x44968 pharmacy services ap 2011 - ASHP Media · X44968 (05/12) ©AHC Department of Pharmacy Services Annual Report 2011 Department of Pharmacy Services

X44968 (05/12) ©AHC

Department of Pharmacy Services

Annual Report 2011


b • Department of Pharmacy Services • Annual Report 2011 Department of Pharmacy Services • Annual Report 2011 • 49

48 • Department of Pharmacy Services • Annual Report 20114848 •• DeDeDepapartrtmementnt of f PhPhara mam cy SServiv cees • AnAAnnual RRRepepeporoo t 20201111 Department of Pharmacy Services • Annual Report 2011 • 1

ContentsWelcome ......................................................................................................................................................... 2Organizational chart ............................................................................................................................................ 3Strategic goals ..................................................................................................................................................... 4Provide the best patient experience .................................................................................................................... 4Drive operational excellence ............................................................................................................................... 4Lead and influence health care reform ................................................................................................................ 4

Provide the best patient experience .................................................................................................... 5Inpatient pharmacy services ................................................................................................................................ 5Aurora Pharmacist Practice Council ......................................................................................................................5Technician training program ................................................................................................................................ 5Ambulatory care pharmacy services ................................................................................................................... 6Pharmacist-managed clinics ............................................................................................................................... 7Aurora Cancer Care ............................................................................................................................................. 8Aurora eICU® Care pharmacy services .................................................................................................................. 9Drug use policy ................................................................................................................................................ 10Investigational drugs ........................................................................................................................................ 10

Pharmacy residency programs ............................................................................................................. 112011 major residency program accomplishments .............................................................................................. 12Residency program goals/initiatives for 2012 ..................................................................................................... 12

Drive operational excellence ................................................................................................................. 13Pharmacy supply chain group ........................................................................................................................... 13Lynx inventory management system .................................................................................................................. 13Information technology ..................................................................................................................................... 14 Centralized order entry...................................................................................................................................... 14 Automation ....................................................................................................................................................... 14Medication packaging center............................................................................................................................. 15

Aurora Health Care inpatient hospital pharmacies ....................................................................... 16

Department of Pharmacy Services – financial performance ...................................................... 31

Publications ....................................................................................................................................................... 32Presentations ..................................................................................................................................................... 33Poster presentations .......................................................................................................................................... 36Honors and awards ........................................................................................................................................... 38Board of Pharmacy Specialties-certified pharmacists .......................................................................................... 38Technician certification ...................................................................................................................................... 40Appointments to professional organizations, offices, boards ............................................................................. 42PharmD student rotations ................................................................................................................................. 45Resident projects ............................................................................................................................................... 46

2 • Department of Pharmacy Services • Annual Report 2011

Welcome to the inaugural annual report of Aurora Health Care’s Department of Pharmacy Services. This report provides an overview of the

accomplishments and challenges of the department in 2011. Our pharmacists, pharmacy technicians, managers and other valued caregivers have worked hard this year to address challenges in health care, and I am excited and proud to offer this report of our many accomplishments.

During the past year, we have made a concerted effort to maintain our exceptional patient care experience in spite of unprecedented national and international drug shortages. Through careful administration, our department’s Drug Use Policy and Pharmacy Supply Chain groups have allowed us to continue to deliver our standard of uncompromising care by managing system inventory levels of critical drugs and quickly developing alternatives when necessary. Their hard work is particularly evident in the access to care we now can offer through Aurora Cancer Care, our newly transitioned ambulatory oncology clinics.

“340B” may very well be the term of the year. 340B refers to a federal drug pricing program that allows certain disproportionate-share hospitals to buy drugs at signifi cant discounts for outpatients. Along with strict inventory management, this program saves money for Aurora while improving access to services and critical medications for patients in our communities. In 2011 alone, and with the assistance of many members of our team and caregivers in other departments, we saved more than $10 million.

We have invested time and expertise in technology to improve safety, compliance and operational effi ciency through the use of automation, telepharmacy and our electronic health record, Smart Chart. Additionally, the implementation of Alaris pumps for intravenous use has signifi cantly improved patient safety through its smart

pump technology in hospitals across the system. The Lynx inventory management system has helped achieve cumulative savings of $1.3 million. A centralized order entry model, currently in development, will provide our pharmacists with opportunities to be closer to patients and to be an integral part of health care team.

Finally, we have expanded our PGY-1 pharmacy residency training programs to include two more sites, as well as critical care and oncology PGY-2 residencies. Our staff members continue to participate in state and national pharmacy organizations providing input and leadership for positive change in pharmacy and the health care fi elds.

There is an old Chinese proverb, “May you live in interesting times.” I certainly feel as though 2011 provided some interesting times. The economy continued to struggle through a recession. Unemployment was at modern-day record highs. The public continued to rebel against higher health care costs and poor patient outcomes. Wisconsin saw unprecedented political upheaval. Despite all of this, we have conquered those challenges to improve patient safety and access to important medications, and reduced the cost of care for patients and the communities we serve.

So, it is with great pride that I present to you the 2011 accomplishments of Aurora Health Care’s Department of Pharmacy Services.

Tom Woller, MS, FASHPSenior Vice PresidentPharmacy Services

Department of Pharmacy Services • Annual Report 2011 • 47 DeDDD parttmentnt oof f PhPhararararmmmamamaccy Servicees s • AnAnAnAnAnnnun al Reppporo ttt 20200201111111 • 4444477 7

Lydon E. Evaluation of observation patient medication practices at Aurora St. Luke’s Medical Center.

The Aurora Health Care Department of Pharmacy Services strives to develop medication practices in Aurora Health Care hospitals that are as safe and effi cient as possible, including observation patient medication practices. The goal of this project is to evaluate and optimize the observation patient medication process at Aurora St. Luke’s Medical Center.

Shuey S. Development of collaborative practice agreements for the management of constipation and diarrhea in patients with cancer.

Aurora Health Care Department of Pharmacy Services identifi ed an opportunity for pharmacists to participate in the management of constipation and diarrhea in patients with cancer. The purpose of the project is to develop evidence-based algorithms for the management of constipation and diarrhea by pharmacists in patients with cancer and incorporate them into collaborative practice agreements (CPAs) for use in the inpatient setting.

Tomczak J. Prostaglandin conversion protocols for patients with pulmonary hypertension.

The complex process of transitioning pulmonary hypertension patients on parenteral prostaglandin analogs involves several carefully planned steps and close monitoring. Currently, there are no standardized protocols in place at ASLMC for these processes. The goal of this project is to create standardized protocols for transitioning pulmonary hypertension patients from one parenteral prostacyclin agent to another.

Van Gompel N. Implementation of inventory control strategies within an integrated health care system and evaluation of the fi nancial impact.

Inventory management represents a vital cost to the pharmacy budget, and not optimizing control measures results in excessive product and slow inventory turn rates. Maximum levels and reorder points were established at each hospital, while inventory cabinets were installed at select oncology clinics.

Verbunker L. Measuring the performance of an insulin infusion protocol.

