Emergency Medicine Petition BPS 2019
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FOCUSED PRACTICE in HOSPITAL MEDICINE Maintenance of Certification (MOC) Examination Blueprint
® FOCUSED PRACTICE IN HOSPITAL MEDICINE Maintenance of Certification (MOC) Examination Blueprint ABIM invites diplomates to help develop the Purpose of the Hospital Medicine MOC exam Hospital Medicine MOC exam blueprint The MOC exam is designed to evaluate the knowledge, Based on feedback from physicians that MOC assessments diagnostic reasoning, and clinical judgment skills expected of should better reflect what they see in practice, in 2016 the the certified hospitalist in the broad domain of the discipline. American Board of Internal Medicine (ABIM) invited all certified The exam emphasizes diagnosis and management of prevalent hospitalists and those enrolled in the focused practice program conditions, particularly in areas where practice has changed to provide ratings of the relative frequency and importance of in recent years. As a result of the blueprint review by ABIM blueprint topics in practice. diplomates, the MOC exam places less emphasis on rare This review process, which resulted in a new MOC exam conditions and focuses more on situations in which physician blueprint, will be used on an ongoing basis to inform and intervention can have important consequences for patients. update all MOC assessments created by ABIM. No matter For conditions that are usually managed by other specialists, what form ABIM’s assessments ultimately take, they will need the focus is on recognition rather than on management. The to be informed by front-line clinicians sharing their perspective exam is developed jointly by the ABIM and the American on what is important to know. Board of Family Medicine. A sample of over 100 hospitalists, similar to the total invited Exam format population of hospitalists in age, gender, geographic region, and time spent in direct patient care, provided the blueprint The traditional 10-year MOC exam is composed of 220 single- topic ratings. -
Learn. Connect. Discover. Join
LEARN. CONNECT. DISCOVER. JOIN. The Society of Hospital Medicine serves as the premier organization for a “big tent” of hospital medicine professionals, including physicians, nurse practitioners, physician assistants, medical students, residents, practice administrators and more. SHM membership connects you with resources, opportunities and people to support your role in hospital medicine. Access free or discounted Network with colleagues Stay up to date with subscriptions on-demand CME through at national conferences to SHM’s publications, The SHM’s Learning Portal and and local chapter meetings. Hospitalist and the Journal of the SHM Education app. Hospital Medicine. Join a special interest group Distinguish yourself by Access SHM solutions to to connect and collaborate with earning a Fellow in Hospital address your QI-related challenges. peers on SHM’s members-only Medicine designation. online community. Membership saves you money on professional and educational resources, conferences and more. Learn more about a membership or join today. hospitalmedicine.org/join Membership Application Join for 1, 2 or 3 years at the current rate. Rates valid through September 30, 2020. Physician $445.00/year Allied Health Professional (PharmD, RN, etc.) $215.00/year Affiliate $425.00/year Resident/Fellow $95.00/year Practice Administrator $215.00/year International Hospitalist $115.00/year Nurse Practitioner/Physician Assistant $215.00/year Student FREE Referred by (if applicable) First Name Last Name Credentials (i.e. MD, NP) Title Specialty Hospital/Institution (if applicable) Residency Program Name * Medical School Name* Graduation/Anticipated Graduation Date* First Year Working in a Hospital Medicine Setting or Anticipated Date. Date of Birth Mailing Address Work Home City State/Province Zip Phone Is this a mobile number? Yes No Email (required) Please check below to indicate preferred contact method. -
History of the Development of Geriatric Medicine in the UK a Barton, G Mulley
