How R.Ph.s helped three hospitals win quality and safety awards

Strong collaboration between pharmacists and physicians set the stage for the University of Michigan Health System (UMHS) to win a prestigious safety and quality award, according to its chief of staff. "I must say that our head of pharmacy and his staff have been integral in developing the processes that led to this," said Darrell A. Campbell, Jr., M.D. "We have been way ahead of the curve on the issue of medical and pharmacy integration. I am very proud of that."

Pharmacist involvement

Campbell's award was in the individual achievement category, given in part for establishing hospitalwide rapid response teams and regular patient safety rounds, both of which, he said, heavily involve his pharmacy department. The award was also in recognition of his role in the expansion of the National Surgical Quality Improvement Program (NSQIP) from Veterans Affairs to the private sector.

"I found early recognition from the administration, and then the medical staff, that we have indispensable knowledge on drugs and drug interactions," said James Stevenson, Pharm.D., R.Ph., director of pharmacy services at UMHS and associate dean of the university's school of pharmacy. "From the beginning of my tenure here eight years ago, this administration has been willing to provide the financial resources necessary to involve clinical pharmacists in all areas of care. The result today is a team examination of whether systems we have are effective."

It is the steadfastness of Stevenson's 100 pharmacists in accepting workload responsibility-and responsibility for patient safety-that "makes their integration with the medical staff so effective," Campbell said. "There is systemwide recognition of their commitment to developing carefully designed [drug] entry protocols. Trust in their professionalism translated into a higher degree of trust in the CPOE [computerized physician order entry] system."

Teamwork

Like Campbell, UTHSC's Thomas stressed the importance of teamwork in reducing adverse events related to medical and medication errors. "When joint teams of nurses and pharmacists, led by physicians, address cause, the result is comprehensive." He pointed to errors that occur because of look-alike, sound-alike (LASA) drugs. "It is impossible to effectively develop the communication necessary to reduce LASA events within a rigid hierarchy," said Thomas. "A team approach, integration of R.Ph.s into the creation of techniques, and implementing a frontline strategy with blame-free error reporting are indispensable."