if so, if these inadvertently dispensed prescriptions contribute to subsequent hospital admissions and patient harm. METHODS: This was a single-center retrospective chart review. Prescription billing data were analyzed for electronic prescriptions for hypotensives, hypoglycemics, anticoagulants, antiplatelets, and statins picked up from 3 outpatient pharmacies within the health system over a period of 1 year. Prescriptions must have been written by a Michigan Medicine health system provider and were excluded if they were written, faxed, or phoned in. Timestamp of pick-up from the pharmacy was compared with timestamp of prescription discontinuation within the electronic health record (EHR). If the prescription was discontinued before pick-up, timestamps were also assessed to determine if the prescription order was discontinued in the EHR before final pharmacist verification. If a prescription was found to be picked up after it was discontinued, the patient chart was reviewed to determine if he or she was admitted within 30 days of the pick-up date. RESULTS: Overall, 10,649 individual electronic prescriptions met inclusion criteria. Of these, 526 (4.94%) were picked up after the prescription order was discontinued in the EHR. The prescription was discontinued before final pharmacist verification for 287 (54.56%) of these prescriptions. Three of these inadvertently dispensed prescriptions could have contributed to hospital admission 30 days after pick-up for 3 individual patients. CONCLUSION: Electronic prescriptions that have been discontinued within the EHR continue to be dispensed to patients in the outpatient pharmacy setting. These inadvertently dispensed prescriptions have the potential to cause patient harm.

Eliminating sexual harassment in pharmacy: Role of the chief pharmacy officer.

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Implementing and evaluating a diversity, equity, and inclusion resident recruitment strategy.

PURPOSE: A recruitment strategy was designed to increase the racial diversity of applicants to the postgraduate year 1 pharmacy program at University of Michigan Health, Michigan Medicine (MM). This article describes MM's diversity, equity, and inclusion (DEI) residency recruitment approach, from conceptualization through implementation, and includes an evaluation of its effectiveness. SUMMARY: The report of the American Society of Health-System Pharmacists (ASHP) Task Force on Racial Diversity, Equity, and Inclusion, published in January 2021, provided a foundation for our recruitment approach. The approach consisted of establishing a residency DEI subcommittee, conducting outreach to under-represented students, and reducing bias in the process by amending the application screening rubric. The combination of these efforts resulted in a 5% increase in applicants from pharmacy schools with a high proportion of under-represented minority students. CONCLUSION: A diverse residency program benefits patients, trainees, and the larger healthcare organization. In addition, incorporating DEI into resident recruitment is required by the new ASHP Accreditation Standard for postgraduate pharmacy residency programs effective July 1, 2023. Evaluation of our recruitment efforts demonstrated targeted recruitment as an effective strategy to increase the diversity of a residency program's applicants. There may be additional barriers not addressed by our interventions to be further explored.

Assessing the self-development potential of a pharmacy management practitioner through self-assessment survey.

PURPOSE: The self-development potential of pharmacy management practitioners related to self-management, team development, and network management was assessed. METHODS: A survey instrument consisting of 12 self-assessment questions and 11 questions about demographics was distributed to pharmacy management practitioners to assess their abilities to manage themselves, their teams, and their networks. The tool was distributed by e-mail hyperlink to 190 potential respondents. Only surveys from respondents who had a pharmacy degree and direct supervisory capacity were analyzed. Respondents rated their progress toward meeting the three imperatives on a scale of 1-5. Responses to the questions were analyzed as ordinal data, with median responses used for assessment. RESULTS: A total of 160 responses were received via e-mail, 149 (93%) of which met the inclusion criteria. About half of all respondents were practicing at institutions of 600 beds or more and supervised at least five employees. The majority of respondents identified their abilities to manage themselves, their teams, and their networks as areas of strength but also acknowledged that using all three of these skills on a daily basis was an area of opportunity. Respondents generally identified management of their network as an area needing work. CONCLUSION: The majority of survey respondents identified their skills in self-, team, and network management as areas of strength. Respondents generally identified management of their network as an area needing work. Respondents also identified the use of all three imperatives on a daily basis as an area of opportunity for improvement.