229 HISTORY OF MEDICINE Postgrad Med J: first published as 10.1136/pmj.79.930.229 on 1 April 2003. Downloaded from History of the development of geriatric medicine in the UK A Barton, G Mulley ............................................................................................................................. Postgrad Med J 2003;79:229–234 In this review the development of the specialty of built in Victorian times under the 1834 New Poor geriatric medicine in the UK is traced from its humble Law, to curtail public spending on poverty.2 Until 1834 individual parishes were responsible for beginnings. Elderly medicine is now thriving and their own poor. Parishes were united after 1834 represents the largest group of physician members of and larger workhouses were known as unions; the Royal Colleges of Physicians. Geriatric medicine is there were about 700 such institutions. The editor of the Lancet campaigned for improvements essentially about optimising the care and wellbeing of within poorhouses. (A previous editor had fa- older people. A key component of this is teamwork. A mously described the workhouse wards as “ante successful service for old people depends on the skills of chambers of the grave”.2) Joseph Rogers, a reformer of workhouses throughout his career as many people, including nurses, therapists, social a doctor, gave advice on the conditions in workers, and others. The contributions made by nurses Victorian workhouses.3 “Workhouse medicine” and other professionals have been immense, but space failed its occupants, there was no casualty provi- sion, no trained nursing staff, no drugs, and no does not permit a historical review of their important surgical facilities.3 Conditions gradually improved role. -
In. ^Ifil Fiegree in PNILOSOPNY
ISLAMIC PHILOSOPHY OF SCIENCE: A CRITICAL STUDY O F HOSSAIN NASR Dis««rtation Submitted TO THE Aiigarh Muslim University, Aligarh for the a^ar d of in. ^Ifil fiegree IN PNILOSOPNY BY SHBIKH ARJBD Abl Under the Kind Supervision of PROF. S. WAHEED AKHTAR Cbiimwa, D«ptt. ol PhiloMphy. DEPARTMENT OF PHILOSOPHY ALIGARH IWIUSLIIM UNIVERSITY ALIGARH 1993 nmiH DS2464 gg®g@eg^^@@@g@@€'@@@@gl| " 0 3 9 H ^ ? S f I O ( D .'^ ••• ¥4 H ,. f f 3« K &^: 3 * 9 m H m «< K t c * - ft .1 D i f m e Q > i j 8"' r E > H I > 5 C I- 115m Vi\ ?- 2 S? 1 i' C £ O H Tl < ACKNOWLEDGEMENT In the name of Allah« the Merciful and the Compassionate. It gives me great pleasure to thanks my kind hearted supervisor Prof. S. Waheed Akhtar, Chairman, Department of Philosophy, who guided me to complete this work. In spite of his multifarious intellectual activities, he gave me valuable time and encouraged me from time to time for this work. Not only he is a philosopher but also a man of literature and sugge'sted me such kind of topic. Without his careful guidance this work could not be completed in proper time. I am indebted to my parents, SK Samser All and Mrs. AJema Khatun and also thankful to my uncle Dr. Sheikh Amjad Ali for encouraging me in research. I am also thankful to my teachers in the department of Philosophy, Dr. M. Rafique, Dr. Tasaduque Hussain, Mr. Naushad, Mr. Muquim and Dr. Sayed. -
Multi-Center Medication Reconciliation Quality Improvement Study)…………………………………… 4 B
MARQUIS IMPLEMENTATION MANUAL A Guide for Medication Reconciliation Quality Improvement ADDENDUM ADDED AUGUST 2017 INCLUDES: * NEW COMMUNITY ENGAGEMENT GUIDELINES * UPDATED SOCIAL MARKETING MATERIALS * NEW DISCHARGE MED REC COUNSELING MATERIALS Prepared by MARQUIS Investigators October 2014 Funded by AHRQ grant 5 R18 HS019598 Copyright ©2014 by Society of Hospital Medicine. All rights reserved. No part of this publication may be reproduced, stored in retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written consent. For more information or to obtain additional copies contact SHM at: Phone: 800-843-3360 Email: [email protected] Website: www.hospitalmedicine.org/MARQUIS MARQUIS Implementation Manual A Guide for Medication Reconciliation Quality Improvement Prepared by MARQUIS Investigators October 2014 Funded by AHRQ grant 5 R18 HS019598 For more information about MARQUIS, visit www.hospitalmedicine.org/MARQUIS. Table of Contents Introduction Contributors Acknowledgments Section A: Setting the MARQUIS Team Up for Success I. First Steps ………………………………………………………………………………………………………………………………… 4 A. Overview of MARQUIS (Multi-Center Medication Reconciliation Quality Improvement Study) ………………………………… 4 B. Pre-Implementation Actions ………………………………………………………………………………………………………… 4 C. Clarifying Key Stakeholders ………………………………………………………………………………………………………… 5 D. Assigning Roles and Responsibilities to Clinical Personnel ……………………………………………………………………… 6 E. Obtaining -
Update on Hospital Medicine ACP TN Scientific Meeting 2019
