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Beta-blocker PDSA by xiaoyounan


									                                                                                                                           Beta-blocker Core Measure PDSA 05/31/12
                                                                                                             Kathy Nowicki, PharmD, PGY1 Pharmacy Practice Resident
Pharmacy student will identify and document all pre-op patients seen in pre-op clinic that take beta-blocker at home in a critical MR.INTAKE
note. This will allow clinical pharmacists to follow-up post-op to ensure the beta-blocker is resumed and thus meet SCIP core measures.
Describe your first test of change                                      Person responsible           When to be done           Where to be done
Document in MR.INTAKE note the name, dose and frequency of              PharmD Student               05/17/12                  Pre-op Clinic
List the tasks needed to set up this test of change                     Person responsible           When to be done           Where to be done
     1. Develop “quick text key” for beta-blocker documentation         Jim Rosendale                05/11/12                  Pharmacy
        Patient on ___________ (Enter BB name and sig), please follow-
        up BB is resumed post-op.
    2. Instruct PharmD student on use of “quick text key”                Kathy Nowicki               05/14/12                   Pharmacy
    3. Document MR.INTAKE note                                           Craig Bower, PharmD         05/17/12                   Pre-op Clinic
Predict what will happen when the test is carried out                    Measures to determine if prediction succeeds
Beta-blockers will be resumed post-op and SCIP Core measure fall-        Verifying MR.INTAKE note falls on the critical workload report and
outs will be avoided                                                     pharmacist documents beta-blocker administered POD1 and POD2
Describe what actually happened when the test is carried out
PharmD student completed medication reconciliation for patients seen in pre-op clinic. For those patients on beta-blockers, he documented in
MR.INTAKE note under patient’s SDC account with the location of OPRA this ensured that the MR.INTAKE would fall on the critical workload
report the day of surgery.
Describe the measured results and how they compared to the predictions
Clinical pharmacists then followed up to ensure the beta blocker was restarted after surgery. Clinical pharmacists documented in the
MR.INTAKE note the times the beta blocker was documented given. For the most part, MR.INTAKE notes were well received. However, it was
suggested that if no information was documented in the MR.INTAKE note, then it be changed to a non-critical status so that it did not fall on the
critical work-load report.
Describe what modifications to the plan will be made for the next cycle from what you learned
     1. Train all students to change the status of MR.INTAKE notes based on information in note
     2. Keep only MR.INTAKE notes with documentation critical
     3. Develop additional “quick text keys” to allow for other forms of documentation

                                                                                                                                           Institute for Healthcare Improvement

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