New Approach to Reducing Adverse Drug Events Anticoagulants Insulin Opioids
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1 New Approach to Reducing Adverse Drug Events Anticoagulants Insulin Opioids October 9, 2013 A partnership of the Healthcare Association of New York State and the Greater New York Hospital Association
2 NYSPFP Approach to ADEs o Align with national priorities o Support hospitals in identifying areas of vulnerability regarding adverse drug events o Focus on improving medication management and reducing adverse drug events o Work with hospitals on four new measures that will provide meaningful information in reducing ADEs o Partner with ISMP to help inform this effort 2
3 Current ADE Measures All NYSPFP hospitals are expected to continue providing ADE data through December 2013 Outcome: Number of ADEs for high alert drugs per 1,000 patient days Process: % of patients receiving medication reconciliation on admission (Note: NYSPFP also collects information on patients receiving medication reconciliation at discharge through the Readmissions Initiative) 3
4 Project Description o New ADE measurement project will be optional for remainder of calendar year 2013 (initial phase) o Stipend available to those hospitals who choose to participate in the initial phase ($2000) o NYSPFP anticipates transitioning fully to these new measures next year 4
5 Hospital s Commitment: o Demonstrate efforts to develop internal systems that capture and report on all four required measures for the project o Submit a CEO-signed form expressing hospital s commitment o Submit a three-month baseline set of data (October through December 2013) by February 15, 2014 o Continue participation in current NYSPFP ADE measurement approach, including submitting the current NYSPFP ADE measures to the data portal o Actively participate in NYSPFP ADE educational programs 5
6 Important Project Dates 6 October 16, 2013
7 Regional NYSPFP/ISMP Adverse Drug Event Educational Sessions Save the Date: o November 13 Buffalo o November 14 Rochester and Long Island o November 15 Manhattan and Syracuse o November 20 Albany o November 22 Newburgh Registration information for each session will be made available on the NYSPFP Web site. 7 October 16, 2013
8 New Required Measures - Anticoagulants Numerator: The number of inpatients prescribed warfarin with an INR greater than 5 Denominator: The number of inpatients prescribed warfarin therapy Included: Excluded: Inpatients prescribed warfarin Patients on observation status; Outpatients 8
9 New Required Measures - Insulin Numerator: Number of episodes of blood glucose results (bedside and lab testing) greater than or equal to 200 mg/dl Denominator: Number of inpatients who are prescribed insulin Included: Excluded: Inpatients prescribed one dose or more of insulin (any type/any form) during an inpatient admission; Patients on observation status; Outpatients 9
10 New Required Measures - Insulin Numerator: Denominator: Number of episodes of blood glucose results (bedside and lab testing) less than or equal to 50 mg/dl Number of inpatients who are prescribed insulin Included: Excluded: Inpatients prescribed one dose or more of insulin (any type/any form) during an inpatient admission; Patients on observation status; Outpatients 10
11 New Required Measures - Opioids Numerator: Number of episodes a reversal agent (e.g., naloxone) is administered to a inpatient who is prescribed opioids Denominator: The number of inpatients prescribed opioids Included: All patients prescribed opioids (inpatient setting only) All opioid formulations (oral solid, oral liquid, transdermal patch, IM or IV) Excluded: Patients prescribed naloxone on admission to the ED for the purpose of treating/diagnosing outpatient opioid toxicity; Patients on observation status; Outpatients 11
12 Next Steps: o Work with NYSPFP Project Managers and staff on developing internal systems and strategies to capture and report the four new measures o Submit CEO signed commitment form, found on NYSPFP Web site (within the data tab) o Continue participation in ADE educational programs o Continue submission of current ADE data into NYSPFP portal 12
13 Thank You! For more information, contact: Your NYSPFP Project Manager Or Nancy Landor Zeynep Sumer 13
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