Offer Med Pass Project Michael D. Crowley, MD, FAAFP,CMD Joan Gannon, RN, CDONA

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Offered Med Pass Project Michael D. Crowley, MD, FAAFP,CMD Joan Gannon, RN, CDONA/LTC Stacey Radcliffe, MGS, NHA The Pines Center Genesis Healthcare Corporation Long Term Care Medicine – 2011  March 24-27, 2011  Tampa, Florida

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Unchain Your Nursing Staff!!

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Learning Objectives: Describe the estimation of a BID Med Pass System Explain how the clinical group can fulfill this activity List ways this procedure can Increase consistence with administrative codes Enhance staff execution Positively influence each day routine for staff Increase staff and occupant fulfillment

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BID Med Pass – Project Definition A BID Med Pass Schedule is created to solidify solution organization times for long haul mind patients, where clinically suitable, to minimize superfluous meds and the quantities of medicines which require organization outside this calendar.

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Quality Improvement/Quality of Life Project what number times do we approach an inhabitant for pharmaceutical organization? A case: Colace 2x/day: 9am & 5pm Seroquel at sleep time: 9pm Nifedipine qd: 9am Alphagan tid: 6am-2pm-10pm Natural Tears qid: 6am-12pm-6pm-12am 6am-9am-12pm-2pm-5pm-6pm-9pm-10pm 8 times/day

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Quality Improvement/Quality of Life Project Decrease every day intrusions for the occupants Improve rest Fewer treatment or exercises interferences Reduce "stick around" time for med organization Increase nursing time spent for non-drug related care and time went through with inhabitants supervision and support of staff Reduce pointless meds/ADR potential Increase Resident and Family Satisfaction

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BID Med Pass – How could we have been able to we isn't that right? Making progress requires Team exertion Administrator Director of Nursing/Assistant Director of Nursing Medical Director, Nurse Practitioner, Attending Physicians Consultant Pharmacist Nursing Staff and Certified Medication Aides Regional Clinical Services Manager Measured approach – one unit at once Communication with all partners

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BID Med Pass – How could we have been able to we isn't that right? Audit every patient's Medication Record for Rescheduling meds as indicated by new med pass times Duplicate medication treatment, incapable medications Safe changes of TID and QID requests to long acting BID dose frames, if accessible Reschedule BID, TID and QID requests to augment cover Close survey of medication regimens to dispense with superfluous medications/measurement, guarantee steady dosage diminishments Optimize occupant particular needs, eg. timing of tube sustaining Close and consistent cooperation with doctors Pre-change Discussion; Chart Documentation Follow up with impact of progress (+ and - )

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BID Med Pass: Our Example what number times do we approach an inhabitant with drug organization post BID Med Pass? Seroquel at sleep time: 9pm Nifedipine qd: 9am Change BID Colace to Senna in addition to at sleep time: 9pm Change Alphagan tid times: 9am-2pm-9pm Decrease Natural Tears to tid: 9am-2pm-9pm (dispense with 12pm dosage) 9am - 2pm - 9pm Reduced from 8 to 3 times each day

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Results of Our Efforts Three LTC Units – 115 Residents 101 Medication Regimens Converted or Consolidated to a BID Schedule 88% Conversion Rate Remember - All solutions may not "fit"

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Results of Our Efforts – Rx #s

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Results of Our Efforts – Staff Time

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BID Med Pass Benefits Regulatory Compliance – Recent Survey Results Quality of Patient Care Services – Improved Customer Satisfaction by 8% Positive Resident Council Reports Care Giver Model Initiated with Additional Staff Hours Enhanced Dining Program Improved Staff Satisfaction by 12% SUCCESS!

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BID Med Pass – Not a Financial Improvement Project BUT Project Implemented April - June 2010 Avg Medication Cost Per Pt Per Month 6 Mon Avg Ending June 2010 = $419/Pt/Mon 6 Mon Avg Ending Dec 2010 = $308/Pt/Mon ↓ $110 Avg Medications Cost per tolerant every month * Order information incorporates all payors (medicaid, medicare, protection, pvt pay)

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A grin says it all!

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