Update on Hospital Medicine ACP TN Scientific Meeting 2019 Chase J. Webber, DO Assistant Professor Clinical Medicine Vanderbilt University Medical Center Section of Hospital Medicine @chasejwebber COI • I have no actual or potential conflict of interest in relation to this presentation. Thinking about Hospital Medicine Thinking about Hospital Medicine Where we are, where we’re going, we’re we’ve been Courtesy: Tennessee State Library and Archives 1994 “Before the Titans, TV shows and pedal taverns” 2019 N Engl J Med 2016; 375:1009-1011 Growth in the Number of Hospitalists in the United States, 2003–2016. N Engl J Med 2016; 375:1009-1011 Old standards. New hits… Timeless Pearls! 1 Best Practices in Medication Reconciliation 2 Antibiotic Stewardship 2018- 2019 3 Delirium management Updates 4 Discharge AMA 5 Discharge Pearls*** Best Practices – Medication Reconciliation CHAOS MEDICATION TRANSITION ADEs Random Common Systematic?? Gold chaos sense Med Rec Standard Med Rec Clinical question – Which Med Rec intervention is most effective at reducing inpatient medication discrepancies? Study design – Mentored, Quality Improvement study Setting – 791 patients in 5 hospitals over 25 months J Hosp Medicine, epub: 8/21/19 DOI 10.12788/jhm.3308 Interventions and Results J Hosp Medicine, epub: 8/21/19 DOI 10.12788/jhm.3308 What stands out? ?Potential for ADEs ?Omitted medications Sources: need at least 2 ?Handwritten vs. EMR Interdisciplinary input Diverse mix -carried over -OTC -vitamins -supplements -nonhelpful or harmful • QR code to access Marquis/SHM resources portal Timeless Pearls • Seek to obtain a Best Possible Medication History (BPMH) on admission. • Specially trained Pharmacy staff and support: essential. -
Intensive Care Units (ICU): the Clinical Pharmacist Role to Improve Clinical Outcomes and Reduce Mortality Rate- an Undeniable Function
Open Access Journal of Clinical Intensive Care and Medicine Review Article Intensive Care Units (ICU): The clinical pharmacist role to improve clinical ISSN 2639-6653 outcomes and reduce mortality rate- An undeniable function Luisetto M1* and Ghulam Rasool Mashori2 1Applied Pharmacologist, Hospital Pharmacist Manager 29121, Italy 2Professor & Director, Peoples University of Medcial & Health Sciences for Woman, Nawabshah, Pakistan *Address for Correspondence: Luisetto M, Applied Abstract Pharmacologist, Hospital Pharmacist Manager 29121, Italy, Email: [email protected] Observing relevant biomedical literature we have see that clinical pharmacist play a crucial role in ICU Submitted: 09 October 2017 settings with reducing in mortality rate and improving some clinical outcomes. Approved: 01 November 2017 Published: 02 November 2017 Copyright: 2017 Luisetto M, et al. This is Introduction an open access article distributed under the Creative Commons Attribution License, which In ICU settings we can easily observe that the mortality rate is higher then other permits unrestricted use, distribution, and wards and for this reason a real multisiciplinatity medical team with added clinical ph. reproduction in any medium, provided the Competences can improve this situation. High intensity of cure, polipharmacy, critical original work is properly cited. patient conditions need also a pharmaceutical competencies to be added to the classic Keywords: ICU; Clinical pharmacy; Pharmaceutical decision making systems (clinical- managerial). The critically hill patients need a more care; Clinical outcomes; Mortality rate rational decision making systems to improve the clinical outcomes and in safety way. Material and Methods In this review and research paper we have searched some relevant biomedical literature in order to evaluate the real eficacy of clinical pharmacist in improving clinical outcomes and reducing mortality rate. -
Introduction to Hospital and Health-System Pharmacy Practice 59 Tients with a Specific Disease State Or for Activities Related to Self Governance Diagnosis
