Print Entire Issue
For a summary of the 2013 Annual Meeting,
Check out new ICHP President, Mike Fotis's
Inaugural Address in Time to Be Bold
KeePosted Info
Features
History of Organized Hospital Pharmacy in Illinois: Membership Organization
Meet Renata Sutter
Celebration of Caring
ICHP 50th Anniversary Gala – A Night to Remember and to Celebrate
Attention ASHP Pharmacist Members
Corresponding Responsibility
Columns
President's Message
Directly Speaking
The GAS from Springfield
ICHP Champions Program
New Practitioners' Network
ICHPeople
Educational Affairs
Medication Safety Pearl
College Connections
Plan, Do, Study, Act – A Rotation in Quality Improvement
Reflecting on Fifty Years of Caring
Residency Preparation for Students in a Three-Year Accelerated Pharmacy Curriculum
American Pharmacist Month
More
Officers and Board of Directors
Welcome New Members!
ICHP Pharmacy Action Fund (PAC) Contributors
Upcoming Events
KeePosted Info
Illinois Council of Health-System Pharmacists
4055 North Perryville Road
Loves Park, IL 61111-8653
Phone: (815) 227-9292
Fax: (815) 227-9294
www.ichpnet.org
KeePosted
Official Newsjournal of the Illinois Council of Health-System Pharmacists
EDITOR
Jacob Gettig
ASSISTANT EDITOR
Jennifer Phillips
MANAGING EDITOR
Scott Meyers
ASSISTANT MANAGING EDITOR
Trish Wegner
DESIGN EDITOR
Amanda Wolff
ICHP Staff
EXECUTIVE VICE PRESIDENT
Scott Meyers
VICE PRESIDENT - PROFESSIONAL SERVICES
Trish Wegner
DIRECTOR OF OPERATIONS
Maggie Allen
INFORMATION SYSTEMS MANAGER
Heidi Sunday
CUSTOMER SERVICE AND
PHARMACY TECH TOPICS™ SPECIALIST
Jo Ann Haley
ACCOUNTANT
Jan Mark
COMMUNICATIONS MANAGER
Amanda Wolff
LEGISLATIVE CONSULTANT
Jim Owen
ICHP Mission Statement
Advancing Excellence in the Practice of Pharmacy
ICHP Vision Statement
ICHP dedicates itself to achieving a vision of pharmacy practice where:
- Pharmacists are universally recognized as health care professionals and essential providers of health care services.
- Patients are aware of the training, skills, and abilities of a pharmacist and the fundamental role that pharmacists play in optimizing medication therapy.
- Formally educated, appropriately trained, and PTCB certified pharmacy technicians manage the medication distribution process with appropriate pharmacist oversight.
- Pharmacists improve patient care and medication safety through the development of effective public policies by interacting and collaborating with patients, other health care professionals and their respective professional societies, government agencies, employers and other concerned parties.
- Evidence-based practices are used to achieve safe and effective medication therapies.
- There are an adequate number of qualified pharmacy leaders within the pharmacy profession.
- Pharmacists take primary responsibility for educating pharmacy technicians, pharmacy students, pharmacist peers, other health professionals, and patients about appropriate medication use.
KeePosted Vision
As an integral publication of the Illinois Council of Health-System Pharmacists, the KeePosted newsjournal will reflect its mission and goals. In conjunction with those goals, KeePosted will provide timely information that meets the changing professional and personal needs of Illinois pharmacists and technicians, and maintain high publication standards.
KeePosted is an official publication of, and is copyrighted by, the Illinois Council of Health-System Pharmacists (ICHP). KeePosted is published 10 times a year. ICHP members received KeePosted as a member benefit. All articles published herein represent the opinions of the authors and do not reflect the policy of the ICHP or the authors’ institutions unless specified. Advertising inquiries can be directed to ICHP office at the address listed above. Image disclaimer: The image used in the Pharmacy Tech Topics advertisement is the property of © 2013 Thinkstock, a division of Getty Images.
Copyright © 2013, Illinois Council of Health-System Pharmacists. All rights reserved.
Features
History of Organized Hospital Pharmacy in Illinois: Membership Organization
Editor’s Note: The October Keep Posted brought readers through the history of organized hospital pharmacy in Illinois to 1975.
Under the leadership of Harland Lee, president (1975-76), ICHP set out to become a strong membership organization. Work continued on the hospital inspection form for the drug compliance investigators. Input was sought from all members by the Professional Practice Division through the local affiliates and the regional vice presidents.
Early Affiliates
There was more interest in the local areas for organization of affiliates. The Sugar Creek Society of Hospital Pharmacists were formally recognized as affiliates of ICHP. Interest was also generated in the Champaign area and the Rockford area to organize local affiliates. In early 1976 the Spoon River Society of Hospital Pharmacists was affiliated. The Council voted to bestow honorary membership upon Louis Gdalman for his many years of service to Illinois hospital pharmacy through many avenues: hospital pharmacy administration, organizational leadership, education, and the Board of Pharmacy to name a few. Another award very special to the Council was the Illinois Hospital Pharmacist of the Year Award. One of the pharmaceutical manufacturers wanted to assume responsibility for this award. It was the ICHP Board’s decision to keep this award as the sole responsibility of the Council.
Discussions continued with IPhA’s officers and ICHP concerning such topics as the IPhA Board Member at Large, areas of mutual concern as well as those best served individually, and the best structural arrangement to meet the needs of all areas of practice. One of the meetings listed topics that might be addressed cooperatively as legislative lobbying, employment services, continuing education coordination, publications, and public relations. Topics that might be best addressed by ICHP alone were arbitration, input to the colleges of pharmacy for educational needs specific to hospital practice, cooperative services between institutions, liaison with other professional groups specifically related to institutional practice, and specialized continuing education.
Catholic Hospital Association
The Council raised concern over the Catholic Hospital Association’s (CHA) stance relative to its member hospitals’ relationships with hospital pharmacists and the economic status provision added to ASHP’s goals. In a letter to Joseph A. Oddis, Executive Vice President of ASHP, Harland Lee stated: “We have many member pharmacists employed in Catholic hospitals thoughout Illinois who have been directly affected by this CHA position. We are most disturbed about the effect it is and will be having on the ability of these members to attend continuing-education seminars sponsored by the ICHP and its affiliates around the state. ASHP will also feel the impact of this through the inability of these members to attend the midyear meeting and other institutes and seminars. The ultimate result is, of course, the negative effects this will have on the continuing competency of these member pharmacists.”
Number of Apprentices
There was also interaction with the Board of Pharmacy. In response to publication of new Rules and Regulations, specifically to “only one apprentice is allowed per registered pharmacist,” President Lee acted decisively. On behalf of ICHP members, he wrote the following to Phil Sachs, Chairman of the Illinois State Board of Pharmacy: “It is clearly evident, from my own experience and of other hospital pharmacists in the state, who have expressed their concern to me, that the number of ancillary personnel that can be supervised adequately varies depending on such factors as the complexity of the work performed; its susceptibility to final checking for accuracy; the training, experience and skill of the pharmacy technician as well as the degree of confidence that the pharmacist reposes in him. The degree of supervision may range from step-by-step instructions and in-process review, to review of completed work which has been performed with relative independence in accordance with established procedures. The decision as to the closeness of review required rests with the pharmacist and his own professional judgment for he is ultimately responsible for all pharmaceutical practices carried out in the pharmacy.
“The responsibility placed upon pharmacy to safeguard the patients’ welfare with respect to drug therapy has not changed and it seems to me that the way to preserve this responsibility with respect to the safe utilization of technicians is to establish guidelines to assure adequate supervision and to define the procedures and conditions to be met rather than to establish an arbitrary ratio …”
Thus the Council was involved on many levels and in many arenas on behalf of its membership.
– Sister Mary Louise Degenhart
Historian
Meet Renata Sutter
by Renata Sutter, 2014 PharmD candidate, UIC-Rockford
“I promise to devote myself to a lifetime of service to others through the profession of pharmacy … with the full realization of the responsibility with which I am entrusted by the public .”1
My name is Renata Sutter, and I am a fourth-year student at University of Illinois at Chicago College of Pharmacy in Rockford. As I quickly approach the final moments of my professional education, I cannot help but to positively reflect on my decision to enter the medical field and combine my lifelong interest in chemistry with the desire to make a meaningful contribution to the general well-being of patients. It has not been without challenges, but I've loved every moment spent in the classroom and now on rotations.
Outside school, my days are busy with swimming classes, skating classes, playdates, birthday parties, Halloween preparations, and G-rated movie nights. Having two daughters made me very aware of, and even more sensitive to, medication safety issues. During my first year of pharmacy school, I initiated contact with a local environmental organization, Keep Northern Illinois Beautiful, and began participating in its annual medication collection as well as promoting the event at our school in order to recruit volunteers. Just this past June alone, we collected over 2,641 pounds of expired/unwanted/unused medications indicating a great need in the community. I am also active in promoting the National Prescription Drug Take-Back Days as well as in educating patients about available pharmaceutical drop boxes located inside local police stations. Over the summer, I volunteered at Slam Dunk for Diabetes Basketball Camp, and in November, I will again attend the “Dream a Little Dream” fundraiser benefiting St. Jude Children’s Research Hospital.
As I embark on this six-week long journey into the unknown world of pharmacy association management, I am looking forward to witnessing first-hand how the Illinois Council of Health-System Pharmacists (ICHP) fulfills its 50-year-old mission of advancing excellence in the practice of pharmacy.