Aurora Health Care implemented a system-wide insulin infusion protocol in July 2011 to ensure a consistent approach for the management of insulin infusions. The goal of this project is to utilize effi cacy and safety data, or glucometrics, to measure the performance of the insulin infusion protocol.

Zhu A. Evaluating cost-effective pharmacist services for Aurora Health Care Clinics.

In anticipation of the changes in health care reimbursements, the Aurora Health Care pharmacy leadership recognizes the need to investigate the feasibility of having more pharmacist involvement in the ambulatory care clinics. The objective of this project is to examine the cost-effectiveness of pharmacist services in clinics and recommend an effective ambulatory pharmacist practice model at Aurora Health Care.

Zimmerman J. Daily interruption of continuous sedation: a multidisciplinary approach for the mechanically ventilated.

Multiple randomized controlled trials have demonstrated that daily interruption of sedation paired with spontaneous breathing trials and early and aggressive physical and occupational therapy have positive outcomes for mechanically ventilated patients without compromising patient safety. The primary objective is to implement a multidisciplinary, evidence-based, best practice protocol that involves a daily interruption of sedation combined with spontaneous breathing trials and early physical and occupational therapy

46 • Department of Pharmacy Services • Annual Report 20114646666 •• DeD partment of Pharmamacycy SSereerviviv ces • AnAnnunualal RRRRRReepe orororrt 200111

Resident projectsBates C. Customization of medication-related alerts to optimize computerized clinical decision support.

The Aurora Health Care System Department of Pharmacy Services identifi ed a need to optimize the medication warnings that the end-user sees in Epic. The goal of this project is to adjust the fi lter settings in an effort to minimize alert fatigue and maximize clinical relevance of medication warnings.

Bernichi B. Standardization of non-sterile compounding throughout a multi-hospital system.

There is a lack of consistency with non-sterile compounding documentation within Aurora Health Care’s 15 hospital integrated system. The current practices are variable between sites and are incompatible with U.S. Pharmacopoeia USP <795> standards and ASHP Technical Assistance Bulletin. The project involves standardization of non-sterile compounding documentation and computer entries throughout a multi-hospital system.

Crnic T. Development and implementation of productivity standards in a health care system packaging center.

Productivity standards allow for the identifi cation of productivity shortcomings and opportunities for improving effi ciency and output. The objective of this study is to develop and implement productivity standards within Aurora Health Care’s Packaging Center.

Desai M. Development of models for pharmacist involvement in discharge medication reconciliation process at Aurora Health Care.

Develop various models for pharmacist involvement in discharge medication reconciliation with a focus on transitions of care. This will be measured through reduction in 30-day readmissions as well as observing trends in medication related discrepancies where pharmacists can make an impact. Greater emphasis will be on increase prescription capture through site’s outpatient pharmacies to improve patients access and adherence to medications.

Gianakakos S. Optimization of unit base cabinet inventory and controlled substances accountability through utilization of reporting tools

The current commercially available data reporting tool available at Aurora Health Care to evaluate Pyxis inventory control and controlled substances accountability is not being used effi ciently due to the diffi culty of analyzing the data provided. I am piloting a new commercially available tool to determine if it is easier for managers to use to help improve inventory control and controlled substances accountability.

Guetschow T. Creating and optimizing system-wide pharmacy to prescriber communication.

Aurora Health Care Department of Pharmacy Services identifi ed a need to improve communication with both hospital and non-hospital based prescribers. The goal of this project is to develop a method to disseminate important and relevant pharmacy information including shortages and safety alerts.

Kilburg A. Development and implementation of processes to improve transition of care from inpatient stay to outpatient setting while increasing prescription revenue.

Aurora Health Care Department of Pharmacy Services recognized an opportunity to improve the transition of care from the inpatient stay to the outpatient setting while increasing prescription revenue in the outpatient pharmacy. The goal of this project is to increase the number of discharge prescriptions captured by the outpatient pharmacy as well as increase patient satisfaction regarding the medication education they receive at discharge.

King S. Evaluation of the impact of pharmacist polypharmacy reviews on readmissions.

Extensive polypharmacy reviews on readmissions utilize three tools to evaluate a patient’s current medications and make therapeutic recommendations to reduce their risk of readmission within 30 days. The project was designed to explore an additional service that pharmacy may offer to potentially decrease 30 day readmissions in Aurora Health Care hospitals.

Department of Pharmacy Services • Annual Report 2011 • 3

4 • Department of Pharmacy Services • Annual Report 201144 • Department of Pharmacy Services • Annual Report 2011

Strategic goalsAurora Health Care’s Department of Pharmacy Services serves patients with a single purpose and vision – to help people live well, and to provide people with better health care than they can get anywhere else.

Provide the best patient experience Creating an environment conducive to real healing is central to providing the best patience experience and consequent patient loyalty. Three key concepts we focused on during 2011 are as follows:• Expanded roles of pharmacy technicians and pharmacists

to become an integrated part of patient care team• Continued to strengthen relationships with schools of

pharmacy (Concordia University Wisconsin, University of Wisconsin – Madison and Rosalind Franklin University)

• Improved and expanded pharmacy residency programs to generate exceptional clinical pharmacists and pharmacy leaders

Drive operational excellence Effi cient, convenient operations increase the time available for us to emphasize and promote the best patient experience and clinical quality. Pyxis unit-based cabinet restocking at all sites and installation of IntelliShelf-Rx systems aided in the drive for operational excellence. To further streamline processes, we: • Implemented barcode scanning at multiple sites to improve

patient safety• Piloted centralized/virtually centralized order verifi cation

to increase operational effi ciencies• Optimized 340B drug discounts for Aurora Health Care

Metro Inc.

Lead and influence health care reform Participating in the reform process will allow us to infl uence how pharmacy practice will change, which in turn provides opportunities to develop operational effi ciencies. To be a leader and infl uence health care reform, we:• Completed successful rollout of Epic at Aurora St. Luke’s

Medical Center, one of the largest hospitals in southeastern Wisconsin

• Increased focus on Aurora pharmacists and technicians to have infl uence at state and national levels

• Pursued planning stages for American Society of Health-System Pharmacists – Pharmacy Practice Model Initiative within Aurora, including redesigning the roles of pharmacy technicians and pharmacists


Caregiver Organization/Office/Board Appointed position Dates of service

Thomas Woller, MS, FASHP

Apexus 340B Prime Vendor Group

Board of Directors 2008 – Present


Apexus 340B Prime Vendor Group

Vice Chair 2010 – Present


Pharmacy Society of Wisconsin Charter Member 1998 – Present


American Society of Health-system Pharmacists

Commission on Credentialing Residency Program Surveyor

Tiffany Nies, CPhT Milwaukee Career College Pharmacy Technician Program Advisory Board

2011 – Present

PharmD student rotations

SiteUW – Madison

ConcordiaMidwesternChicago

Iowa Drake Other

ASLMC 18 30 1 2

ASMC 6 1 MATC – 2

AMCS 6

AMCG 4

AWAMC 8 1

AMCMC 2

ABMC 8 4 1

ASMMC 1 2

AMCWC 4

ALMC

AMCK 1 6 1 South Univ. Savannah, GA – 2Midwestern Univ. Glendale, AZ – 1Univ. of Minnesota – 2