Part II: Managing Medication Use CHAPTER 4 Medication Management Kathy A. Chase ■■ ■■■ Key Terms and Definitions Learning Objectives ■■ Closed formulary: A list of medica- After completing this chapter, readers tions (formulary) which limits access should be able to: of a practitioner to some medications. 1. Describe the purpose of a formulary A closed formulary may limit drugs to system in managing medication use in specific physicians, patient care areas, or institutions. disease states via formulary restrictions. 2. Discuss the organization and role of the ■■ Drug formulary: A formulary is a pharmacy and therapeutics committee. continually updated list of medications 3. Explain how formulary management and related information, representing works. the clinical judgment of pharmacists, 4. List the principles of a sound formulary physicians, and other experts in the system. diagnosis and/or treatment of disease 5. Define key terms in formulary manage- and promotion of health. ment. ■■ Drug monograph: A written, unbi- ased evaluation of a specific medica- tion. This document includes the drug name, therapeutic class, pharmacology, indications for use, summary of clinical trials, pharmacokinetics/dynamics, ad- verse effects, drug interactions, dosage regimens, and cost. ■■ Drug therapy guidelines: A document describing the indications, dosage regi- mens, duration of therapy, mode(s) of administration, monitoring parameters and special considerations for use of a specific medication or medication class. ■■ Drug use evaluation (DUE): A process used to assess the appropriate- ness of drug therapy by engaging in the evaluation of data on drug use in a given health care environment against predetermined criteria and standards. ◆■ Diagnosis-related DUE: A drug use evaluation completed on pa- INTRODUCTION TO HOSPITAL AND HEALTH-SYSTEM PHARMACY PRACTICE 59 tients with a specific disease state or for activities related to self governance diagnosis. -
MARQUIS IMPLEMENTATION MANUAL Table of Contents
MARQUIS IMPLEMENTATION MANUAL Table Of Contents Introduction 3 Contributors 4 Section A: Setting the MARQUIS Team Up for Success 5 I. First Steps 5 1. Overview of MARQUIS (Multi-Center Medication Reconciliation Quality Improvement Study) 5 2. Pre-Implementation Actions 5 3. Clarifying Key Stakeholders 6 4. Obtaining Support and Approval from the Institution 7 5. Summary 8 II. Medication Reconciliation: Definition 9 III. Medication Reconciliation: Process 10 Step 1: Take a Best Possible Medication History (BPMH) to create the Preadmission Medication List (PAML). Record the PAML in the patient’s chart. 11 Step 2: Write admission medication orders. 14 Step 3: Compare the PAML with admission orders, identify and correct any unintentional discrepancies in admission orders. 14 Step 4: If applicable, write transfer medication orders, using the PAML and current inpatient (pre-transfer) medications as a guide. 15 Step 5: Compare PAML medications, pre-transfer medications and transfer medications, identify and correct any unintentional discrepancies in transfer orders. 16 Step 6: Write the Discharge Medication List (DML) using the PAML and current inpatient medications as a guide. Document the DML. 16 Step 7: Compare PAML, current inpatient medications and the DML. Identify and correct any unintentional discrepancies in the DML. 17 Step 8: Review the DML with patient. Highlight and explain stopped, changed or new medications compared with the PAML and the reasons for those changes. 18 Step 9: Forward a second copy of the DML to post-discharge providers. Explain stopped, changed or new medications compared with the PAML and reasons for those changes. 19 IV. Medication Reconciliation: Brief Literature Review 20 V. -
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Original Research PRACTICE-BASED RESEARCH Descriptive Analysis of Acceptance by Prescribers and Economic Benefit of Pharmacist Recommended Interventions in a Critical Care Unit YoonJung Lee, PharmD1, 2; Lana Gettman, PharmD2 1Texas Tech University Health Sciences Center; 2Harding University College of Pharmacy ABSTRACT Background: Pharmacist clinical intervention is defined as the action that identifies and prevents medication-related problems and optimizes patient’s medication therapy in cooperation with other healthcare professionals. Types of clinical interventions may vary, but each is patient specific. Few studies have focused on clinical pharmacists interventions in a critical care setting at a rural hospital. Objectives: The purpose of this study was to assess physician acceptance rate of pharmacist-recommended interventions in the critical care unit (CCU) at a rural hospital over five years and to evaluate the economic benefit of accepted pharmacist-recommended interventions over a one-year time period. Methods: This study was a retrospective chart review over a five-year time period. Each intervention was categorized and analyzed for acceptance or non-acceptance by the treating physician. Evaluation of economic benefit, cost saving and cost avoidance, for a one-year time period was performed. Results: A total of 1275 interventions were documented during study period. The average acceptance rate for documented interventions was 56%. The acceptance rate by physicians increased over the study period; with the acceptance rate in 2013 being statistically significantly higher than any other years. The overall cost saving for selected interventions was $432 for the one year. The overall cost avoidance of all accepted interventions for the one year was $453,339.36-$468,327.62. -