I have already begun working on incorporating interactive features into the upcoming Pharmacy Tech Topics™ home-study CPE module for pharmacy technicians and completed a peer review of the January issue. I've also familiarized myself with www.healthsystemce.org: the e-learning center for national health-system pharmacy society members. I was invited to attend staff meetings; Spring Meeting Planning Committee conference calls; and division meetings. Moreover, I reviewed the ongoing ICHP Emergency Response Network project folder.
Very quickly, I am beginning to realize the amount of work and commitment it takes to be a vital part of an organization completely focused on supporting various pharmacy professionals and making certain that they are well-informed and ready to practice at the top of their license.
In addition, with the most recent pending changes to the Illinois Pharmacy Practice Act Rules, the launching of Health Insurance Marketplace, and signing of SB 493 bill into law, I feel very fortunate and excited to be here.
Reference:
Celebration of Caring
by Trish Wegner, BS Pharm, PharmD, FASHP, Vice President-Professional Services
The 2013 Annual Meeting marked a milestone in ICHP’s history – “50 years of Caring for Patients, the Profession and Each Other.” To celebrate, ICHP offered outstanding educational programming, honored valuable volunteers and put on a party! ICHP volunteers and staff began planning two years ago, excitedly creating ideas on how to emphasize the 50th year theme of Caring, highlight the many achievements of the organization and its members, and dazzle attendees with a formal celebratory event.
The meeting drew a record 527 in attendance including numerous students and residents, which as one attendee said: “added to the enthusiasm and energy of the annual meeting.” Evaluations demonstrated the success of the meeting:
- 98% of attendees strongly agreed or agreed that the meeting location was convenient.
- 94% strongly agreed or agreed that the format and content of the meeting allowed them to maximize their educational opportunities.
- 95% strongly agreed or agreed that the programming was of high quality.
The Annual Meeting boasted three Keynote Speakers to emphasize our mission of advancing excellence in the practice of pharmacy. Jim Jorgenson, Chief Operating Officer at Visante, focused on how we as pharmacists and pharmacy technicians can have our voices heard by key decision makers. He demonstrated the vital role pharmacy plays in healthcare through the provision of quality care while reducing costs and inefficiencies. Gordon Schiff, general internist and researcher at Brigham and Women’s Hospital, discussed the importance of working collaboratively to care for our patients with compassion and evidence based practices. Eric Kastango, President of Clinical IQ and USP 797 expert, extolled the importance of quality processes to ensure patient safety. Here are some comments about our keynote presenters:
- “Keynotes were great!”
- [Dr. Jorgensen’s presentation] “was a great talk. Very timely with practical, applicable advice.”
- [Dr. Schiff’s presentation] “was very eye opening! Loved the presentation!”
- [Dr. Schiff] – “Great speaker, great topic, simply awesome!
- [Mr. Kastango] – “Excellent presentation!”
Educational programming encompassed many clinical and practice issues within several health-system areas – from MTM to transplant to technology, to quality outcomes, to practice guidelines in various disease states, to research. Programming also bridged learning for pharmacists, residents, students and technicians. Here are just a few comments about the meeting from attendees:
- “Great meeting. Best sessions ever. Proactive, nice focus on ambulatory transition topics.”
- “Great variety in presenters.”
- “Great meeting as always! Gives me a chance to network and catch up with folks I don’t see often. Good work!”
- “Great educational programming and meeting.”
- “Wonderful, wonderful, wonderful Annual Meeting. Just perfect!”
- “Great meeting, topics and speakers.”
- “Another very good meeting. Thank you.”
With decreasing educational grants being awarded for programming, support from our industry partners during the Exhibit Program is key to maintaining lower registration costs. We greatly thank the 56 vendors who participated in the Exhibit Program! Special thanks also to the following meeting sponsors:
- Novo Nordisk – Platinum Sponsor
- Apoteca – Silver Sponsor
- Boehringer Ingelheim – Silver Sponsor
- Baxter BioScience – Silver Sponsor
- CardinalHealth – Sliver Sponsor
- Cubist – Silver Sponsor
- McKesson – Silver Sponsor
- Omnicell – Silver Sponsor
- Pfizer – Silver Sponsor
- Sanofi – Silver Sponsor
- Stericycle – Silver Sponsor
We do not plan any educational programming during the Exhibit Program to encourage all our attendees to visit with our vendors so that they continue to partner with us and exhibit. Without their support, ICHP would have to increase the price of the meeting registration fee to cover expenses. So next year, please use the time to network with our industry partners and learning about new products and services they offer.
Stars were shining brightly during the Award Ceremony. In fact, ICHP introduced two new awards this year. The first new recognition award was the Shining Star Award. This award was created to recognize volunteer members who have stepped up their volunteer involvement a notch over the past year. The 2013 Shining Stars are:
- Colleen Czerniak
- Liz Gorski
- Erika Hellenbart
- Antoine Jenkins
- Zahra Khudeira
- Mary Lee
- Kyle Mays
- Megan Metzke
The second new award for 2013 is the Amy Lodolce Mentorship Award. This award was created in memory of Amy Lodolce who passed away in August of 2012. Amy was a great mentor to her students, residents and colleagues. Nominees for this award must meet the following criteria: 1) be a current ICHP pharmacist or pharmacy technician member, 2) be a preceptor, professor or mentor of students, residents, technicians and/or new practitioners, 3) demonstrate efforts to advance the practice of pharmacy, 4) demonstrate strong mentorship capabilities, 5) exhibit clear community service participation, and 6) have impacted the nominator’s career. Amy’s husband, James Lodolce, presented the award to Kevin Colgan of Rush University Medical Center for his long term commitment to mentoring students, residents, young pharmacists and technicians and his dedication to advancing pharmacy practice worldwide. Also in attendance for this year’s award were Amy’s two sons, Aidan and Preston, and her parents, Diane and Marc Vuletich.
The New Practitioner Leadership Award was presented to Scott Bergman of SIUE. Scott epitomizes this award through his tremendous efforts as President of the Sangamiss Society – bringing it back to life by offering educational and social programming throughout the year; serving on the Governmental Affairs Division; and as ICHP’s Central Region Director. Professionally, Scott is integral in the development of a PGY-2 Infectious Disease Residency in conjunction with St. John’s Hospital in Springfield where he also works in collaboration with infectious disease physicians at SIUE School of Medicine.
The Student Chapter Award went to the Southern Illinois University Edwardsville chapter for promoting the mission of ICHP through their many activities throughout the year. The selection criteria are divided into three categories: presence of the student chapter at ICHP activities, activities the student chapter uses to promote the mission of ICHP, and documentation of how the activities promote the ICHP mission through submission of an essay.
The Outstanding Volunteer Award was presented to Jaime Borkowski for her tremendous efforts as the Chair of the Gala Catering and Decorations Subcommittee. This subcommittee was responsible for creating the beautiful ambiance at the Gala, fashioning the beautiful floral arrangements and table décor, devising the menu, and establishing the table favors. The Gala was a spectacular event and much of it was attributed to her creativity, design and organization.
The President’s Award was given by President, Tom Westerkamp, to Linda Fred of the Carle Foundation Hospital and Clinics. Linda served as the Director of the Division of Organizational Affairs over the past year, which had to review, edit and rewrite parts of the ICHP Constitution and Bylaws to reflect structural changes proposed to the organization.
Honorary Membership in ICHP is given to individuals who are or have been especially interested in, or who have made outstanding contributions to pharmacy practice. This year, two recipients received this award – Dr. Henri Manasse and Michael Posey. Dr. Manasse was recognized for his significant contributions to the profession of pharmacy in the state, nationally and internationally. Dr. Manasse was the Dean at the University of Illinois at Chicago in the 1980’s; was Executive Vice President of ASHP; and is very active in the International Pharmaceutical Federation. Michael Posey made significant contributions to the evolution of ICHP from 1986-1992 as its Administrative Director through his association management company. ICHP established several new programs and products under his leadership, and Michael assisted with the transition for ICHP to establish its own office and Executive Director.
ICHP’s highest award, the Pharmacist of the Year Award, was given to Ann Jankiewicz of Rush University Medical Center. Ann is a Past-President of ICHP and has served in many roles and on several Divisions. She can always be counted on if assistance is needed. Ann displays the same qualities at work where she is a Clinical Specialist Supervisor for Medication Safety and Performance Improvement. She is a departmental leader and cheerleader, championing the profession. Ann is also a dedicated wife and mother, staying very engaged in all her children’s activities. Her nominator suggested we use the mantra “I want to be like Ann”.
ICHP congratulates all the award winners who truly are bright stars not only for ICHP but also for Pharmacy! ICHP also wishes to thank Tom Westerkamp, Immediate Past-President, for his wisdom and caring over the past two years as President-elect and President. He has been a great leader. Many thanks to all the volunteers who made the 50th Anniversary Annual Meeting a success! ICHP welcomes Mike Fotis to take over “the gavel” and marshal the organization to “Be Bold”.
Please join ICHP at the Spring Meeting, March 28-29th at the Marriott Conference Center in Bloomington-Normal where we will be “Taking Bold Steps for Patient Care”.
ICHP 50th Anniversary Gala – A Night to Remember and to Celebrate
by Maggie DiMarco Allen, PhD, Director of Operations
ICHP President Thomas Westerkamp and the Board of Directors hosted the ICHP 50th anniversary celebration Gala on Friday evening, September 20, 2013, as part of the Annual Meeting at Drury Lane in Oakbrook Terrace. The Annual Meeting included historical tidbits with a slideshow of historical photos ongoing in the foyer for people’s viewing pleasure in between continuing education sessions and during exhibitor breaks. ICHP had celebration anniversary cake for the break treat on Friday afternoon for all those attending the meeting. Then Friday’s CPE sessions ended a little early, so everyone could dress up for the Black-tie optional Gala.
