Directly Speaking - The PPMI Four letters to learn to live!

by Scott A. Meyers, Executive Vice President, RPh, MS, FASHP
March 20, 2012

Rather than learning to love these four letters, what exactly do I mean by learning to live the PPMI?  The PPMI is ASHP’s new Pharmacy Practice Model Initiative (PPMI) that is the result of a summit held nearly 18 months ago.  Unless you are not an ASHP member and have not attended an ICHP Spring or Annual Meeting since the November 2010 Summit, you’ve probably heard something about it at least once or twice.

The PPMI Summit - If you haven’t heard about the PPMI, here’s a very brief summary of the event and its recommendations because the focus of this article is to ask Illinois Pharmacy leaders to take the next step toward the PPMI by completing the Hospital Self-Assessment and Action Plan.  The PPMI Summit was held in Dallas, TX on November 7-9, 2010 with approximately 100 health-system pharmacy leaders in attendance.  Their goal was to discuss and then describe the pharmacy practice model for health-system pharmacy in the future.  ASHP’s Pharmacy Practice Model Initiative was intended to:

  1. Create a Framework - Create a framework for a pharmacy practice model that ensures provision of safe, effective, efficient, accountable, and evidence-based care for all hospital/health system patients;
  2. Determine Services - Determine patient care-related services that should be consistently provided by departments of pharmacy in hospitals and health systems and increase demand for pharmacy services by patients/caregivers, healthcare professionals, healthcare executives, and payers;
  3. Identify Emerging Technologies - Identify the available technologies to support implementation of the practice model, and identify emerging technologies that could impact the practice model;
  4. Develop a Template - Support the optimal utilization and deployment of hospital and health-system pharmacy resources through development of a template for a practice model which is operational, practical, and measurable; and
  5. Implement Change - Identify specific actions pharmacy leaders and staff should take to implement practice model change including determination of the necessary staff (pharmacy leaders, pharmacists, and technicians) skills and competencies required to implement this model.)

The Summit participants came up with five areas of beliefs, assumptions and recommendations.  They were:
A.    Imperatives for the new pharmacy practice model
B.    Optimal pharmacy practice models: characteristics, requirements, and challenges
C.    Advancing the application of information technology in the medication use process
D.    Advancing the use of pharmacy technicians
E.    Successful Implementation of the new pharmacy practice models

From these specific areas of discussion came 74 beliefs and assumptions that in turn resulted in specific recommendations.

Now you’re probably asking yourself, “So what do I do with the results from the PPMI Summit?  What does this have to do with my institution here in Illinois?  Why is this pharmacist who no longer practices pharmacy as I know it telling me all this?”  

The answer to your questions is that it’s my job to carry out the mission of ICHP which is “Advancing excellence in the practice of pharmacy.” Encouraging each Illinois hospital pharmacy to move closer to what the PPMI Summit identified as the future model of pharmacy practice is one way I can do that.

The Hospital Self-Assessment (HSA) Challenge - A few of you (pharmacy directors and managers) have already taken the next step that I recommend, but apparently most of you have not.  Only 12 of Illinois’ 230 hospitals have completed the HSA that will tell you where your institution currently sits with respect to the PPMI recommendations and assumptions.  The HSA is a 106 question survey that once completed will measure your institution’s status compared to the PPMI and will provide you with a benchmark with how you compare to the aggregate of all the other institutions who have also completed it.

The HSA is not a simple survey.  The 106 question length of it should be your initial indicator, and some of the questions will require a little searching or digging for numbers.  The average participant thus far indicates that the survey takes approximately two hours to complete.  But the results will be well worth it!

Here’s why completing the HSA is important on several levels.  First, it tells you, the pharmacy director, pharmacy manager or other pharmacy staff where you are with respect to the newly proposed model.  This provides goals and identifies opportunities for practice improvement.  Second, it provides you with ammunition (data) to show your administration where you would like to lead the pharmacy department in order to better serve your patients, physicians and other staff.  Changes cost money and time and data is critical when asking for either from your administration.  Data on how you can improve care is a valuable resource.  Finally, it provides ICHP with data to use in the legislative and regulatory arenas to change the Pharmacy Practice Act and Rules to enable you to achieve this new model.

Short-term goal of the HSA Challenge – Along with all of the above mentioned reasons for completing the HSA, I am encouraging you to do it now so that during the ICHP Annual Meeting in September, we can use the aggregate data to present a “State of the State and the PPMI” program.  This program will review where we are in Illinois in general.  We will also identify a few key areas where all of Illinois needs to do some heavy lifting to achieve a recommendation or goal and then bring in practitioners who have met that goal to show you how you can too!  It would be nice to have at least 50% of Illinois’ 230 hospital pharmacy directors complete the HSA.  The higher the response rate, the more robust and representative our data will be and the better we’ll be able to help move your institution forward.

How to get started – The HSA is available here:  Download and print it before you begin, so that you can gather all the information you will need before you begin.  You may also go directly into the self-assessment and begin to enter data and save periodically when you need to dig for answers, but reviewing the document in advance may give you a better idea of the types of information required to answer the questions accurately.

How non-directors can help – If you’re not a pharmacy director or manager but feel this is an important step your department needs to take, share this article with your director or manager.  Offer to gather data that will be necessary to answer the assessment questions.  Even offer to complete the HSA yourself for your boss!  Encourage your colleagues to read up on the PPMI.  Get a better understanding of what steps you can quickly take to improve your practice and which steps are going to take some serious time and effort.

Is the PPMI the Holy Grail? – A very large percentage of the recommendations of the PPMI are on target with where practice needs to be.  There are a few that will be difficult if not impossible stretches in the time frames the Summit participants have suggested.  For one, the recommendation that by 2015 any technician taking the PTCB certification exam must first have completed an accredited training program is more than a stretch.  On the other hand, requiring a background check for those same candidates by that time seems much more achievable.  There may be other examples you will find and you read through the PPMI Summit proceedings that you feel are more than a stretch, but I’m sure you will find that the vast majority of the recommendations will improve pharmacy practice and patient care.  You will also find that your institution is already on its way toward the practice model and that while you may not meet some recommendations now, you may have already mastered others.

The ICHP office will be sending out email and mailed encouragements to the pharmacy directors and managers asking them to complete the HSA.  We will also provide progress reports to add to the motivation.  I hope that PPMI will become four letters we all learn to live!

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