Involving R.Ph.s helped these hospitals nab Premier award

September 17, 2007

Pharmacist participation in performance improvement was indispensable to recipients of the recent Premier Inc. 2007 Awards for Quality.

Premier Awards for Quality are given in six clinical areas: acute myocardial infarction (AMI), coronary artery bypass graft, heart failure, hip and/or knee replacement, maternal and neonatal care, and pneumonia. "In each of these areas there was plenty of opportunity for pharmacist involvement," said Pope. Quality and cost data were submitted to Premier by about 400 member hospitals that regularly submit to the Premier Perspective database for performance benchmarking. Award criteria included clinical quality outcomes, clinical process indicators, and resource utilization outcomes.

Total performance

"What distinguishes these awards is that we focus on hospitals for not only their clinical quality measures but also their demonstrated ability to provide cost-effective clinical care through efficient use of resources," said Dan Peterson, M.D., Premier VP and medical director.

What distinguished one award winner was a strong collaborative effort that heavily involved pharmacists, said Steve Petersen, Pharm.D., director of pharmacy at Avera McKennan Hospital & University Health Center, a five-state regional health system based in Sioux Falls, S.D. Avera won awards for AMI, heart failure, pneumonia, and hip-and knee-replacement procedures-the most for anyhealth system. "Our department has long taken ownership and accountability for quality measures," he said. "We work within teams to facilitate multidisciplinary approaches, and we're willing to spend a great deal of time on this."

"They have great credibility because of their ongoing commitment to quality measurement and promotion," said Glenda VanRoekel, R.N., Avera's national quality initiative specialist. "They've shown they are always willing do what it takes, and so their input is always respected."

Hips and knees

That commitment paid off with the hip-and knee-replacement antibiotics protocols.

The federal Surgical Care Improvement Project's (SCIP) surgical site infection (SSI) guidelines call for the administration of prophylactic antibiotics within one hour prior to surgery and discontinuing prophylactic antibiotics within 24 hours after surgery. Avera's surgery department, with the assistance of clinical pharmacists, closely followed those guidelines, using tools such as operating-room checklists.

Pharmacists were also heavily involved in the award received by Meadville Medical Center, Meadville, Pa., a 220-bed facility that won the quality award in hip and knee replacement. The award resulted not only from strict adherence to the SCIP guidelines but also because the hospital was proactive in deep vein thrombosis (DVT) analysis, improving the recognition and prevention of DVT that can follow hip and knee replacement.

A commitment to quality by pharmacy departments epitomizes the standards inherent in the Premier Awards for Quality, said Pope. "More and more we are seeing clinical pharmacists being given the respect they deserve in the development of quality measures," he said. "We have further to go, but this is improving all the time. These awards are a good example."

THE AUTHOR is a writer based in Gettysburg, Pa.