242 guests spent time getting re-acquainted with old friends and making new friends at the Friday night Gala. First up for the guests’ enjoyment was the music of the After5 Jazz quartet, who played during the reception with cocktails and hors d’oeuvres. Everyone then moved into a beautifully decorated ballroom for dinner, with a delicious meal served by Drury Lane.
During this historic celebration, five of ICHP’s most impactful volunteers presented recollections and stories about the founding of ICHP and its growth over the past 50 years. Sister Mary Louise Degenhart, Harland Lee, Michael Posey, Henri Manasse, and the current Executive Vice President, Scott Meyers, all shared wonderful memories with the dinner guests.
ICHP will be posting video snippets of the speeches on our Facebook page as soon as the editing is completed, so please watch for those and more photos from the Gala! As an added treat, former board President and volunteer Avery Spunt created the ICHP History Book, available online (click here), full of recollections from ICHP Presidents and Pharmacists of the Year for the past 50 years. If you would like to view the PDF of the Gala Program Book – one of the mementos for the Gala guests – please click on this link.
In addition, a professional photographer took pictures all night which will be posted as soon as they have been edited and are available as well. A few staff and guest photos are at right to give you a taste of the evening. But watch for more photos and video to come!
Dinner was followed by non-stop dance music provided by a great DJ who kept the dance floor full. Plus a Photo Booth with props was set up in the Ballroom foyer, and that kept everyone who was not dancing, laughing to the end. Visiting, dancing, and posing went on until midnight and all the guests had a wonderful and memorable time!
Everyone sends a big Thank You to the Gala Sponsors –
Presenting Sponsor:
Amgen
PharMEDium Services LLC
University of Illinois College of Pharmacy
Benefactor Sponsor:
Cerner
Chicago State University College of Pharmacy
Med Assets
Midwestern University Chicago College of Pharmacy
Omnicell
Roosevelt University College of Pharmacy
Rosalind Franklin University College of Pharmacy
Southern Illinois University Edwardsville School of Pharmacy
Advocate Sponsor:
Krieg DeVault
ScriptPro
Stericycle
Avery Spunt
And last but not least – everyone also sends a big Thank You to the Gala Planning Committee and Subcommittees who spent two years working on all the components - decorations, catering, entertainment, history, communications and sponsorships – that made the ICHP Gala truly a night to remember!
Attention ASHP Pharmacist Members
ICHP is looking for Delegate Nominations to ASHP’s House
by Scott A. Meyers, Executive Vice President
The ASHP Summer Meeting for 2014 will be held in Las Vegas, NV and in 2015 it could be anywhere! For 2015, ASHP hasn’t identified the city yet, and who knows which cities are high on the list with ASHP at decision time? Who would have thought last year that they would have selected Las Vegas in June for the coming year!
Regardless of where the meetings will take place, ICHP needs to elect two delegates to join Chris Rivers, Ann Jankiewicz and Andy Donnelly as the Illinois delegation for 2014. Delegate candidates must be ASHP pharmacist members, planning on attending the ASHP Summer Meetings for both 2014 and 2015 at their own expense, attend one of the Chicago-based Regional Delegate Conferences each May, and provide their own nomination via e-mail, fax or mail to the ICHP office by Nov. 15, 2013. Nominees must provide nomination statements which include years of membership in ASHP, current employment position, pharmacy association memberships, volunteer experiences related to pharmacy associations and any other relevant information the potential candidate would like to include. However, candidate statements must be limited to 250 words or less. The ICHP Committee on Nominations will select the final four candidates for this year’s ballot. The two candidates receiving the highest vote totals will be credentialed as delegates for 2014 and 2015 and the remaining two candidates will serve as alternate delegates for 2014 only.
The 2014 Summer Meeting is scheduled for May 31-June 4, 2014 at the Mirage Hotel and Casino in Las Vegas. No date has been set for the 2015 event, but we know it should be in early June of that year. Delegates and alternate delegates are reimbursed for expenses relating to attendance at the Regional Delegate Conferences, but all other expenses are the delegates’ and alternate delegates' responsibilities. ASHP’s House of Delegates is the policy making body within ASHP and is responsible for and approving all ASHP position statements and practice guidelines.
This is a great opportunity for someone who has served at the State level for some time and wishes to move up within ASHP. It is probably not a good match for someone with no pharmacy association experience.
Elections will be held in late November with all ASHP pharmacist members eligible to vote via the internet. Election results will be announced in the January issue of KeePosted.
Corresponding Responsibility
by Phil Burgess, RPh, Chairperson, Illinois State Board of Pharmacy
You may have heard that at the June meeting of the American Medical Association (AMA) in Chicago, the House of Delegates adopted a policy stating that “a pharmacist who makes inappropriate queries on a physician’s rationale behind a prescription, diagnosis or treatment plan is interfering with the practice of medicine.” The policy statement goes on to state that “if this problem isn’t resolved, the AMA will advocate for regulatory and legislative solutions to prohibit pharmacies from denying medically necessary treatments”.1
The Rules of the Illinois Pharmacy Practice Act (Section 1330.30) defines “Unprofessional/Unethical Conduct” as:
Paragraph “F”: Filling a prescription when a pharmacist knows, or reasonably should know, that no valid physician-patient relationship exists.
Paragraph “H”: Failing to use appropriate professional judgment when dispensing drugs.
Paragraph “L”: Failing to exercise sound professional judgment with respect to the accuracy and authenticity of any prescription drug order dispensed.
As I’m sure you know, “unprofessional/unethical conduct” exposes the pharmacist to the potential of discipline to his/her license.
From my perspective, it appears clear that the Board of Pharmacy expects that pharmacists, prior to dispensing prescriptions, are taking the appropriate actions necessary to ensure those prescriptions are being written for legitimate purposes. Blindly just filling every prescription that walks through the door does NOT meet the standards outlined in the above stated Rules. Verification with the prescriber will in fact sometimes be required.
So, what is the “corresponding responsibility” of the prescriber and pharmacist? The health care community is at a critical crossroads as to how we resolve these two conflicting expectations/requirements with regard to the role that pharmacist should play as part of the overall health care delivery system. And, specifically, who is to decide what are “inappropriate queries” to the physician.
A key aspect of the Affordable Care Act (ACA) is to promote team-based care, management of chronic diseases and move away from paying for each individual service….and instead “pay for performance”. The underlining principle of the ACA is an attempt to drive our health care system towards VALUE. IMPROVED QUALITY PATIENT CARE AT LOWER COSTS. We will not achieve these desired outcomes unless all members of the health care community join together for the benefit of the patient...and disengage from a “protect my turf” mentality.
I hope that the AMA (and the physician community as a whole) will join with us in focusing on the patients’ needs. I also urge Illinois pharmacists to seize this opportunity and not back down when their efforts to improve patient care run into obstacles.
Make Patient Care Your Priority.
1. Lubell J. AMA meeting: Pharmacists warned on intruding into prescribing decisions. American Medical News.
Columns
President's Message
It’s Time to Be Bold
by Mike Fotis, ICHP President
I would like to take a minute to thank Tom Westerkamp. Of course we all should thank him for his service to ICHP – for his commitment, patience, persistence, judgement, and good sense. Can I add a personal note of thanks? One or two of you might also know that Tom and I worked together years and years ago at Northwestern Memorial. Tom was one of those candidates who you just knew could not miss. He also was one of those special pharmacists who end up making everything better. Relations within our department as well as outside of our department improved almost immediately after he started. He was not afraid to be bold. We set out to develop clinical pharmacy services in a way that everyone, and I mean everyone, said couldn’t be done. Well Tom, as you know we did it, and I just want to make sure you know how grateful I have always been that you decided to join us at NMH. Now about 30 years later, it was a special experience for me to work together with you once again, and I certainly do look forward to continuing to work with you on the ICHP Board for another year.
It’s Time to Be Bold.
Our strengths can often be our weaknesses. This concept is described as recently as the Harvard Business Review and as far back as scriptures. For example - and every single one of us in this room has this trait - paying close attention to detail can lead us to missing the big picture. And I think at times we have. One cannot succeed as a pharmacist without paying close attention to detail. We simply need to remind ourselves this can also be a weakness and make time to consider the big picture. Pharmacists are such goody goodies. We are so careful to follow every rule and regulation. Particularly those rules set out for us by our employers. We also do everything we can to improve efficiency. Of course it is a good thing to work efficiently, and play by the rules. But one imagines that pharmacists and technicians working at some of those compounding pharmacies we have heard so much about were also working very efficiently. Sometimes efficiency is not enough. We also need to ask if what we are doing serves the proper purpose and if it is worth doing in this way. If all we do is worry about efficiency, well that’s a good way to end up on 60 minutes exercising our right to evoke the Fifth Amendment. Not the way any of us want to be seen on network TV.
As students (and even as preceptors) we learn to answer questions but not when or how to ask questions. We teach our residents, students and new practitioners to meet goals but not when or how to set goals. We all certainly can get things done, but we don’t always ask if these things are worth doing. We learn to memorize information but can too easily avoid having our own understanding of these concepts. We become highly informed about a limited body of knowledge yet remain uniformed about the rest.
Our nation is working to transform healthcare and pharmacists need to work to transform the practice of pharmacy. In order for us to formulate new directions, new ways of doing things we must have our own knowledge and understanding of every key issue, not simply repeat what is taught.