MHOB 1

APH

AMCO 4 2 1

ASLSS 2



Paul Windisch, PharmD

Pharmacy Society of Wisconsin JPSW Editorial Board

Prati Wojtal, MS, RPH Pharmacy Society of Wisconsin Milwaukee Area Membership Task Force

Prati Wojtal, MS, RPH Premier Chair of Automation and Medication Supply Task Force

Robert Bayudan PharmD, BCPS

Rosalind Franklin University – School of Pharmacy

Clinical Assistant Professor of Pharmacy Practice

October 2011 – Present

Robert Bayudan, PharmD, BCPS

Concordia University Wisconsin – School of Pharmacy

Interview Committee

Ryan Servais, PharmD, BCPS

Pharmacy Society of Wisconsin Leadership Conference

Ryan Servais,PharmD, BCPS


Ryan Servais,PharmD, BCPS


Sarah Ray, PharmD, BCPS

American Pharmacists Association Chair Elect of the Clinical/Pharmacotherapeutic Section of the Academy of Pharmacy Practice and Management

March 2010 – March 2011


American Pharmacists Association Chair of the Clinical/Pharmacotherapeutic Section of the Academy of Pharmacy Practice and Management

March 2011 – Present




2008 – Present

Scott Missall, PharmD Epic Willow Inpatient Certification

Sol Yoder, PharmD, BCOP

Hematology Oncology Pharmacy Association (HOPA)

Member of HOPA Oncology Pharmacy Practice Standards Task Force

2011 – 2012

Stephanie Santos, PharmD

Epic Willow Inpatient Certification

Sue Haight, MS, PharmD

Pharmacy Society of Wisconsin Hospital Pharmacy Advisory Board 1/2012 – Present


CUWSOP Experiential Education Preceptor Advi-sory Board

1/2012 – Present



Suzanne Kopp, RPH Concordia University Wisconsin – School of Pharmacy

Interview Committee

Teresa Kreger Epic Willow Inpatient Certification



Pharmacy Residency Excellence Award Recipient Selection Committee

2010 – Present



Pharmacy Residency Capacity Stakeholders Conference

Feb – 2011


Premier Purchasing Group National Pharmacy Advisory Committee 2004 – 20092010 – Present

Appointments to professional organizations, offices and boards

Department of Pharmacy Services • Annual Report 2011 • 5 Department of Pharmacy Services • Annual Report 2011 • 5

Provide the best patient experienceInpatient pharmacy servicesBased on the model of patient-centered care, the Aurora Health Care Department of Pharmacy Services continues to focus on superior clinical quality. With patient safety a top priority, clinical pharmacists practice evidence-based medicine, aided by clinical tools that are developed based on the most recent clinical guidelines and Aurora System Pharmacy and Therapeutic Committee policies. Inpatient pharmacy services are provided by centralized and decentralized pharmacy models that vary across the system. Despite the variation, our top-quality clinical services include:• Verifying medication orders for hospital sites that are

computer physician order entry (CPOE) or pharmacist order entry of medication orders for non-CPOE sites to ensure safety of individualized medication therapies for inpatients

• Reviewing patients’ profi les for allergies, duplicate therapies and drug-drug interactions to optimize drug regimens to minimize adverse drug reactions and events

• Providing medication recommendations to physicians and members of the medical team to assist with treating patients safely and effectively

• Monitoring of vancomycin, aminoglycosides, phenytoin and valproic acid based on clinical indication and therapeutic drug monitoring

• Anticoagulation monitoring of unfractionated heparin, low molecular weight heparin and warfarin according to The Joint Commission to reduce the risk of bleeding events associated with anticoagulation

• Monitoring of antibiotics for indication, cultures and sensitivities to optimize antibiotic use, and promoting antimicrobial stewardship, including dose adjustment and adherence with restriction policies

• Adjusting dosage of multiple drugs based on Aurora System Pharmacy and Therapeutic Committee renal dosing policy to prevent adverse events

• Reviewing of medications that are on the Beers list to prevent or avoid serious adverse events

• Converting medications from IV to PO route of administration to help responsibly manage resources

• Providing discharge counseling to patients on high-risk medications, such as insulin U-500 and warfarin

• Continuing pharmacy technician accountability for bedside barcode medication administration functions, and continuing to troubleshoot issues to place patient safety as a high priority

Aurora Pharmacist Practice Council The Aurora Pharmacist Practice Council was developed in 2009 as a systemwide clinical decision-making body. The members of the council focus on developing safe, consistent, responsible and high-level pharmacy practice standards across the system. All 15 Aurora Health Care inpatient facilities are represented on the council, along with representatives from the pharmacy cabinet, pharmacy leadership council, care management group, clinical coordinators and pharmacy informatics.

Notable achievements in 2011 include:• Increased the visibility of pharmacists by focusing on

pharmacist-patient encounters• Developed a strategy and decision-making tool for council

decisions regarding Cerner and Epic computer systems• Developed a standardized vial reconstitution list for

consistency across IV rooms systemwide• Recommended site-based rapid response teams to

standardize products contained in code carts, resulting in signifi cant savings

• Planned next steps for moving toward goals defi ned by American Society of Health-System Pharmacists – pharmacy led Pharmacy Practice Model Initiative

Technician training programThe department of pharmacy services has created a formal pharmacy technician education and training program. The fi rst class is planned for Aurora St. Luke’s Medical Center in April 2012 with plans to expand the program throughout the system.

Program goals focus on providing comprehensive and consistent training for the expanding roles and responsibilities within the technician group. This includes increasing caregiver engagement while decreasing technician turnover, and helping to improve patient safety.

This comprehensive education and training program is 16 weeks in length, and will be comprised of 400 hours of broad-ranging didactic courses and 200 hours of experiential learning. The program will be offered twice yearly with the goal of training 25 to 50 technicians per year.

6 • Department of Pharmacy Services • Annual Report 20116 •• DeDepapartrtmemementnt ooof f PhPhararmamacycy SSSererviviv ccecececeesssss ••• AAnAnnunualal RRepepeporort tt 20202011111

Ambulatory care pharmacy servicesThe Department of Pharmacy Services provides care for the diverse needs of patients who access the 135 clinics and 15 hospitals of Aurora Health Care. Aurora Pharmacy Inc. is a centrally managed operation of more than 70 for-profi t pharmacies, dedicated to serving both patients and caregivers of Aurora Health Care.

These pharmacies deliver timely and accurate prescription services by providing drug information, transitioning

patient cases from inpatient to outpatient, and coordinating prescription drug coverage benefi ts. The team is likewise focused on providing complementary over-the-counter medications and home medical equipment.

State-of-the-art technology and automation are used in the outpatient pharmacies, allowing the pharmacists to focus on patient care and provider support rather than distributive functions.

