AP harmacist Quality Improvement Project: Modifying the Institute

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					Pharmacist Quality Improvement
 Project (PQIP): Modifying the
    Institute for Healthcare
  Improvement Breakthrough
    Series (IHI BTS) Model
   This presentation will cover:
     Lessons Learned

     Project Overview

     Results

     Unanswered questions
PQIP: Lessons Learned
   Essential elements
      Face-to-face meetings

      A team, rather than one person, involved from
       each participating organization
      Clinical champion

      Organizational leadership support

      Data sources

      Accountability; senior leader reports
PQIP: Lessons Learned
   ICIC* Essential Elements
      Leadership support

      Measurement system

      Pool of disease and QI expertise

      Opportunity to collaborate with peers

    *ICIC (Improving Chronic Illness Care)
PQIP: Lessons Learned
   Essential tools
     AMI change concepts

     Model for Improvement

     Group Learning Model
PQIP: Lessons Learned
   ICIC Essential Tools
      Condition-specific change concepts

      System change concepts

      Improvement Strategy

      Learning Model
PQIP: Project Overview
   Project Overview
      13 month modified IHI BTS

      Focus on pharmacist led QI in AMI care

      Participants selected area(s) for focus

       from the CMS AMI indicator list
      Thirteen teams plus two observers
PQIP: Project Overview
   Modified Collaborative design
     Only an initial face-to-face meeting

        Baseline data

        Clinical evidence

        Model for Improvement

        Working time

     Email list

     Monthly teleconferences
PQIP: Project Overview
  No monthly reports required
  Measurement expected
PQIP: Project Overview
   In process modifications of the modified
      Added face-to-face meeting time

      Added seminar at the state pharmacy

       association annual continuing education
PQIP: Results
 Nine of the thirteen teams actively
  participated (level of activity variable)
 Measurement/data collection done by most
 The most common process change was
  preprinted orders implementation
PQIP: Results
 Few teams participated regularly in the
  monthly teleconferences
 Few participants utilized the e-mail list
 Essentially no interest in the AMI smoking
  cessation indicator
   Unanswered questions
     Pharmacists not familiar or comfortable in role
      as QI leaders? Lack of knowledge?
     Lack of more face-to-face meetings a primary
     Only pharmacists present at initial meeting a
      primary barrier?
     What really are the essential elements of an IHI
      BTS or IHI BTS-like Collaborative?

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