Sometimes we need to accept and take risks for our profession. (I am not talking about putting our patients at risk.) Years ago when I was first appointed Residency Program Director I had the opportunity to attend a leadership conference at Eli-Lilly headquarters in Indianapolis. At one session we were divided into groups to play a game that required each group to plan and execute a dangerous trip by camel across the Arabian Desert. I think some of you in the room remember this game. We had to decide how much food, water, and shelter to take, and to choose a route to our destination. There was a direct route that took you right across the desert. There were indirect routes that led to a series of oasis stops where your team could replenish supplies such as food and water. Of course all of the pharmacy teams took what seemed to be the safe route going around the desert and stopping at every oasis. All of the pharmacy teams chose this method, stocking up on food and water and traveling very slowly – too slowly it turns out and we were overexposed to the desert because we were afraid to risk taking the most direct route. As you might expect, all of the pharmacy teams perished in the desert. My team was the first to perish. You needed to realize that you had to take a risk in order to survive. Take the direct route to the destination, and travel light and fast. None of the teams that played it safe survived, because the odds were stacked against you. But some of the teams that took a risk made it safely to their destination.
I had the opportunity to participate in preparing the Pharmacy Forecast 2013-2017 published by the ASHP Foundation. While discussing the findings with colleagues, I noticed an interesting inconsistency in responses. Under technology, the predictions are bold and optimistic for progress in all areas- such as CPOE, integrated and comprehensive IT decision support, time spent, etc. Basically, the forecast predicts A-Z advances in technology. Good stuff! But I noted that in the practice model section most responses were conservative and perhaps the opposite of bold. We predict minor or no real changes in pharmacy practice. In other words, we predict the status quo. Peter Drucker had so many good quotes in his career, but one of my favorites is: "There is nothing so useless as doing efficiently that which should not be done at all."
I think if we do achieve multiple advances in technology, we had better make necessary changes to our daily practices. Fine tuning the status quo is simply not good enough. Making candles ever more efficiently does not lead one to the electric light bulb. Can we as pharmacists become bold enough to disrupt our routine and move on to a new practice model?
Our healthcare system does not always work very well. If you or a loved one has never been seriously ill or if you are a US Senator or Congressman, I can understand why you might disagree with me. For the rest of us, I believe there are too many avoidable errors, much cost inefficiency, and for the most part we leave our most vulnerable patients to fend for themselves. So many pharmacists do exceptional work to improve our health system. We need to change the way we work as pharmacists so that all of us can provide this level of care. Our patients need us to do this.
My closing advice for all of the students in the room is that in addition to everything else they are learning this year that you:
Learn when and how to ask questions;
Learn when and how to set goals;
Work with your mentors to determine if our activities are worth doing;
Have interests beyond a single area of expertise;
Help us to formulate new directions, new ways of doing things by having your own knowledge and understanding.
I want to thank the Nominations Committee and everyone here for your confidence in me. If like me you are tired of being a goody goody and want to rebel…but in a pharmacist sort of way, why, I would love to talk to you. Please introduce yourself at any time!
Directly Speaking
You Tell Me
by Scott A. Meyers, Executive Vice President
How many of you have used the phrase “You tell me” in a conversation with another person? I’ve personally used it many times and often with different connotations. I had to poll the ICHP staff to make sure I could recount as many examples as possible for this article and thankfully they were very helpful! Probably because I used the phrase on each of them a time or two.
For example, when someone asks you a question, and you know they know the answer but are just unsure that they know, I often respond, “You tell me.” That way they can provide the answer they believe to be true, and I can reinforce their response, assuming it is correct.
Another example is when a colleague seeks your opinion on a controversial issue, and you suspect that your answer could potentially draw fire. I respond with, “You tell me,” in order to determine how strongly or softly I express my opinion. And while many who know me might think that if the opinions differ, my response would be made strongly, because I tend to tell it like I feel it is, I often respond the opposite way in order to keep the peace or to create time to fight at a later date.
The next example of when I use “You tell me” is when you know that the question comes from someone with a very strong opinion and is looking for a confrontation. The “You tell me” draws their position out immediately, and it allows me to formulate a response that will either diffuse the confrontation or escalate it, depending on my interest in quickly resolving the issue, my commitment to the issue, the need to maintain decorum in the current setting and my current level of energy at that time. Once the issue and the other person’s position is clearly identified, it may be much easier to provide a response that avoids a lose-lose situation.
But none of these examples is why I’m asking each of you, ICHP’s members, to respond to the “You tell me” phrase today. Instead, I want you to tell me your stories. Not just any stories or jokes (although clean jokes that I can share anywhere are always appreciated when emailed!), but I’m asking for stories of success in your pharmacy practice. Not just any stories of success but stories of success when your success also matches up with ICHP’s Mission – Advancing excellence in the practice of pharmacy. In other words, when your department has implemented a new service or process that advances excellence in the practice of pharmacy at your institution, I want to hear about it! If you’ve been successful for budget reasons or because you were ordered to implement something by an administrator or another department, that doesn't count. Those are successes, often required to keep your employment, but they aren’t the stories I would like to share. And I completely understand that those successes are often just as important or sometimes more important to you at the time. I live there, too!
I usually use my column to tell you what you should do: advocate for this, implement that, plan for this, etc. That’s easy for me, but it is sometimes not that interesting or motivating. Sharing your successes with all our other members can be reassuring or even inspiring. Showing others that they can make things happen by following someone else’s plan helps everyone (by not having to reinvent the wheel, hello, and that it can be done!). Plus, you all are out in the trenches, you’re fighting the fight every day for your patients and your institutions, so when you achieve victory it’s important and rewarding to share it with others!
Your stories will also be helpful to me. They will get me closer to the real practice of pharmacy and help me identify the most current issues confronting our members. This helps us plan educational programming, revise statutes and regulations and identify member needs that might be met by new products or services.
I’ve attended almost every Pharmacy Director Dinner that has been held in and around the state since we reestablished them a few years ago. I’m not sure whether or not I have actually even missed one, but that’s not the point. These dinners help me stay in touch with the practice from the pharmacy directors’ point of view. And the directors are very open in their discussions, but I know there’s more of you out there who can share. I know that when a new program or process is identified, developed, implemented, evaluated and improved, that all the staff in a department get involved. So I want to hear from all of you!
I want to hear your perspective. I want you to tell me how it worked, what didn’t work and how you fixed it, how it made you feel, and how it improved care for your patients. And if more than one of you want to share the same story, the different perspectives you provide will add to the learning.
So my new challenge to all of you is: “You Tell Me!”
The GAS from Springfield
Time to gear up for the elections of 2014!
by Jim Owen and Scott Meyers
The last few months have not been pretty both at the state and federal levels. The pension fight or rather the paycheck fight over the pension fight between Governor Quinn, and the General Assembly leaders, Michael Madigan and John Cullerton, accomplished little or nothing except perhaps to pay ineffective legislators even more pay (interest added by the judge who ruled withholding their pay was unconstitutional) for doing nothing to solve Illinois’ largest problem! At the federal level, stubborn elected leaders allowed their brinksmanship to halt much of the government’s work, stop payments to bereaved family members of soldiers killed during service to our country and perhaps even damage the country’s debt rating which could have untold consequences in the future!
Are you ready to throw the whole bunch out during the 2014 elections? Or at least those we can? Unfortunately some like the President, 67 of the 100 US Senators and 40 Illinois Senators are not up for re-election, so the entire gang can’t go if you want them to! But if you’re tired of the games being played in Washington and Springfield, it’s time to make your plans to go after Illinois’ Governor, 118 Illinois Representatives, 19 Illinois State Senators, 18 Congressmen and Congresswomen, and 1 US Senator. And if you’re not fed up with what is being passed off as governing by those we call the legislative and executive branches, you still need to begin to think about how you can help your legislators get re-elected.
So what can you do to make a difference in 2014? First, you need to become more familiar with the details of the hot issues. We heard a Congresswoman state just the other day that no one still knows what’s in the Affordable Care Act! It was passed 3 years ago! Even if it is more than 2,500 pages, she should have been able to get through it by now, even reading out loud to a class of first graders and explaining each section! There’s no excuse for not knowing details on issues that impact you every day.
The second step you can take is to start looking at and meeting when you can, the potential candidates for the office that are most important to you. Every time you meet them you share your quick elevator message and eventually they will not only remember you, they’ll remember your issue! Plus, you’ll get to see which ones remember the quickest (they are probably the ones paying the most attention!), and you’ll also get to see how they react to your cause. Electing your representatives in Washington and Springfield is like hiring someone to work for you. You really should conduct an interview or two so that you don’t waste your vote!
Finally, you can put your money where your mouth is! ICHP has a State political action committee named the ICHP Pharmacy Action Fund, and while we don’t get financially involved in federal elections, we do play a role in many of the State elections. The size of the role is up to each and every one of you, the ICHP members. By contributing to the ICHP Pharmacy Action Fund, you can make your dollars go further by pooling them with other like-minded professionals to support those candidates who support pharmacy.
Currently there are a few dozen members who contribute regularly. But ICHP has nearly 2,000 members including more than 800 pharmacists who could easily contribute a mere $25 a year creating an annual base of $20,000. Add to that just $5 per year from every student and technician and we’re up to $26,000 annually! And those dedicated current contributors all give more than the minimum recommended $25, so we would be even further past our goal.
But it all starts with you. Not the other pharmacists, students or technicians you work with, but you. You’re the only one you can commit to helping make ICHP’s message heard. You have to make the decision to give. Then you can encourage your colleagues to give, and it’s much easier to do so by following your personal ask with a statement like, “I’ve already made my contribution for this year!”
Let’s face it, campaign contributions get the politicians’ attention. They get their attention much quicker and more effectively than even a great cause. It’s not fair, it’s not right, it’s just the truth. If you think you’re above making a contribution to a candidate, then you’re not paying attention and not living in the reality we call American democracy. Again, it’s not right, but it’s the truth. Will we fix this someday? We hope so, but until then, we have to work within the system that exists.