2011 ambulatory services summary

Medication Therapy Mgt. (through November 2011)

Immunizations (through November 2011)

Pharmacy Prescriptions RevenueEst. cost avoidance*

Quantity Revenue

Aurora St. Luke’s Medical Center – Outpatient

97,209 $4,397 $151,269 191 $20,047

Aurora St. Luke’s – Physician Office Building

34,734 $3,332 $67,038 145 $10,633

Aurora St. Luke’s South Shore – Outpatient

28,658 $446 $2,703 37 $4,797

Aurora Sinai Medical Center – Outpatient Pharmacy

39,609 $828 $141,509 13 $838

Aurora Sinai – Outpatient Health Center

30,820 $255 $2,128 0 --

Aurora Psychiatric Hospital 16,663 $249 -- 0 --

Aurora West Allis Medical Center – Aurora Pharmacy

55,359 $774 $6,607 3 $156

*Estimated cost avoidance as calculated by Outcomes Pharmaceutical Health Care



Craig Herman, PharmD


Dennis Brierton, PharmD, BCPS, FASHP

Pharmacy Society of Wisconsin Chair, Hospital Pharmacy Advisory Board

1/2011 – 12/2012

Eleanor Shterenfeld, PharmD


Interview Committee

Emma Hews, PharmD Pharmacy Society of Wisconsin JPSW Editorial Board

Eze Elechi PharmD Concordia University Wisconsin – School of Pharmacy

Interview Committee

Greg Weber, MS, RPH Wisconsin Pharmacy Examining Board

Chairman of the Board 20122008 – 2009

Greg Weber, MS, RPH Wisconsin Pharmacy Examining Board

Member 2006 – Present

Gretchen Mokros Pharmacy Society of Wisconsin President of Technician Board August 2011 – Present

Jane Bubik, RPH Pharmacy Society of Wisconsin JPSW Editorial Board

Jane Bubik, RPH Concordia University Wisconsin – School of Pharmacy

Interview Committee

Jane Spaeth, CPhT Epic Willow Inpatient Certification

Jules Felsecker, PharmD


Interview Committee

Julie Dagam, PharmD, BCPS



2011 – Present

Katie Valdovinos, PharmD, BCPS

Pharmacy Society of Wisconsin JPSW Editorial Advisory Board


CUWSOP Assessment Committee October 2011 – Present


AACP New Investigator Award Reviewer Oct – 2011


ACCP Annual Meeting Resident/Fellow Travel Award Reviewer

Sep – 2011


AACP Pharmaceutics Section Planning Committee for 2012 AACP Annual meeting

September 2011 – Present



Delegate for 2011 AACP Annual Meeting House of Delegates

July – 2011



Assistant Professor – Pharmacy Science

Linda Cook, CPhT Pharmacy Society of Wisconsin Technician Section Board SecretaryBoard Member

2010 – 20112010 – Present

Mike Grunske, PharmD, BCPS

Pharmacy Society of Wisconsin Board of Directors August 2010 – Present

Olivera Gligorevic, CPhT

Pharmacy Society of Wisconsin Technician Region Director E 2011 – Present

Patty Hill, PharmD Pharmacy Society of Wisconsin Leadership Conference


Technician certification

Packaging Center

Kari Cordie Frieda Hakim Theresa Lackowski

Automation Team

Bonnie Niemuth Vidalia Rodriguez Benita Zarate

Donna Zoltak

Pharmacy IT

Amber Pekel Jane Spaeth Jackie Brown

Appointments to professional organizations, offices and boards


Abby VenHuizen PharmD


Interview Committee

Allan Loeb, MS, RPH Pharmacy Society of Wisconsin Board of Directors August 2010 – Present

Amber Pekel, CPhT Epic Inpatient Decision Support Masters Certification

Amber Pekel, CPhT Epic Reporting Workbench, Report Writing, and Administration Certification

Anne Sexton, CPhT Concordia University Wisconsin – School of Pharmacy

Assistant Instructor Pharmaceutics Lab

Arlene Iglar, MS, RPH American Society of Health-system Pharmacists

ASHP House of Delegates 2008 – 2013

Arlene Iglar, MS, RPH American Society of Health-system Pharmacists

Council on Pharmacy Practice Nov – 2011

Ashley Feldt, PharmD, MBA


Barry McClain, PharmD, MS

American Society of Health-systems Pharmacists

New Practicioners Forum Communications & Technology Advisory Group

2011 – Present


American Society of Health-systems Pharmacists

ASHP Section Advisory Group on Ambulatory Care Informatics

2010 – 2011

Chad Smith, PharmD, MBA, BCPS


Chad Smith, PharmD, MBA, BCPS

Pharmacy Society of Wisconsin Hospital Director Newsletter

Chris Lodl, RPH Concordia University Wisconsin – School of Pharmacy

Interview Committee

Chris Lodl, RPH Concordia University Wisconsin – School of Pharmacy

Selection Committee

Cindy Erickson, PharmD


Department of Pharmacy Services • Annual Report 2011 • 7 Department of Pharmacy Services • Annual Report 2011 • 7

Major 2011 accomplishments• Achieved drug cost savings of $1.5 million by participating

in 340B program at fi ve Aurora Health Care sites• Received “Best in Class” designation by Outcomes

Pharmaceutical Health Care• Estimated cost avoidance of $394,411 from March 2011

through August 2011• Participated in Aurora Pharmacy Central Fill Pharmacy

rollout, which enhances patient convenience by generating automatic refi lls available for pickup at an Aurora Pharmacy or mailing prescriptions directly to the patient’s home

• Participated in the Aurora Pharmacy Durable Medical Equipment accreditation

• Remodeled the Aurora St. Luke’s Outpatient Pharmacy to include a full line of durable medical equipment

• Trained for implementation of electronic medical record (Smart Chart) at Aurora St. Luke’s

• Completed renovations at Aurora St. Luke’s South Shore, Aurora St. Luke’s Physician Offi ce Building and Aurora Sinai outpatient pharmacies

• Implemented discharge pilots that focus on transitions of care and increased prescription capture

2012 goals/initiatives• Achieve 340B drug cost savings in “organization 100”

pharmacies• Assess and increase capture of discharge prescriptions

at Aurora St. Luke’s, Aurora St. Luke’s South Shore and Aurora Sinai medical centers

• Advance Pharmacy Practice Model Initiative in the outpatient pharmacies

• Expand the role of pharmacists in primary care clinics

Pharmacist-managed clinicsAmbulatory anticoagulation clinicsTwo pharmacist-managed ambulatory anticoagulation clinics are available at Aurora Sinai and Aurora St. Luke’s.

Ambulatory anticoagulation clinics operate under an institutional collaborative practice agreement. The pharmacists evaluate and manage 285 patients at Aurora Sinai and 300 patients at Aurora St. Luke’s.

Major 2011 accomplishments• 5,795 patient visits at Aurora St. Luke’s Medical Center• 4,806 patient visits at Aurora Sinai Medical Center• Participated in structure and development of 19 ambulatory

anticoagulation clinics throughout Aurora

Medication Therapy Management clinicLocated in the Family Practice Center at Aurora St. Luke’s, the Medication Therapy Management clinic was established in October 2010 as a pharmacist-managed outpatient clinic practice to provide disease management. Patients are referred to a pharmacist for diabetes, lipid, hypertension and general medication management.

