Promoting integration of pharmacy expertise in care of hospitalized patients with acute myocardial infarction.

Purpose. The substantive integration of pharmacists into quality-improvement initiatives aimed at improving the care of hospitalized patients with acute myocardial infarction (AMI) is described. Methods. A 2-year, mixed-methods, interventional study was conducted in 10 U.S. hospitals, directed at pr...

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Publicado en:American Journal of Health-System Pharmacy Vol. 75; no. 13; pp. 962 - 973
Autores principales: Curry, Leslie A., Brault, Marie A., Cherlin, Emily, Smith, Marie
Formato: research tables/charts Journal Article
Publicado: Oxford University Press / USA 7/1/2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 7/1/2018
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      pub: Oxford University Press / USA
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        atl: Promoting integration of pharmacy expertise in care of hospitalized patients with acute myocardial infarction.
      aug:
        au:
          Curry, Leslie A.
          Brault, Marie A.
          Cherlin, Emily
          Smith, Marie
        affil: Department of Health Policy and Management, Yale School of Public Health, New Haven, CTYale Global Health Leadership Institute, Yale University, New Haven, CT
      sug:
        subj:
          Myocardial Infarction Drug Therapy
          Quality of Health Care
          Quality Improvement
          Pharmacists
          Human
          Male
          Female
          Medical Practice, Evidence-Based
          Organizational Culture
          Organizational Change
          Patient Education
          Information Technology
          Treatment Outcomes
          Professional Role
          Thematic Analysis
          Health Care Delivery, Integrated
          Male
          Female
      ab: Purpose. The substantive integration of pharmacists into quality-improvement initiatives aimed at improving the care of hospitalized patients with acute myocardial infarction (AMI) is described. Methods. A 2-year, mixed-methods, interventional study was conducted in 10 U.S. hospitals, directed at promoting the use of evidence-based strategies and fostering domains of hospital organizational culture associated with lower risk-standardized mortality rates (RSMRs) for patients with AMI. The adoption of 5 evidence-based strategies associated with reducing RSMRs for AMI was measured at baseline, 12, and 24 months. Data were collected via face-to-face interviews conducted at each hospital. Ethnographic observations were conducted at baseline and 18 months. Results. Significant changes in the use of evidence-based strategies were observed over the 2-year study period (p = 0.02), with the mean number of strategies used per hospital increasing from 2.4 at baseline to 3.9 at 24 months. Innovative approaches for integrating pharmacotherapy and pharmacy practice expertise included information technology solutions, targeted rounding for patients with AMI, medication-bridging programs, and education of patients with AMI. Conclusion. A mixed-methods interventional study in 10 hospitals examined the substantive integration of pharmacists into quality-improvement initiatives aimed at improving the care of patients with AMI. The investigation revealed the ability of this integration to meet clinical challenges by generating novel, feasible solutions that were tailored for specific hospital contexts. Inclusion of pharmacists strengthened relationships across disciplines and allowed pharmacists to become routinely embedded in broader quality efforts.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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