So it’s time to educate yourself on the issues, begin to meet the potential candidates and put your money where your mouth is. If you want provider status in Illinois, if you want collaborative practice and pharmacist prescribing, you’re going to have to do more than just whine about it to your friends. You’re going to have to plan and participate in the elections of 2014!
ICHP Champions Program
by Jennifer Ellison, PharmD BCPS, Director, Marketing Affairs
Are you looking for new ways to stay informed? Want to get more involved with ICHP? The ICHP Champions Program is a great avenue for doing both. The purpose of this program is to provide continuing education and ICHP news to members. ICHP’s goal is to have a Champion volunteer from each hospital in Illinois. Over the past several years, ICHP’s Division of Marketing Affairs has made efforts to recruit ICHP members to serve as Champions for their respective hospitals. Currently, we have Champions for 60 hospitals out of a total of 233 in Illinois. We are currently on the lookout for more! The Champion’s duties include sending out information regarding ICHP events and setting up Champion CPE webinars at their institutions. All of this information is provided to the Champion by the ICHP office.
The Champion CPE webinars are broadcasted every 1-2 months on weekday afternoons. In order to fit more easily into members’ schedules, the webinars are only 30 minutes long (0.5 hours live CPE). Past topics include evaluating student/resident journal clubs, assessing inpatient HIV orders (when you are not an expert in HIV), and treatment of nausea and vomiting in pediatric oncology patients. All of these webinars were presented by ICHP members. Not only do the webinars provide opportunities for members to learn about practical, pertinent pharmacy topics, but they also provide members with a chance to flex their speaking skills!
If you have not done so already, take advantage of our Champion program, either by attending a webinar, presenting a webinar, or by stepping up to be your hospital’s Champion. You can contact the ICHP office at the following email: trishw@ichpnet.org.
New Practitioners' Network
“Everyone Shines, Given the Right Lighting”
by Jennifer Arnoldi, PharmD, BCPS
This article’s title is a quote from Quiet: The Power of Introverts in a World That Can't Stop Talking, by Susan Cain.1 It’s not often that I read a book that makes a lasting impact, but I found that this book definitely offered some insights that I will carry with me. I didn’t need to read this book to be able to identify myself as an introvert, although I may not have previously used that term. Within this book I discovered that at least one-third of the population are introverts like me, and that I share this trait with notables such as Rosa Parks, Dr. Seuss, Steven Spielberg, and J.K. Rowling. I won’t summarize the book here, but I will say that reading it did several things for me. Beyond confirming my introversion, the book helped me understand more about myself and how I communicate, work, and relate to others. I learned that, as an introvert, I may process information, respond to situations, and socialize differently than some of my more extroverted colleagues and students. I would absolutely recommend reading this book to anyone who suspects they might be an introvert, but also to extroverts who would like to appreciate and better understand your introverted friends, family, colleagues, and students.
If you’ve ever taken a Myers-Briggs personality test, some of these concepts may already be familiar to you. Another helpful resource is the Strengths Finder assessment by Tom Rath.2 After completing the assessment, you are provided with a report of your top five themes or strengths, along with a description of the strengths and information about maximizing or building those strengths. The intent of the Strengths Finder is not to waste time trying to fix weaknesses or faults, but to make the most of your natural abilities. When I received the report of my top themes, I was amazed at how accurate it was. A few of my colleagues and I took the assessment during the same time period and had a discussion about our individual strengths. Learning their strengths and sharing mine with them was eye-opening. Knowing each others’ strengths and motivations has helped us work together effectively and call upon each others’ talents appropriately.
Why am I telling you about these books and assessments? As I mentioned above, I took away aspects from Quiet and Strengths Finder that I think have improved my work life. Even something as small as understanding that, because I’m an introvert, I may need to give myself ample time to “recharge” after presentations or lectures has enhanced my performance. I’m not saying that you need to read these books to be successful in your career. However, I do think that knowing yourself and your strengths, especially as a new practitioner, are aspects of your personal and professional development that should not be overlooked. Maximizing your strengths and appropriately utilizing your personality traits can be helpful if you are looking for an ideal fit in a potential career path. Once in a particular job setting, you can also use this information to aid you in choosing tasks, projects, and goals that both challenge and fulfill you. You may also be able to enhance your communication skills and your success in working with others. It can mean the difference between surviving and thriving in your chosen area of practice.
References:
1. Cain S. Quiet: The Power of Introverts in A World That Can't Stop Talking. New York: Crown Publishers, 2012.
2. Rath T. Strengths Finder 2.0. New York: Gallup Press, 2007.
ICHPeople
ICHP staff member, Jo Haley, welcomed her first grandson, Elijah William Zissler, on October 18 at 2:35 pm. Baby was 6 lbs 6 oz, 19 inches long. Congratulations, Jo!
Congratulations to the ICHP Members who received Awards at this year's Annual Meeting!
Scott Bergman
Jaime Borkowski
Kevin Colgan
Colleen Czerniak
Linda Fred
Liz Gorski
Erika Hellenbart
Ann Jankiewicz
Antoine Jenkins
Zahra Kudeira
Mary Lee
Henri Manasse
Kyle Mays
Megan Metzke
Michael Posey
SIUE Student Chapter
Welcome to Office
The following ICHP members have all been sworn into office in their new roles:
Michael Fotis - President
Tom Westerkamp - Immediate Past President
Carol Heunisch - Secretary
Ginger Ertel - Treasruer
Michael Weaver - Chair, House of Delegates
Kathy Komperda - Director, Organizational Affairs
Desi Kotis - Director, Professional Affairs
Diana Isaacs - Chair, New Practitioners Network
Kathryn Schultz - Northern Region Director
Jennifer Arnoldi - Central Region Director
Brian Thompson - Southern Region Director
Congratulations to the UIC-Rockford Student Chapter who won the 2013 ICHP Student Chapter Video Contest with their video, Living the Pharmacy Dream. Click here to check it out.
Educational Affairs
As MedWatch turns 20, what is the role of pharmacists in adverse drug event reporting?
by Swapna Chakrabarti, BS, RPh
The United States Food and Drug Administration (FDA) is celebrating the 20th year anniversary of the launch of its program MedWatch. Launched in 1993, MedWatch is a safety program which collects and reviews reports from healthcare professionals and consumers about possible problems with medical products regulated by FDA like drugs, medical devices, biological products, dietary supplements, infant formula and cosmetics.
In the 1950's a single physician's report alerted the FDA to fatal blood disorders associated with the use of the antibiotic chloramphenicol. Following that, physicians were encouraged to systematically report adverse medical product events. Eventually, concerted efforts by the FDA over the following decades led to the launch of MedWatch. The goal was to expand the voluntary reporting system beyond physicians to other healthcare professionals such as pharmacists and nurses.
Since then, the program has adapted to the changing healthcare framework in the country and has expanded in scope to address issues like:
- making it easier for providers to report adverse drug events (ADEs)
- providing clear communication about what information and reports FDA would like to receive
- how the reports are analyzed and relevant drug safety information is disseminated in a timely manner.
In keeping with this progressive mandate, MedWatch has launched two new initiatives:1
- MedWatch Consumer Form (Form 3500B) is a consumer friendly version of the Form 3500 used by healthcare professionals and students to report ADEs. This was introduced in response to concerns that the earlier version was too technical and hence most consumers felt discouraged to report their problems. The FDA hopes that this easy to use form will encourage consumer participation and the increased data collected on adverse drug events will lead to more accurate signal detection and analysis.
- A web-based learning tool called MedWatch Learn that teaches healthcare professionals and consumers in how to properly complete the report. It uses case studies to walk the reporter through different pieces of information that needed.
Information obtained from these reports in maintained in utmost confidentiality and personal details of the patients and reporters are never released to the public. The FDA analyzes the reports obtained from the healthcare professionals, consumers and indirectly from manufacturers and medical literature, wherever applicable and then issues drug safety communications and alerts for the consumer. A recent example is the Drug Safety Communication issued in August 2013 titled "Acetaminophen: Drug Safety Communication. Association with Risk of Serious Skin Reactions.”2 As a result of their investigation, the FDA will require a warning to be added to the labels of prescription drugs with acetaminophen to address the risk of possibly severe skin reactions. The FDA will also request manufacturers to add warnings on labels of over the counter (OTC) acetaminophen preparations.
Pharmacists play an important role in the management of medication therapy for their patients. Armed with extensive clinical and medication related training, pharmacists are uniquely qualified to identify potential and actual drug related problems. However as the reporting of adverse events to the FDA is growing, the numbers regarding pharmacists have not followed a similarly aggressive trend. In 2000, pharmacists reported 19,000 adverse events which increased to 36,500 in 2010. In contrast, physicians have almost quadrupled their reporting in the same ten-year span, with 230,000 reports submitted in 2010. This reticence is a cause for concern as the expertise of pharmacists is being underutilized in this critical area of drug safety monitoring. Gavaza et al reported barriers and facilitators for pharmacists' reporting of serious adverse drug events.3 Lack of knowledge about what constitutes an adverse event, and information about the process of reporting, lack of time, high work load as well as lack of access to complete medical records of the patients were reported to be the most common barriers. Not surprisingly, knowledge and training about adverse drug events and reporting emerged as the important facilitators.
It is time for the pharmacist community to take charge and introduce in their practice settings, monitoring and documentation programs that view the reporting of adverse events as an integral part of medication therapy management. Setting up Adverse Drug Event Reporting programs that encourage and reward proactive and periodic reporting can be a facilitator for pharmacists in non-clinical settings. In clinical settings, where pharmacists have been proven to be the most thorough chart-reviewers, an automated chart surveillance program that can aid the pharmacist without taking up too much time away from the clinical duties will be a bonus.4 One such program has been developed by Dr. Steven Chen at the USC School of Pharmacy.5 The Medication Therapy Intervention and Safety Documentation Program is a tool to quantify medication safety measures and document adverse events. A documentation program, in an electronic form can be used to "feed" the reports into the MedWatch database after some additional information has been added.