The clinic provides high-quality patient education, including evaluation and management under an established collaborative practice protocol to assure optimal outcomes.

Major 2011 accomplishments• 288 patient visits• Average decrease of 1 percent Hgb A1c was seen for

19 patients being managed for diabetes• Average decrease of 13/6 mm Hg was seen for six patients

being managed for hypertension• Average decrease of 28 mg/dL LDL cholesterol and 26

mg/dL triglycerides was seen for seven patients being managed for hyperlipidemia

8 • Department of Pharmacy Services • Annual Report 201188 •• DeDeDepapapaartrtrtmemememennntnt oof f PhPhhararrmamacycy SSere vices • AnAnnunualal RReeport 2020001111111111111

Aurora Cancer CareAurora Advanced Healthcare’s Oncology Department and Vince Lombardi Cancer Clinic have provided world-class, clinic-based oncology treatment. These clinics help ensure that patients always have access to cutting-edge oncology specialists and treatments close to home.

Clinic-based oncology teams work in consultation with other specialists located at Aurora St. Luke’s Medical Center and Aurora Sheboygan Memorial Medical Center. This relationship was strengthened with department reorganization at the end of 2011, which brought together oncology care within these two organizations.

Some key advantages to the consolidated cancer care are:

• Improved medication access and medication redistribution mechanisms to ensure patients receive therapies in a timely and effi cient manner

• Transition of oncology clinics into the organization, along with the 340B program, allowed for acquisition costs for select medications at the hospital to be extended to the oncology clinics, and benefi ted patients by increasing access to critical medications

• Presented unique opportunities for the pharmacy department to develop clinical pharmacist services at various clinics

• Through the use of high-defi nition cameras, pharmacists now are able to visually check chemotherapy prepared at another clinic by a pharmacy technician

This transition was a major undertaking with combined efforts of many individuals. With the consolidation to Aurora Cancer Care, patients have access to the most extensive oncology treatment network in the state.


Aurora BayCare Medical Center

Nancy Anderson Yemi Awosanya Lois Burmeister

Megan Jachthuber Janny Lor Sarah Strickler

Kelly Weigand

Aurora Medical Center in Manitowoc County

Sandra Kozlowski Karen Mancheski

Aurora Sheboygan Memorial Medical Center

Dawn Brownson Linda Cook Bonnie Lazarewicz

Marijo Parsons Sherryl Schneider Michele VandePas

Katie VanHelden Susan Waack Gloria Zinthefer

Aurora Medical Center in Oshkosh

Chris Hansen Sara Matuszak

Aurora Memorial Hospital of Burlington

Iwona Flores Leo Graf Lori Harpster

Laura Kelly Leslie Mueller Theresa Welter

Aurora West Allis Medical Center

Lisa Agnello Kathy Bauer Janet Goudy

Ken Lamping Debbie Reinhardt Anthony Staniak

Marlena Tzakis

Aurora Psychiatric Hospital

Terri DiGiacomo

Aurora Medical Center in Washington County

Suzette Brandt Anna Peachy Rose Schwartz

John Zabrowski

Aurora Pharmacy

Karen Jensen Barbara Smith Christina Vad

Joilyn Rutzinski Pat Quinn-Benson


Technician certification

Aurora St. Luke’s Medical Center

Kristine Bongard Darlene Bouzek Alisha Burt

Kathleen Chmiel Christi Davis Carol Diedrich

Brenda Dilworth Maria Figueroa Sarah Ganos

Olivera Gligorevic Duangpak Jackson Annette Keiller

Valarie Kendall Michelle Knapp Karen Krueger

Jennifer Leitner Sydney Lien Alicea Lilliam

Minnie Luckette Michelle Merkle Holly Nerbun

Lisa Peterke Frances Quintanilla Tammy Ritzman

Corey Robinson Peter Ross Lori Rotsart

Iwano Sarenac Mary Schoensee Michelle Schuh

Marilyn Schultz Nicole Segel Linda Sharafinski

Peggy Studer Kelly Sullivan Christine Thomson

John Starz Chauncey Turzinski Brianna Wirth

Kandra Zielinkski

Aurora Sinai Medical Center

Sue Braunreiter Jennifer Davis Ken Graham

Ron Harrell Tracy Johnson Diana Kotowski

Ashley Mommaerts Kim Nicol Pam Seifert

Reshunda Sisk

Aurora Medical Center in Kenosha

Lora Bryniarski Asma Mumtaz Kori Parker

Tina Saulys Cassandra Skokut

Aurora Medical Center in Grafton

Jill Christensen Nancy Fidler Christy Freeman

Nicole Guardiola Christopher Miller Samantha Napierala

Ann Sexton Michael Ward

Aurora Medical Center in Summit

Jessica Donovan Carolynne Fugate Tiffany Nies

Linda Rhodes Marcy Wieczorek

Aurora Lakeland Medical Center

Ruth Farber Karen Oglesby


Aurora eICU® Care pharmacy servicesHigh-quality care is accessible for all intensive care unit patients throughout Aurora with the lifesaving Aurora eICU® Care (electronic ICU care). Aurora eICU Care operates around the clock from an off-site facility separate from the hospitals. The facility itself does not house any patients, but offers advanced care with Aurora physicians, pharmacists and nursing staff providing additional and constant bedside care via interactive video monitoring.

On fi rst shift, Aurora eICU Care pharmacists monitor intensive care patients only. Areas of emphasis include medications associated with mechanical ventilation, medications dosed for renal function, sedation protocols, antibiotic stewardship, anticoagulation, and other high-risk medications. In 2011, Aurora eICU Care pharmacists documented more than 1,500 interventions on potentially harmful medication therapy (see graph below).

On second and third shifts, Aurora eICU Care pharmacists provide verifi cation of mediation orders for both ICU and non-ICU patients receiving care at sites that do not have their own 24-hour pharmacy. The pharmacists assist with drug information questions, pharmacokinetics, medication procurement, and have multiple physician and nurse interactions to ensure that high-quality care is accessible always for patients at any Aurora hospital 24 hours a day, seven days a week.

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Novem

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Number of documented interventions captured with Aurora eICU® Care in 2011

10 • Department of Pharmacy Services • Annual Report 20111010 •• DeDepapartrtmementnt ooff PhPhararmamacycy SSerervivicecess •• AnAnnunualal RRepeporortt 20201111

Drug Use Policy teamThe primary responsibility of the Drug Use Policy team is to establish policies and practices that ensure safe, effective and responsible use of medications. The team also helps ensure that medication-use decisions are accessible to staff pharmacists, preparing clinical tools and resources to facilitate the translation of policy into practice.

Another core function of the team is to support the Aurora System Pharmacy and Therapeutics Committee, which has purview over a single formulary shared by all Aurora Health Care hospital sites. This committee meets on a monthly basis to review materials prepared and presented by the Drug Use Policy team pharmacists, including formulary reviews, medication use evaluations, and corresponding protocol and medication-safety recommendations.

