2015 Initiative Yields to PPMI
[February 1, 2012, AJHP News]
BETHESDA, MD 18 January 2012—As pharmacy practice evolves, so do the strategies that help drive those changes—including the ambitious and comprehensive Pharmacy Practice Model Initiative (PPMI), which has supplanted ASHP's 2015 Initiative.
Launched in 2003, ASHP's Health-System Pharmacy 2015 Initiative was a member-driven plan "structured to help us reach the ASHP vision for pharmacy practice in hospitals and health systems," said ASHP's Douglas Scheckelhoff, vice president of professional development.
The most recent version of the 2015 Initiative consisted of six goals and 31 related objectives. In general, the 2015 Initiative emphasized the pharmacist's role in promoting public health and ensuring that medication use is safe, effective, and based on scientific evidence.
Hospitals have aligned patient care projects with the 2015 Initiative and shared their success stories with ASHP. Successful projects that fit the 2015 Initiative's goals and criteria encompass a variety of practice areas, including cardiovascular, kidney, and pulmonary care; medication-error prevention; understanding medication-use patterns; and hospital discharge planning.
"What we saw with the 2015 Initiative was that individual hospitals used those goals and objectives as part of their strategic planning and their work. And we also saw that many state affiliates had used the initiative to guide their education and some of the initiatives at the state level," Scheckelhoff said.
Then, through the work of the 2010 Pharmacy Practice Model summit, came PPMI, through which 147 recommendations from the summit were distilled into 26 measures grouped under five "overarching goals," Scheckelhoff said.
PPMI emphasizes pharmacists' accountability for patient outcomes; advanced roles for pharmacy technicians; and the use of technologies that improve medication safety. The practice environment envisioned by PPMI is one in which pharmacists spend most of their time working collaboratively with other health care providers to manage complex therapy issues.
Scheckelhoff said there are areas of overlap between the 2015 Initiative and PPMI, especially in objectives related to the roles of pharmacists and pharmacy technicians and the use of technology. Rather than keeping the 2015 Initiative alive as a separate project, he said, it made more sense to fold it into PPMI.
PPMI is sponsored by ASHP and the ASHP Research and Education Foundation, aided by more than a dozen health care industry supporters.
Measuring impact. One of the shortcomings of the 2015 Initiative was uncertainty about its uptake by health-system pharmacies.
"We know that many hospitals have used it, but we weren't in a position to know how many had used it," Scheckelhoff said. "We will be in a much better position to know that with the PPMI. The way this is structured it will enable us . . . to measure progress
over time and do it in a very quantifiable fashion."
One way to evaluate progress is through the PPMI hospital self-assessment tool, which allows institutions to complete an online survey and see how well they conform with the project's goals.
"You can complete the survey in a relatively short period of time, probably 20 or 25 minutes. It's very intuitive, and pharmacies can fill it out as many times as they want," Scheckelhoff said. "It's a great way to get started and become familiar with the essence of the PPMI [summit's] recommendations."
At the end of the 106-question self-assessment, users can create an action list for their hospital and compare their results against aggregate data from other hospitals that have completed the
Scheckelhoff said the action list and comparisons give pharmacy directors a way to show hospital administrators where resources and changes are needed to improve pharmaceutical care for patients.
"The tool itself also has a number of other resources—articles, websites, documents, case studies of other hospitals that have implemented specific services and many times have either shown improvement in outcomes or reduced costs—that can help make the case for implementing similar services at their hospital," Scheckelhoff said.
About 300 hospitals had completed the survey by the beginning of December, Scheckelhoff said.
Another new tool is the PPMI National Dashboard, a broad national indicator of hospitals' attainment of PPMI's five overarching goals. Updated annually and presented for the first time at ASHP's 2011 Midyear meeting, the dashboard is created using data from ASHP's annual national survey of pharmacy practice in hospital settings.
The dashboard revealed a national conformity level of around 20% to goals related to pharmacy technicians' roles and the training and credentialing of pharmacy technicians and pharmacists. Hospitals' use of automation and technology scored nearly 45%; leadership and accountability scored about 55%; and pharmacists' roles, activities, and practices related to medication use approached 60%.
Scheckelhoff said that like the 2015 Initiative, PPMI is meant to be a tool for state pharmacy societies, and not just individual hospitals, to drive practice change.
He said ASHP state affiliate societies in Michigan, Wisconsin, and Utah are actively promoting the self-assessment tool to hospitals in their states.
"They've used their own state-specific data to develop plans, education, and other actions that they might take as a state-based organization to improve practice in their locale," Scheckelhoff said.
Other state pharmacy societies have told ASHP that they plan to similarly promote PPMI in their states this year, he said.
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