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Showing items related by title, author, creator and subject.
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An Evaluation of Student Pharmacist Admission Medication Histories at a Level 1 Trauma, Academic Medical Center: A Descriptive StudyObjectives: The purpose of this study is to demonstrate the effect of using advanced pharmacy practice experience (APPE) students in the collection of admission medication history at an academic teaching hospital prior to pharmacist review. Methods: The study is a retrospective, descriptive study. Using electronic medical records, the study looked at patients admitted to specific floors during a two-month period. The primary outcome was number of discrepancies found by the APPE students. The secondary outcome was the type of discrepancy found (omission, duplication, wrong dose, wrong frequency, wrong dosage form, and medications the subject no longer takes). Results: Over eight weeks, the APPE students identified 2,666 discrepancies, which equates to approximately 4.71 ± 4.76 discrepancies per patient. The majority of these discrepancies were identified as omissions of therapy (39.1%), followed by medications the patients were no longer taking (29.8%), and wrong dosing frequencies (18.1%). Conclusions: APPE students assisted the medication reconciliation process by identifying numerous medication discrepancies which may have prevented patient harm. APPE students are an underutilized resource and prove to be an asset to the healthcare team.
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Medication Therapy Management: Methods to Increase Comprehensive Medication Review ParticipationSpecific Aims: To compare the Comprehensive Medication Review (CMR) rate for Workflow Model #1 (used in 2010) to the CMR rate for Workflow Model #2 (used in 2011) at the Medication Management Center (MMC). Methods: A retrospective database analysis was completed in which Comprehensive Medication Review (CMR) completion rates for 2010 and 2011 were assessed. Comparison included only Center for Medicare and Medicaid Services (CMS) contracts that the Medication Management Center (MMC) provided Medication Therapy Management (MTM) services for both in 2010 and 2011. Data was used to determine the effect a process change had on CMR participation rate at the MMC and best practices for improving the rate of Medication Therapy Management Program (MTMP) beneficiaries participating in a CMR. Main Results: In 2010, patient participation and response to a CMR offer letter was low (0.2%). The changes in process yielded an increase in the CMR completion rate (6.93%); this in turn yielded higher performance measurements for prescription drug plans. Conclusion: Workflow modifications, including a pro-active secondary CMR offer, led to a marked increase in member participation and CMR rates. Patients are more apt to consent to a CMR if they are called for a specific medication related problem. It is recommended to continue to convert TMR calls to CMRs whenever possible, monitor CMR rates at least quarterly, and make cold calls where needed to increase CMR percentages.
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The Cinderella Syndrome: A Case Study of Medical School Admission DecisionsMaking decisions about whom to admit to medical school and how to create diversity in the process has come under increased scrutiny. An additional layer of complexity is introduced when committees utilize the AAMC's prescribed holistic review in addition to their institutional diversity policies. This comparative case study explores how two medical schools (one public and one private) are charged with implementing holistic review when challenged by the institutional culture which may resist a holistic approach. Through interviews, meeting observations, and document analysis, the study examines how and when diversity is introduced into the admissions process, and how diversity policies function in the overall medical school environment. Applying a framework of institutional isomorphism (DiMaggio & Powell, 1983), the study found that medical schools are highly concerned about a decrease in MCAT scores and coursework grades, which could negatively impact medical school rankings. It could also contribute to institutional inertia when introducing a new review process, causing resistance by admissions committee members. Additionally, admissions committees and leadership may differ regarding philosophical and historical factors that create bias within the process resulting in isomorphic change. Isomorphic change is a result of the ambiguity and the lack of institutional buy-in on various levels (DiMaggio & Powell, 1983). Virtual adoption (Birnbaum, 2000) is a result of an increased focus emulating processes of peer medical schools that misalign the school's priorities, creating confusion about how to address the national shortage of diverse physicians. Future research needs to account for additional influences on admissions decisions, including the impact of the current Fisher v. University of Texas case that may redefine how diversity is measured in medical school admissions.