Major 2011 accomplishmentsAurora System Pharmacy and Therapeutics Committee/Clinical• Increased focus on systemwide formulary standardization

to reduce process variability • Actively participated in communication and

implementation of Aurora System Pharmacy and Therapeutics Committee and clinical initiatives

• Aided in development of warfarin protocol, automatic renal dose adjustment protocol, Epic clinical scoring tool

• Conducted hypertonic saline medication-use evaluation, leading to revised hypertonic saline ordering and monitoring process through order sets to avoid adverse events

• Established systemwide insulin U-500 procedure, plus a pharmacist competency to ensure safe use of a high-risk medication

Safety• Developed clinical management strategies, including drug

utilization restrictions and alternatives to cope with critical drug shortages

• Established and chaired systemwide Alaris analytics work group to optimize safe administration of medications using smart pump technology

– Signifi cantly improved use of smart pump technology in the pediatric population through education, pump architecture and use of safety posters (increased utilization from 75 to 93 percent in 2011)

– Revised system sodium bicarbonate protocol from mL/hr to mEq/kg/hr dosing to reduce programming errors

• Maintained system IV medication guidelines and drug tallman lettering to ensure safe medication distribution and administration

• Served as representative on System Nursing Pediatric work group and Medication Safety committees

Financial• Led several cost-reduction initiatives for annual savings

across the system

• Participated in annual drug budget review process

Educational• Continued to support and enhance pharmacy residency

training during drug-use policy learning experience

Investigational drugsBecause we believe every patient deserves the best care, the purpose of Aurora’s Investigational Drugs service is to provide patients with access to clinical drug trials, compassionate-use drugs and orphan drugs, when appropriate. Jane Bubik, specialty pharmacy coordinator, coordinates investigational drug studies for Aurora St. Luke’s and acts as a resource for other sites. Specialty pharmacy coordinators Jennifer Halsey and Anne LaDisa coordinate investigational drugs studies at Aurora West Allis and Aurora Sinai medical centers respectively.

To ensure quality and compliance, a pharmacy dispensing procedure is created and followed by pharmacists as they prepare and dispense investigational agents. Pharmacists who recently started working in satellite oncology clinics will support investigational drug studies at those sites.

As of December 2011, the Aurora St. Luke’s inpatient pharmacy is supporting 15 protocols that involve the use of investigational drugs. Some of these studies are phase two or three clinical trials, which ultimately may lead to U.S. Food and Drug Administration approval of new agents. Others involve studying additional indications for drugs already approved by the FDA.

Aurora is placing an increased emphasis on scientifi c research, so it is anticipated that the department’s involvement in investigational drug studies will continue to increase.


Aurora West Allis Medical Center

Barker, Jennifer BCPS Clinical Pharmacist

Halsey, Jennifer BCPS Specialty Pharmacy Coordinator


Brierton, Dennis BCPS Director Clinical Pharmacy Services

Cook, Margaret BCPS Drug Policy and Formulary Specialist

Puotinen, Julie BCPS Drug Policy and Formulary Specialist

Aurora Medical Center in Summit

Gellendin, Julie BCPS Clinical Pharmacist

Korducki, Jennifer BCPS Clinical Pharmacist

Sterzinger, Joseph BCPS Clinical Pharmacist

Valdovinos, Katie BCPS Clinical Pharmacist

Van Abel, Amy BCPS Clinical Pharmacist

Aurora Sinai Medical Center

Hawk, Steven BCPS Clinical Pharmacist

LaDisa, Anne BCPS Specialty Pharmacy Coordinator

Aurora Medical Center in Grafton

Markoff, Jeffrey BCPS Clinical Pharmacist

Aurora Medical Center in Kenosha

Bayudan, Robert BCPS Clinical Pharmacist

Aurora Memorial Hospital of Burlington

Connor, Linda BCPS Clinical Pharmacist

Aurora Psychiatric Hospital

Small, Jessica BCPP Supervisor Outpatient Pharmacy

BCPS Board Certified Pharmacotherapy SpecialistBCNP Board Certified Nuclear PharmacistBCOP Board Certified Oncology PharmacistBCNSP Board Certified Nutritional Support PharmacistBCPP Board Certified Psychiatric Pharmacist


Honors and awards

Caregiver Honor/award description

Allan Loeb, MS, RPH 2011 Winston J. Durant Lecture Award Winner

Jeffrey Zimmerman, PharmD Aurora Scientific Day Poster Presentation 3rd Place

Jessica Small, PharmD, BCPP 2011 Pharmacy Society of Wisconsin Innovative Pharmacy Practice Award

Joe Sterzinger, PharmD, BCPS 2011 PSW Young Pharmacist of the Year nominee

Joilyn Rutzinski 2011 Aurora Star Award

Karen Jensen 2011 Aurora Star Award

Nick Ladell, PharmD 2011 Pharmacy Society of Wisconsin Student Achievement Award

Board of Pharmacy Specialties certified pharmacists

Aurora St. Luke’s Medical Center

Aldag, Erika BCPS Specialty Pharmacy Coordinator

Bushman, Amanda BCPS Clinical Pharmacist

Clement, Theresa BCNSP, BCPS Clinical Pharmacist

Dagam, Julie BCPS Pharmacy Residency Program Director

Desai, Megha BCPS Health System Pharmacy Administration Resident

Doede, Chris BCPS Clinical Pharmacist

Glienke, Craig BCPS Clinical Pharmacist

Godden, Jon BCPS Specialty Pharmacy Coordinator

Grunske, Mike BCPS Clinical Pharmacist

Hilgendorf, Stacy BCPS Clinical Pharmacist

Johnson, Kelcy BCPS Clinical Pharmacist

Klink, Christopher BCPS Supervisor Outpatient Pharmacy

Kolinski, Andrew BCPS Clinical Pharmacist

Larew, Janel BCPS Clinical Pharmacist

Mathia, James BCPS Clinical Pharmacist

Mathia, Tracy BCPS Specialty Pharmacy Coordinator

Maynard, Michelle BCPS Clinical Pharmacist

North, Jaclyn BCPS Clinical Pharmacist

Patten, Ann BCPS Clinical Pharmacist

Ray, Sarah BCPS Specialty Pharmacy Coordinator

Robinson-Strane, Susan BCPS Clinical Pharmacist

Servais, Ryan BCPS Clinical Pharmacist

Smith, Chad BCPS Manager Pharmacy Services

Spexarth, Frank BCPS Specialty Pharmacy Coordinator

Strane, Timothy BCNP Specialty Pharmacy Coordinator

Volquardsen, Angela BCPS Clinical Pharmacist

Yoder, Sol BCOP Specialty Pharmacy Coordinator

Zukkoor, Sarah BCPS Clinical Pharmacist


Pharmacy residency programs Aurora Health Care’s Department of Pharmacy Services maintains seven distinct residency programs eligible for American Society of Health-System Pharmicists accreditation, including:• PGY-1 Community Pharmacy Residency – Milwaukee• PGY-1 Pharmacy Practice Residency – Milwaukee• PGY-1 Pharmacy Practice Residency – West Allis• PGY-1 Pharmacy Practice Residency – Green Bay• PGY-2 Pharmacy Health System Administration• PGY-2 Pharmacy Specialty Residency – Critical Care• PGY-2 Pharmacy Specialty Residency – Oncology

These residency programs are designed to prepare residents for eligibility for specialized residencies or clinical pharmacy practice. Our explicit goal is to fi ll the resident program with both clinical and professional challenges, providing residents the experience needed to become well rounded, competent and caring pharmacists.