Exposure to adverse drug events and medication error reporting should start in the pharmacy schools. Presently, most students learn this by didactic experiences but there are not many opportunities for experiential rotations, work experiences, etc. Promoting this culture while training the future pharmacists will encourage them to carry it on in their individual practice settings.
Adverse drug event reporting is a crucial part of the post market surveillance of drugs approved in the United States. Since its inception, the reports received by the FDA through the MedWatch program have led to the introduction of numerous safeguards and prescribing guidelines like black box warnings, contraindication statements and "Dear Doctor" letters. Such information has helped the healthcare professionals optimize therapy decisions for their patients. Just as a lone report by a physician alerted the FDA and subsequently the medical community about the fatal adverse effects of a popular antibiotic, a single adverse event report can be the starting point for meaningful FDA action. The primary driving force for FDA investigation and action is the reporting of clinically significant adverse events by health care professionals. Pharmacists are on the frontlines for identifying, monitoring and reporting ADEs because of their unique training and special insight into drug related problems. Even though it may not be immediately obvious, such reporting can lead to FDA action ultimately affecting public health.
REFERENCES
Medication Safety Pearl
Implementation of Patient Specific Doses of Intermediate and Long-Acting Insulins
by Kathy Tang, UIC-P3 Student, Rebecca Lee, UIC-P3 Student and Zahra Khudeira, PharmD, BCPS, CPPS
Introduction
Medications that have the highest risk of causing patient harm when misused are known as high-alert medications.1 Insulin is one of the top five high-alert medications.2 The consequences of an error with a high risk medication are more devastating to patients.2 Insulin is a high-alert medication due to its low therapeutic index and complex dosing, which can cause significant injury to patients.3 High-alert medications are involved in 65% of serious medication errors, of which 11% involved insulin misadministration.4 In order to reduce such errors from occurring, it is important to reduce the risk for insulin error by implementing safe insulin storage practices.3
Safety Issue
Hospitals often store insulin vials on the nursing units (“floor stock”) for ease of use. Long-acting and intermediate-acting insulins, based on the pharmacokinetics, are not necessarily emergently needed on the units. By placing all of the insulins on the units, nurses may be prone to choosing the wrong insulin for administration. If a nurse makes a mistake in the amount of insulin administered, the patient’s blood sugars will need to be monitored and corrected for up to 24 hours. The Medication Safety Committee of Mount Sinai Hospital agreed to remove the long-acting and intermediate-acting insulins from the nursing units and to dispense patient specific doses to improve patient safety. The nurses continued to have fast and rapid acting insulin available in the medication rooms.
Safety Solution
Mount Sinai Hospital implemented a process for patient specific prefilled intermediate and long acting insulin syringes in September 2010. The process of patient specific insulin syringes is outlined in Figure 1. The process begins with a batch of all patients on long acting and intermediate acting insulins. Throughout the day, if a patient has a dose change or is newly admitted, the pharmacy draws up doses as needed throughout the day. The technician that delivers the syringes to the nursing units checks and removes all previous and different intermediate and long acting insulin syringes twice daily. When a nurse reports a missing insulin dose, the pharmacy team does not replace it. Instead, the technician goes to the unit and helps the nurse find the syringe. This helps prevent nurses from committing an administration error.
In addition to the improved patient safety, the pharmacy also witnessed a financial savings with this initiative. Before the centralization of pharmacy dispensed unit dosed glargine, the hospital purchased an average of 28 vials per month. After the patient specific dispensing, the hospital’s average was 20 vials per month. This equates to an annual savings of $10,000. A similar savings was observed with the intermediate and mix insulins.
Hospital pharmacies can track the number of insulin related errors and determine if the number has decreased after this process change. Mount Sinai Hospital did not see a difference in medication errors or adverse events related to insulin. The lack of difference, however, can be attributed to low reports. The number of hypoglycemic events can also be tracked before and after the intervention to reveal improved patient safety.
Lessons Learned
The process was monitored to ensure adequate and timely delivery to nursing units. The Pharmacy Department initially started with just the long acting insulin to get nurses comfortable with the process. After one month, the intermediate and mix insulins were added.
The process was also refined soon after implementation. The technicians initially were printing a report of all patients that had long acting and intermediate insulins. Within three months of implementation, we prepared batch labels to avoid the daily printing of a report. The nurses welcomed the change in having prefilled syringes. The new process did not affect physicians but they appreciated the improved patient safety aspect.
The nurses were instructed to wait for any dose from the pharmacy and could not modify the prefilled syringes if a lower dose was ordered.
Conclusion
The implementation of patient specific insulin syringes went smoothly. Prior to implementation, the process was outlined and shared with pharmacists and technicians to obtain feedback and modifications. The two batches per day did not place a huge workload on any staff member. The continuous communication between the pharmacy and nursing personnel allowed this implementation to be successfully accomplished. Hospitals should consider dispensing unit dosed intermediate, long-acting and mix insulins to improve patient safety.
In the latest ISMP Nurse Advise-ERR, there was a case of a contaminated insulin vial that possibly was used in 70 patients. ISMP recommends using the 3 mL vials which would result in less exposure and to have the pharmacy prepare patient specific insulin doses.
References
- Belknap S. High-alert medications and patient safety. Sentinel Event Alert. 1999; 11. Available at: http://www.jointcommission.org/sentinel_event_alert_issue_11_high-alert_medications_and_patient_safety/. Accessed on September 20, 2010.
- Institute for Safe Medication Practices. www.ismp.org (accessed March 30, 2013).
- Cohen MR. Pharmacists’ role in ensuring safe and effective hospital use of insulin. Am J Health-Syst Pharm. 2010; 67:S17-21.
- Cohen MR, Proulx SM, Crawford SY. Survey of hospital systems and common serious medication errors. J Healthc Risk Manag. 1998 Winter;18(1):16-27.
- Grajower MM, Harris, WC, et al. How long should insulin be used once a vial is started? Diabetes Care 2003. 26;(9), 2665-2669.
- ISMP Nurse Advise-ERR. October 2013; 11(10).
College Connections
Plan, Do, Study, Act – A Rotation in Quality Improvement
by Josephine Aranda, PS-4, Midwestern University Chicago College of Pharmacy
Although I am in my final year of pharmacy school, I still look back at the time I volunteered at a hospital assisting a medication safety pharmacist. My experiences there sparked a curiosity that remained throughout pharmacy school. In the summer of 2012, I pursued a research opportunity to work with medication safety and quality pharmacists, which further ignited my interest in safe medication use processes and integration of informatics. The following spring, I was notified about APPE rotation placements and was ecstatic to receive my top choice elective at Telligen, the quality improvement organization (QIO) of Illinois.
QIOs are contracted by Centers for Medicare and Medicaid Services (CMS) to improve health quality at the community level by providing resources and support to providers and facilities. The Telligen staff utilizes quality improvement processes such as plan, do, study, act (PDSA) cycles, process mapping, root cause and failure mode effects analyses to improve the quality of healthcare delivery in Illinois. They collaborate in teams to work on improving initiatives such as care transitions, quality data reporting, healthcare-acquired conditions and infections. My preceptor, Izabella Wentz, PharmD, FASCP, is the sole pharmacist at Telligen working on the preventing adverse drug events initiative, which focuses on improving safety with diabetes, anticoagulation and antipsychotic high-risk medications.
Additionally, QIOs have developed partnerships with the Patient Safety and Clinical Pharmacy Services Collaborative (PSPC). PSPC is a nation-wide initiative sponsored by the Health Resources and Services Administration (HRSA) to improve healthcare quality by integrating evidence-based clinical pharmacy services into the management of high-risk, high-cost, complex patients. PSPC teams are composed of community-based health care providers who actively learn and implement leading practices in their care delivery system.
A majority of Dr. Wentz’s work currently involves recruitment and engagement of PSPC teams to progress through several growth stages. The stages start from building to implementing change that results in measurable patient improvement. The final stages focus on scaling up and spreading services to gain executive leadership commitment and sustainable payment models. Some of the teams we worked with included pharmacists from HomeScript Pharmacy, Advocate Health Care, Mt. Sinai Hospital and Norwegian American Hospital. Together, we developed their high-risk patient populations of focus and assisted with data outcomes tracking. I learned how pharmacists applied PDSA cycles by implementing, evaluating, and modifying new services from a small scale to a larger one. We also provided support to teams in developing a value proposition or business case, to ultimately secure partnerships and sustainable reimbursement models for their services.
I witnessed innovative pharmacy practice models through my involvement with PSPC team visits. The teams mainly focus on diabetes and anticoagulation populations, but they also manage lipids, blood pressure, heart failure, asthma and COPD. The pharmacy teams at Advocate, Mt. Sinai, and Norwegian all provide comprehensive MTM and disease state management from primary care clinic settings. They work in multidisciplinary teams of physicians, nurses, dieticians, social workers, residents and students. Norwegian and Mt. Sinai also engage and educate their communities with diabetes classes. On the other hand, HomeScript pharmacy is a unique home delivery pharmacy in which technicians or MTM liaisons, conduct patient home visits to obtain thorough medication histories, establish relationships and provide continuity of care. The pharmacist then follows up with patients and physicians via telephone to clarify concerns, check progress and provide medication recommendations or education. All of the team leaders have exemplified a commitment in shifting high-risk patients to lower-cost, controlled and coordinated care.