Gap Analysis Between Patients' Expectations and Services
JRFHHA Gap Analysis between Patients’ Expectations and Services Provided by Pharmacy10.5005/jp-journals-10035-1018 Store of a Tertiary Care Hospital RESEARCH ARTICLE Gap Analysis between Patients’ Expectations and Services Provided by Pharmacy Store of a Tertiary Care Hospital 1Jharna Bajpai, 2Nirmal K Gurbani ABSTRACT INTRODUCTION Pharmacy store of hospital is among one the major revenue In recent years, awareness has risen on how patients perceive generating area of hospital. Its performance can be a vital the quality of their healthcare. Consequently measuring element in the success of any upcoming hospital. Nowadays, not only the availability of prescribed drugs matters but explanation patient satisfaction has become an important tool to gain of dose, frequency and duration of drugs to be taken, behavior of attention and value among the healthcare consumers as well pharmacist and waiting time to get drugs play an important role as competitors. Measuring patient satisfaction encompasses in satisfaction of patients. The pharmacy store of the hospital evaluating patient’s perceptions and determining whether provides more specialized and more time-saving services they felt that their needs met.1 Research in the area of ‘Hospital for patients. It also eases the financial burden on pharmacy users via drug discounts. A cross-sectional comparative study Administration in India’ is still in its infant stage. To men- was conducted on 90 respondents. A self administered pre- tion a few important research works carried out in India, designed, pretested, structured questionnaire was given to a reference can be made to Sreenivas2 who examined why selected respondents on first contact to the pharmacy store the hospital administrator should take patient-satisfaction of the hospital with the aim to study the perception of patients seriously as a measurement. -
Integrating the Healthcare Enterprise Hospital Pharmacy and Community Pharmacy Use Cases and Standards White Paper Final Text Ve
Hospital Pharmacy and Community Pharmacy – Use Cases and Standards – v1.2 Integrating the Healthcare Enterprise Hospital Pharmacy and Community Pharmacy Use Cases and Standards White Paper Final Text Version 1.2 1 / 70 Copyright © 2010, IHE Europe Hospital Pharmacy and Community Pharmacy – Use Cases and Standards – v1.2 Document version Editor Remarks 1.2 N. Canu, PHAST Final Text G. Claeys, Agfa Healthcare T. de Jong, HL7 A. Estelrich, GIP/DMP I. Gibaud, SIB S. Juvin, GIP/DMP F. Macary, GMSIH V. Mary, SIB J. Nuñez Suarez, INDRA C. Rica, GIP/DMP A. Slee, NHS M. Sprenger, NICTIZ J. Surugue, EAHP S. Thun, DIMDI L. Tzimis, EAHP 2 / 70 Copyright © 2010, IHE Europe Hospital Pharmacy and Community Pharmacy – Use Cases and Standards – v1.2 Contents _____________________________________________________________________________________ 3 / 70 Copyright © 2010, IHE Europe 1 Introduction The Pharmacy domain is increasingly adopting Information & Communication Technologies to support their main activities like prescription and medication dispense. In order to guarantee interoperability among the different ICT systems in the Pharmacy domain, it is important that all stakeholders (users, vendors, payers) agree on a set of common communication standards. The purpose of this White Paper is to identify the critical interoperability needs in the Pharmacy domain, describe the corresponding interoperability Use Cases and propose a set of communication standards to implement these Use Cases. The White Paper can serve as basis for the development of one or more IHE Pharmacy Integration Profiles. The document starts with an overview of the main business processes in the pharmacy domain, describing the workflow and the information flows. These business processes are the basis for describing the various Interoperability Use Cases.