The Fifth Vital Sign: Cornerstone of a New Pain Management Strategy

Pain has recently become the focus of attention as a major health problem in the US. The implementation of a pain management strategy in a rural not-for-profit federal hospital is described in this article. The strategy heightened awareness and changed the practice behaviors of clinicians in recognizing, assessing, treating and following patients with pain. Quality improvement initiatives monitored the performance of the healthcare staff regarding use of the assessment and documentation tools. Reduction of pain was surveyed in both transitional care patients and outpatients. Outpatients were also interviewed for satisfaction with their pain management plan. The efforts are ongoing as healthcare professionals continue to focus on reducing pain and suffering in their patients. Additional work is directed toward meeting both the objectives in the strategic plan and standards set by the health systems organization accrediting body described for pain management.Disease management programmes, Pain

INSTRUCTIONAL DESIGN AND ASSESSMENT A Required Course in the Development, Implementation, and Evaluation of Clinical Pharmacy Services

Objective. To develop, implement, and assess a required pharmacy practice course to prepare pharmacy students to develop, implement, and evaluate clinical pharmacy services using a business plan model. Design. Course content centered around the process of business planning and pharmacoeconomic evaluations. Selected business planning topics included literature evaluation, mission statement development, market evaluation, policy and procedure development, and marketing strategy. Selected pharmacoeconomic topics included cost-minimization analysis, cost-benefit analysis, cost-effectiveness analysis, cost-utility analysis, and health-related quality of life (HRQoL). Assessment methods included objective examinations, student participation, performance on a group project, and peer evaluation. Assessment. One hundred fifty-three students were enrolled in the course. The mean scores on the objective examinations (100 points per examination) ranged from 82 to 85 points, with 25%-35% of students in the class scoring over 90, and 40%-50% of students scoring from 80 to 89. The mean scores on the group project (200 points) and classroom participation (50 points) were 183.5 and 46.1, respectively. The mean score on the peer evaluation was 30.8, with scores ranging from 27.5 to 31.7. Conclusion. The course provided pharmacy students with the framework necessary to develop and implement evidence-based disease management programs and to assure efficient, cost-effective utilization of pertinent resources in the provision of patient care

Collaborating with Pharmacists to Strengthen Primary Care Infrastructure and Student/Resident Training

According to predictions, the ratio of primary care practitioners (primary care physicians, nurse practitioners, and physician’s assistants) to the population is expected to fall nine percent between 2005 and 2020. As a country, we spend almost as much money on problems caused by medications as we do on the medications themselves. Team-based care has been proposed as the most viable solution to save our primary healthcare system, and thus should also be emphasized in the way medical professionals are trained at all levels. In 2011, the Pennsylvania Pharmacists Association’s (PPA) commissioned a white paper to provide information, answer questions, and raise awareness to the roles of pharmacists in the Patient-Centered Medical Home (PCMH) model of healthcare. Features of PCMHs include: enhanced access to and continuity of care, population management, planned and managed care, self-care and community support, tracking and coordinating care, and measuring and improving performance outcomes. Considering the extent to which pharmacists are trained and many are credentialed, by working at the “top of their license”, pharmacists are competent to perform PCMH duties that involve medication management with physician supervision. Using concepts/components from the PCMH model as a springboard, this session will focus on describing existing collaborative efforts between pharmacists, physicians, and other healthcare professionals that 1) provide medication management infrastructure in primary care settings and 2) provide support for educating students and residents at all levels of training. Learning Objectives: At the end of the session, participants will: 1. Identify three areas in which pharmacists can provide infrastructure for medication management in a primary care setting 2. Identify strategies for incorporating pharmacists into student and resident education in academic and clinical settings