With each team, the same practice challenges kept resurfacing. Attaining pharmacist provider status and establishing sustainable reimbursement payment models are battles that significantly affect practice and are worth fighting for. Pharmacists in my home state of California are celebrating their recent monumental victory of attaining provider status, one that I hope Illinois will soon follow. Together we must continue to use our expertise to provide exceptional patient-centered care so that our patients, colleagues, communities and nation will recognize our valuable contributions. The lessons that I learned from the quality improvement application at this rotation will help me in any pharmacy setting. Likewise, the passion and innovation from these teams have inspired me as a new practitioner for many years to come.
Reflecting on Fifty Years of Caring
by Ann Ryan, PS-3, ICHP Mental Wellness Co-Chair; Reviewed/co-authored by: Nadiyah Chaudhary, PS-3, ICHP Co-President, University of Illinois College of Pharmacy - Rockford
I don’t know where to begin describing an incredible evening shared on September 20, 2013 with my classmates along with some of ICHP’s shining stars. I remember when I first heard about the ICHP Gala at my internship two summers ago, I thought “that’s nice…it’s like a Winter Formal for the grown-ups. Wonder if any of the other kids are going?” At the time I did not entertain the thought that I may be one day attending. After the fall 2013 semester began, multiple e-mails from ICHP and classmates continued to remind me about this glamorous evening. At this point I began to entertain the idea of attending. As weeks passed by faster than rapid monomorphic ventricular tachycardia, my desire to go to the gala was building.
Suddenly an e-mail notified me that there were tickets available for students that were donated by one of the sponsors. Thanks again, Amgen! I jumped at the opportunity and I am so grateful that I did. The gala proved to be a memorable evening that I was able to share with great friends where I cultivated a deeper appreciation for the people who drive the success of ICHP.
I learned so much more about the impact ICHP has had on the pharmacy profession. I did not know that ICHP was an integral part of actively developing the idea for pharmacy technician certification standards. Moreover, ICHP was heavily involved in the creation of this certification test.
Tom Westerkamp introduced pharmacist after pharmacist who made strides to improve the quality of pharmacy practitioners (through residency training and access, legislative actions, standards of practice, and many more noble initiatives). The gala highlighted the work of many great pharmacists who committed their career to elevating the profession. Sister Mary Louise Degenhart, as a co-founder, was an integral part of promoting residencies and opportunities for pharmacists. She reminded us how a “humble beginning” can result in great accomplishments. This motivated me to not get bogged down by negative attitudes. It showed me that although you may not be able to see the impact of your work now or the influence you have, you may be creating something that will shape the future of pharmacy. Harland Lee showed us how innovation can result in revamping the infrastructure of the practice of health-system pharmacy. It motivated me to hear about how the people of ICHP raised expectations for pharmacists and pushed for well trained practitioners to dominate the field.
It was surprising to see how far ICHP has come. To hear how the original annual meetings consisted of around 60 members, and now students alone make up more than that. As students, we tend to lose sight of all the efforts that were put forth before us. We don’t always appreciate the tremendous impact ICHP has, not only on campus, but off campus as well. This is a reflection of many years of hard work to get where we are today.
After feeling pretty burned out from the week preceding the gala coupled with the stress of the semester building to explosive pressures; I realized that I needed to hear the messages the gala had to offer. Never ever give up! Keep pushing to enhance the work of those who came before you. Do what you can to move forward with the mission they started. Hard work can have supremely real consequences. This work can make or break the life of a patient, and in the end that is what this is all about. If you proved yourself during the interview and earned an invitation to be a student of pharmacy, cherish that accomplishment. As I’ve been told by a well respected leader, life will only become busier from this point forward. With caring, comes responsibility along with high expectations of character.
It was an honor to celebrate the theme of caring among the leaders of pharmacy. Upon speaking with my friends it became clear that they shared the same appreciation. Thank you for the motivation, ICHP, we needed this reminder!
Residency Preparation for Students in a Three-Year Accelerated Pharmacy Curriculum
by Alex Mersch PS-3, SSHP President, Roosevelt University College of Pharmacy
With the advent of new pharmacy schools, expansion of pharmacy services, recovering economy, and interest in clinical pharmacy, the availability of residencies has become increasingly competitive. Students are realizing the vast benefits of participating in such rigorous programs. Pharmacy students begin to discover the option of residency early in their didactic years in pharmacy school; however, the challenges and requirements necessary to secure a residency are not fully realized until later in the curriculum. Professional organization participation, pharmacy work experience, patient related projects as well as summer internships provide a variety of opportunities for students to enhance their abilities and strengthen their CV’s. Prior to Midyear, students have approximately three years to make their mark. With the advent of Roosevelt University’s three-year program, students are in a unique circumstance to achieve the same level of accomplishments as their four-year counter parts in only two years. To address this issue, Roosevelt University’s Student Society of Health-System Pharmacy (SSHP) has made it our top priority to educate our students about residency and provide them with a plethora of leadership, philanthropic and professional development opportunities.
The first issue we chose to address was providing students with the foundational knowledge of the following: what is a residency, types of residencies, benefits of doing a residency, and challenges in matching to a residency site. Our presentation titled “Residency 101” was provided by two of our clinical faculty, Dr. Matthew Nelson and Dr. Craig Cooper; several of our second year students provided insight on their experiences thus far as well. Attendance was approximately 75% of the entire first year class. Students were engaged throughout the presentation and asked a variety of questions. Informal conversations with students afterwards revealed that they had extremely positive feedback, which ultimately resulted in keen interest in SSHP membership to learn more about residency training.
The second issue we chose to address was how best to provide leadership, professional, and academic development opportunities for our first-year pharmacy students. We decided upon a comprehensive approach by creating more leadership positions, increased availability of speakers and projects as well as exposure to more residency training related information. Leadership positions we have created to expand chapter services include journal club committee, first year liaison, and service chair. Our membership drive provided students with information on what ASHP, ICHP, and SSHP offer student members with regard to residency training and success in health-system pharmacy pursuits.
The third issue we chose to address was how to help our students develop professional skills. We are currently offering frequent journal club discussions for all classes. P-2’s and P-4’s will be expected to participate while P-1’s will be able to observe and learn. Journal club discussions will improve student knowledge, communication and critical thinking abilities. We will also be offering CV workshops to provide our students with tips as well as opportunities to receive feedback on their CVs. Our SSHP chapter is also planning a resident panel to give our students insight into various residency programs as well as to learn more about a day in a resident’s life, the application, and the match process. We will also be hosting our second annual local Clinical Skills Competition to enhance our professional skills and develop critical thinking skills. We would also like to host a Residency Roundtable to provide various opportunities for our students to learn from practicing pharmacists whom have completed residency in a particular area. This will help excite students as well as grow their knowledge base and interest in the areas they can practice in the future.
Ultimately there is no proven path to securing a residency. Each and every pharmacy student has a unique journey, skills, and experiences to offer. Our SSHP chapter is hoping to provide the foundation as early as possible to help our students achieve the most in their truncated time in pharmacy school. We are looking forward to providing you with updates and sincerely welcome any input or ideas to further this cause.
American Pharmacist Month
by Jennifer Rispens, P-3, ICHP Secretary, Rosalind Franklin University of Medicine and Science-College of Pharmacy
As members of a nascent, but quick-developing college of pharmacy, students at Rosalind Franklin have embraced the opportunity to start new traditions and establish events that will be held for years to come. One recent, exciting example involved the coordinated celebration of Pharmacy Month across the many pharmacy-related student organizations. Each group devoted an entire week to the promotion of pharmacy within and beyond the school and community.
As part of this event series, we had the honor of hosting inspiring speakers, who promoted pharmacy practice and discussed residency experiences. The first speaker, Dr. Hina Patel, PharmD, BCPS represented NorthShore University Health System. She discussed the importance of becoming involved in student-led activities while in pharmacy school. Despite our hectic schedules and never-ending nights of studying, Dr. Patel reminded us of the criticality of participation, as professional organizations can make a genuine difference in the field of pharmacy. She emphasized that, no matter what you are doing, it is important belong to a community, and to strive to make your patients feel like they belong.
Our school is fortunate to have Captain James A. Lovell Federal Health Care Center next door. Recently, three PGY-1 Residents visited our campus to explain the ins and outs of the residency programs and discuss the application process. Many Rosalind Franklin University School of Pharmacy students are eagerly researching potential residencies and looking at different sites in an effort to learn as much as they can about them before our P-4 year. We had the privilege of having a question/answer session with these residents that allowed us to talk openly and honestly about whether or not a residency is right for us, as well as what to look for.
In addition to having speakers come in and promote pharmacy, our ICHP chapter managed a display booth in the school, which imparted information to medical, physician assistant, podiatry, and physical therapy students about what pharmacists can contribute to the healthcare community. Our school is highly interprofessional so it is important to teach the other professions what pharmacy is about and how we can all work together to help better the lives of our patients. During lunch, we had students sitting at the booth to talk with other students and faculty about pharmacy and our ICHP Student Chapter.
Though we are a new pharmacy school and a new ICHP Student Chapter, we are working very hard to make a difference at our school and within our community. American Pharmacist Month is one of the many events we host and are involved with. As our chapter continues to grow and develop we look forward to creating more opportunities for our chapter members.