Current pharmacy residents

PGY-1 Pharmacy Practice Residency – MilwaukeeProgram Director: Julie Dagam, PharmD, BCPS• Carly Bates – University of Illinois• Bouchra Bernichi – Loma Linda University• Theresa Crnic – Creighton University• Stacy Gianakakos – Midwestern University, Chicago• Tyler Guetschow – University of Wisconsin, Madison• Shelley King – Auburn University Harrison• Erin Lydon – University of Iowa• Jennifer Tomczak – Midwestern University, Chicago• Lindsey Verbunker – Nova Southeastern University• Alicia Zhu – University of Pittsburgh

PGY-1 Community PharmacyProgram Director: Sarah Ray, PharmD, BCPS• Audra (Hudrlik) Kilburg – University of Iowa

PGY-2 Health-System Pharmacy AdministrationProgram Director: Tom Woller, MS, FASHP• Megha Desai – Aurora Health Care PGY-1 Pharmacy

Practice Resident• Nicholas Van Gompel – Aurora Health Care PGY-1

Pharmacy Practice Resident

PGY-2 Pharmacy Specialty Residency – Critical CareProgram Co-directors: Ann Patten, PharmD, BCPS, and Julie Dagam, PharmD, BCPS• Jeffrey Zimmerman – Aurora Health Care PGY-1

Pharmacy Practice Resident

PGY-2 OncologyProgram Director: Sol Yoder, PharmD, BCOP• Stephanie Shuey – Aurora Health Care PGY-1 Pharmacy

Practice Resident

2011-2012 PGY-1 Pharmacy Residents

2011-2012 PGY-2 Pharmacy Residents


Graduated pharmacy residents – where are they now?

Major 2011 accomplishments• Expanded PGY-1 Pharmacy Practice Residency –

Milwaukee program to include two additional resident positions

• Initiated second class of residents in PGY-2 Critical Care and Oncology programs

• Obtained and began recruiting candidates to fi ll two pharmacy practice resident positions based at Aurora West Allis Medical Center and Aurora BayCare Medical Center

• Developed and implemented a formalized preceptor application process for preceptors in the residency programs, which aided in the formalization of the preceptor development plan and further expanded relevant preceptor development options

• Participated in the Concordia University Wisconsin School of Pharmacy Academic Seminar series

• Offered pharmacy practice residents a Clinical Teaching Certifi cate program, supported by Concordia University

• Expanded rotation options to include ambulatory care, oncology, cardiothoracic transplant, abdominal transplant, and clinical teaching

2012 goals/initiatives • Obtain American Society of Health-System Pharmicists

accreditation for PGY-2 Critical Care and Oncology programs

• Prepare for American Society of Health-System Pharmicists accreditation of PGY-1 Pharmacy Practice Residency West Allis and Green Bay programs

• Explore feasibility and timing of further expansion of pharmacy resident positions or programs

• Revise Clinical Teaching Certifi cate program and continue to offer program to subsequent resident classes

• Use preceptor application process to identify new preceptors, recertify existing preceptors and determine additional preceptor development options

• Expand rotation options to include an emergency department rotation for PGY-1 Pharmacy Practice Residency – Milwaukee and PGY-2 Critical Care programs, and incorporate oncology clinics in PGY-1 Pharmacy Practice – Milwaukee and PGY-2 Oncology programs

• Incorporate student precepting expectations for residents and preceptors into the structure of each residency program


Caregiver ( and co-presenters, if applicable)

Title Venue Date/location

Lori Harpster C. Ph.T Implementation of bar code dispensing automation at community hospital inpatient pharmacy

PSW Educational Conference

3/2011 Madison, WI

Megha Desai, PharmD, BCPS

Ensuring compliance with critical practices and procedures throughout an integrated health system


3/1/2011Madison, WI


Development of models for pharmacists involvement in discharge medication reconciliation process at Aurora Health Care reconciliation process at Aurora Health Care

ASHP Midyear 12/2011New Orleans, LA

Nick Van Gompel, PharmD

Lean principles for streamlining medication preparation and distribution


3/2011 Madison, WI



Aurora Scientific Day

5/2011Milwaukee, WI


Implementation and evaluation of inventory management strategies within an integrated health care system

ASHP Midyear 12/1/2011New Orleans, LA


Assessment of feasibility and potential implementation of pharmacy services in the emergency department of a tertiary care medical center.


3/2011 Madison, WI

Shelley King, PharmD Evaluation of the impact of pharmacist polypharmacy reviews on readmissions


Stacy Gianakakos, PharmD

Optimization of unit based cabinet inventory and con-trolled substances accountability through utilization of reporting tools

ASHP Midyear 12/1/2011New Orleans, LA

Stacy Wucherer, RPh Rapid implementation of unit based cabinets in a multi hospital health system


3/2011 Madison, WI

Stacy Wucherer, RPh Implementation of bar code dispensing automation at community hospital inpatient pharmacy


3/2011 Madison, WI

Stephanie Shuey, PharmD

Implementation of a Risk Evaluation and Mitigation Strategy (REMS) program affecting erythropoiesis-stimulating agents


3/2011 Madison, WI


Development of collaborative practice agreements for the management of constipation and diarrhea in patients with cancer


Susan Robison-Strane, PharmD, BCPS

Incorporation of a medication safety learning experience for PGY1 pharmacy residents into an organization’s medication safety improvement process into an oranization’s medication safety improvement process


Suzanne Kopp, PharmD

Implementation of bar code dispensing automation at community hospital inpatient pharmacy


3/2011 Madison, WI

Theresa Crnic, PharmD

Development and implementation of productivity standards within a health care system packaging center


Tyler Guetschow, PharmD

Creating and optimizing system wide pharmacy to prescriber communications



Poster presentations


Title Venue Date/location

Al Klewin, RPh Incorporation of a medication safety learning experience for PGY1 pharmacy residents into an organization’s medication safety improvement process into an oranization’s medication safety improvement process


Alicia Zhu, PharmD Evaluating Cost Effective Pharmacist Services for Aurora Health Care Clinics


Anne Deitrich, PharmD

Improving clinical monitoring through the development of an electronic patient acuity scoring tool


5/2011Milwaukee, WI

Audra Kilburg, PharmD

Development and implementation of processes to improve transition of care from inpatient stay to outpatient setting while increasing prescription revenue


Bouchra Bernichi, PharmD, MS

Standardization of Non Sterile Compounding throughout a Multihospital System


Carly Bates, PharmD Customization of medication related alerts to optimize computerized clinical decision support