More
Officers and Board of Directors
TOM WESTERKAMP Immediate Past President224-948-1528 tom_westerkamp@baxter.com
GINGER ERTEL Treasurer 660-342-5022 gertel@msn.com CAROL HEUNISCH Secretary 847-933-6811 cheunisch@northshore.orgTRAVIS HUNERDOSSE Director, Educational Affairs Travis_Hunerdosse@rush.edu
JENNIFER ELLISON Director, Marketing AffairsJennifer.C.Ellison@osfhealthcare.org
DESI KOTIS Director, Professional Affairs
JENNIFER PHILLIPS Assistant Editor, KeePosted 630-515-7167 jphillips@midwestern.edu KATHRYN SCHULTZ Regional Director North
JULIE BUCEK Student Chapter LiaisonUniversity of IL C.O.P. bucek@uic.eduNADIYAH CHAUDHARY President, Rockford Student Chapter University of IL C.O.P. nadi925@gmail.comJANEY YU President, Student ChapterMidwestern University C.O.P. janey.yu@mwumail.midwestern.edu
BERNICE MAN President, Student Chapter Chicago State University C.O.P. bman@csu.edu TRAMAINE HARDIMON Student Representative Chicago State University C.O.P thardimo@csu.edu ZAK VINSON President, Student Chapter Southern Illinois University S.O.Pzvinson@siue.edu
ALEX MERSCH President, Student Chapter Roosevelt University C.O.P. amersch@mail.roosevelt.edu
JENNIFER AGUADO President, Student Chapter Rosalind Franklin University C.O.P. jennifer.aguado@my.rfums.org SCOTT MEYERS Executive Vice President, ICHP Office 815-227-9292 scottm@ichpnet.org
ICHP AFFILIATES
PETE ANTONOPOULOS President, Northern IL Society (NISHP) JULIA SCHIMMELPFENNIG President, Metro East Society (MESHP) jschimmelpfen@sebh.org MEGAN METZKE President, Sangamiss Society memiller8@yahoo.com
ED RAINVILLE President, West Central Society (WSHP) 309-655-7331x ed.c.rainville@osfhealthcare.org
Vacant Roles at Affiliates —
Director, Government Affairs; President, Rock Valley Society; Southern IL Society; Sugar Creek Society
Welcome New Members!
New Member |
Recruiter |
Mary Pfister |
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Ghadeer Abdelrahman |
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Elba Sertuche |
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David Martin |
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Naureen Kamal |
Ghadeer Abdelrahman |
Christopher Hutson |
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Katherine Sencion |
Michael Schmidt |
Wendy Chen |
Michael Schmidt |
Lauren Endriukaitis |
Michael Schmidt |
Bobbiann Auer |
Michael Schmidt |
Katherine Lee |
Michael Schmidt |
Zachary Bannor |
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Matthew Deraedt |
Michael Schmidt |
Ina Liko |
Michael Schmidt |
Lirije Culafovski |
Michael Schmidt |
Amber Williams |
Michael Schmidt |
Christopher Phillips |
Michael Schmidt |
Weiliang Kang |
Michael Schmidt |
Quratulain Ali |
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Michelle Kapugi |
Michael Schmidt |
Shivani Salvi |
Michael Schmidt |
Emily Armgardt |
Michael Schmidt |
Betty Khilevich |
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Anmin Wang |
Michael Schmidt |
Rebecca Kozuck |
Michael Schmidt |
Cong Nguyen |
Michael Schmidt |
Timothy Stoehr |
Michael Schmidt |
Nashrah Maryum |
Michael Schmidt |
Kayla Savant |
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Marie Choi |
Michael Schmidt |
Agnieszka Smirnow |
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Min Tzu Chung |
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Chalsea Aiwohi |
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Laura Lofky |
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Alvin Godina |
Michael Schmidt |
Steven Nylen |
Patrick Binaday |
Michael Sleiman |
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Alexandra Colorato |
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Seir Fen Davidson |
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Daniel Hinojosa |
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Amanda Jackson |
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Hung Le |
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Evangeline Oriakhi |
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Julia Sears |
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Calvin Thi |
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Byoung Hahm |
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Mark Wadley |
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Brooke Culen |
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Joseph Hegazin |
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Stacy Kmentt |
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Randall Ayar |
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Kaitlin Ferguson |
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Chelsea Burns |
Mitch Steinbrenner |
Edith Scigala |
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Gregory Garcia |
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Matthew Witt |
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Princess Mohammed |
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Maressa Kolo |
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Kavita Parikh |
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Zane Elfessi |
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David Hensler |
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Christina Bonanno |
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Lidia Grygutis |
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Kelly Park |
Gabriel Park |
Danielle Petric |
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Gina Milazzo |
Carolyn Toy |
Jad Khairallah |
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Angie Galetti |
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Navneet Singh |
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Stephanie Chang |
Michael Schmidt |
Stacey Pan |
Michael Schmidt |
Thuong Pham |
Michael Schmidt |
Kristin Orr |
Michael Schmidt |
Aimee Miller |
Michael Schmidt |
Daniel Gratie |
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Roshani Patel |
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Nicholas Liu |
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Jessica Lorenson |
Anna Arthur |
Pratixa Patel |
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Reham Mohamed |
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Matthew Steinbrenner |
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Linda Ngo |
Patrick Binaday |
Christine Azar |
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Vaidehi Patel |
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Shan Siddique |
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Laurel Jensby |
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Emily Donahue |
Anna Arthur |
Gregory Hakala |
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Rebecca Myers |
Ashley Brown |
Nedina Kalezic |
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Kelly Nagorzanski |
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Brian Montalbano |
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Nicholas Kolo |
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Jaclyn Sullivan |
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Rouzan Srour |
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Reem Farooq |
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Kristen Nelson |
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Georgia Katsoulis |
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Marina Koval |
Michael Schmidt |
Michelle Travieso |
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Peter Wu |
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Estera Opris |
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Maria Evan |
Chris Rivers |
Emily Ludke |
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Amal Azar |
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Sabeen Rizvi |
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Michelle Wegge |
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Aparna Reddy |
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Farheen Jefferi |
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Hieu Nguyen |
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Manahil Malik |
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Michelle Jara |
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Humera Syed |
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Michelle Solano |
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Chandni Vaidya |
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Sherif Abdou |
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Susanna Moulton |
Desi Kotis |
Sara Juraco |
Elizabeth Sebree |
Jill Shah |
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Edward Eischen |
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Hwai Luu |
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Ana Fernandez |
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Colleen Ball |
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Jacob Johnson |
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Hardik Majmudar |
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Karam Alkakoz |
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Leena Patel |
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Tina Lertharakul |
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Edith Liang |
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Chau Tran |
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Christina Nguyen |
Janey Yu |
Dom Nguyen |
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Yiyang Wang |
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Aisha Karim |
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Najibullah Wardak |
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Nora Jaber |
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Salma Shah |
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Beth Lubecke |
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Kaitlin Starosta |
Gary Peksa |
Tracie Motyka |
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Leslie LaMontagne |
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Tristan O'Driscoll |
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Rebecca Jett |
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Ashley Santore |
Michael Schmidt |
Elizabeth Eitzen |
Michael Schmidt |
Julie D'Amico |
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Asmaa Mustafa |
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Julie Tromp |
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Diana Park |
Stephen Jankovic |
Roxann Miller |
Maxine Lenz |
Adrienne Jones Rogan |
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Morenike Ope-Oyelahan |
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Christine Rash |
Michelle Martin |
Marissa Pasquini |
Michael Schmidt |
Leena Hamadeh |
Michael Schmidt |
Nahome Fisseha |
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Quynh Hoang |
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Ariane Ganza |
Michael Schmidt |
Lisa Nguyen |
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Brian Maynard |
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Tram Thai |
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Steven Engles |
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Peter Nguyen |
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Niveen Hilal |
Michael Schmidt |
Maria Bottorff |
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Lyly Tran |
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Georgiana Ismail |
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Bruce Hartman |
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Sabrin Jaber |
Michael Schmidt |
Alex Hadesman |
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Wajiha Syed |
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Jessica Peng |
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Josh Gener |
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Lauren Miklavcic |
Ann Corkery |
ICHP Pharmacy Action Fund (PAC) Contributors
GENERAL ASSEMBLY GUILD - $1000 & More Scott BergmanKevin ColganEdward DonnellyDave HicksFrank KokaislWilliam McEvoy
Scott MeyersMichael NovarioMichael WeaverThomas Westerkamp SPRINGFIELD SOCIETY - $500-$999 Stephanie CrawfordRauf Dalal
CAPITOL CLUB - $250-$499
Margaret Allen
Vern Johnson
Janette Mark
Edward Rainville
Heidi Sunday
Jill Warszalek
LINCOLN LEAGUE - $100-$249
Anonymous
Phyllis Lulinski
Marie Williams
GRASSROOTS GANG - $50-$99
Jennifer Ellison
Glenna HargreavesBarbara Smith CONTRIBUTOR - $1-$49 Izabela Wozniak
Upcoming Events
Monday, November 4
Clinical Practice and Research Network Meeting
Northwestern Memorial Hospital | Chicago, IL
Monday, November 4 and Wednesday, November 13
CPE Event! Champion Webinar: Mr. ROSS
LIVE Webinar
Wednesday, November 6
CPE Event! NISHP Webinar with LIVE Q&A: 2013 Clinical Practice Guidelines for Pain, Agitation, and Delirium
University of Illinois at Chicago College of Pharmacy | Chicago, IL
Tuesday, November 12
CPE Event! Live CPE Program: A Review of Pneumococcal Vaccination Recommendations and Considerations for Use of Prevnar 13®
Lake Pointe Grill | Springfield, IL
Wednesday, November 20
Pharmacy Directors Network Dinner
Via Carducci | Chicago, IL
Tuesday, December 3
Non-CPE NISHP Program: Effient (prasugrel): Antiplatelet Therapy for Patients with Acute Coronary Syndrome (ACS) Managed with Percutaneous Coronary Intervention (PCI)
Maggiano's | Oakbrook, IL
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