Courtney Morris, PharmD

Implementation of commercially available parenteral nutrition formulations at a tertiary care center


3/2011Madison, WI

Dareen Bleibel, PharmD

Expansion of medication therapy management (MTM) services for eligible patients


3/2011 Madison, WI

Erin Lydon, PharmD Evaluation of observation patient medication practices for Aurora St. Luke’s Medical Center


Frances Quintanilla C.Ph.T

Implementation of bar code dispensing automation at community hospital inpatient pharmacy


3/2011 Madison, WI

Jeffrey Zimmerman, PharmD

Analysis of medication administration documentation accuracy and billing pre- and post-implementation of barcode medication administration (BCMA)


3/2011 Madison, WI


Analysis of medication administration documentation accuracy and billing pre- and post-implementation of barcode medication administration (BCMA)


5/2011Milwaukee, WI


Daily interruption of continuous sedation: a multidisciplinary approach in the mechanically ventilated


Jennifer Barker, PharmD, BCPS

Development of a medication safety dashboard PSW Educational Conference

3/2011 Madison, WI

Jennifer Tomczak, PharmD

Prostaglandin conversion protocols for patients with pulmonary hypertension



Incorporation of a medication safety learning experience for PGY1 pharmacy residents into an organization’s medication safety improvement process into an oranization’s medication safety improvement process


Leslie Mueller C.Ph.T Implementation of bar code dispensing automation at community hospital inpatient pharmacy


3/2011 Madison, WI

Lindsey VerBunker, PharmD

Measuring the Performance of an Insulin Infusion Protocol



Drive operational excellencePharmacy Supply Chain groupAurora Health Care includes an integrated network of hospitals, clinics, outpatient pharmacies and home infusion pharmacies. One unique challenge is supplying each site with medications that are consistent with the standardized system formulary, managing current drug shortages, optimizing opportunities, such as 340B drug discounts, and other drug supply issues. The Pharmacy Supply Chain group oversees each of these areas.

Major 2011 accomplishments• Combined efforts of Pharmacy Supply Chain group,

pharmacy operations and Drug Use Policy staff has led to timely access to lifesaving medications that are on national shortage

• Constant monitoring of allocated medications by the Pharmacy Supply Chain group is ensuring distribution of required medications to necessary sites

• Continual monitoring of contractual compliance on an ongoing basis is ensuring signifi cant cost savings through contract purchases

• Successful implementation of 340B discount program has led to cost savings of more than $10 million in 2011

Efforts to maximize 340B cost savings are continuing in 2012 as the program expands to include all eligible patients at qualifying hospitals.

Lynx inventory management systemAs Aurora Health Care and Aurora Advanced Healthcare’s oncology clinics became Aurora Cancer Care, inventory management for each site was standardized using an automation tool called Lynx.

This product is an electronic storage cabinet that contains all the chemotherapy agents at a particular site. Lynx offers the added benefi t of accurate inventory assessments done remotely. It also facilitates adequate product ordering to meet the therapeutic needs of the patient. Since implementing Lynx at only seven clinics, a cumulative cost savings of $1.3 million has been achieved.

Oncology clinic inventory trends after Lynx implementation

East Mequon

Good Hope

MenomoneeFallsSheboygan

Slinger

Summit

Two Rivers

14 • Department of Pharmacy Services • Annual Report 201114 • Department of Pharmacy Services • Annual Report 2011

Information technology Leverage of automation and technology is key to supporting compliance and safety. It also helps drive operational effi ciencies, which make it possible for us to fulfi ll our purpose and vision.

Major 2011 accomplishments• Supported Aurora St. Luke’s Medical Center’s conversion

to electronic health record – the state’s largest hospital.

• IntelliShelf implementations for Burlington, Hartford, Kenosha, Lakeland, Oshkosh, Sheboygan

• IT team and clinical pharmacist combined efforts to perform ongoing evaluation and optimization of clinical monitoring tool to increase patient monitoring effi ciencies

• New job codes created for both the automation and IT (Cerner/Epic) technicians (pharmacy applications support technicians who have expertise in Carefusion, Cerner, Epic and McKesson)

• Automation databases routinely updated centrally by automation technicians and network archiving for both CareFusion and McKesson

• Automation technicians comprise the majority of the pharmacy technician Epic credentialed trainer group

• Automation technicians provided process support (from purchasing through post go-live issue resolution) for installation of CareFusion A-systems and cabinets

• Pharmacy applications support technicians (both automation and IT) provided go-live and post go-live issue resolution with Aurora St. Luke’s conversion to Epic and for six sites that went live with IntelliShelf

In 2012, we will continue to seek out and implement the cutting-edge technologies that set the Department of Pharmacy Services apart.

Centralized order entry The Centralization of Order Processing Project went live at four Aurora hospitals Jan. 31, 2012. Aurora Memorial Hospital of Burlington, Aurora Medical Center in Kenosha, Aurora Lakeland Medical Center and Aurora St. Luke’s South Shore now process orders as a collective group from a common work queue. Plans are in place to go live at Aurora hospitals in Oshkosh, Summit and Two Rivers.

A second centralized order processing group will be created from EPIC facilities over the next several months. Additional hospitals will be added over the next year to each group with the goal of all Aurora Hospitals processing orders in this centralized manner. By centralizing the processing of orders, more time will be available for clinical activities. This increase in dedicated clinical time will serve as the foundation for PPMI and advancement of pharmacy services at Aurora Health Care.

AutomationDespite widespread recognition and efforts, medication errors still occur – and many are preventable. Aurora Health Care recognizes the role of automation and various technologies in facilitating a safe medication administration process. The majority of inpatient hospital pharmacies use centralized barcode dispensing via McKesson Robot-Rx, McKesson MedCarousel or McKesson Intellishef-Rx, or a combination of automation.

• Intellishef-Rx uses barcode technology to pick medication from stationary shelves and medication storage areas.

• McKesson MedCarousel improves the speed and accuracy of dispensing batch orders and restocking by using automated rotating shelves and barcode scanning technology to guide technicians to picking correct medication storage bins.

• McKesson Robot-Rx is a robotics system used to automate the storage, dispensing and restocking of daily unit-dose medications.

• All these devices are used to facilitate speedy and accurate dispensing of cart-fi ll, fi rst doses and replenishment of Pyxis unit-based cabinets, and to improve inventory management.



Title Venue Date


Ischemic and Hemorrhagic Stroke Clinical Forum May – 2011


Interprofessional practices – pearls for providing value to physicians


Aug – 2011


Cardiology update for the community pharmacist PSW Educational Meeting

Apr – 2011


Vasculopathy in heart transplant recipients: perfusing hearts in ways cupid cannot

Clinical Forum Feb – 2011



Great Lakes Pharmacy Residency Conference

Apr – 2011

Peter Stussey, PharmD Traditional therapies and new possibilities in select drug overdoses

Pharmacy Grand Rounds Feb – 2011


Assessment of feasibility and potential implementation of pharmacy services in the emergency department of a tertiary care medical center


Apr – 2011


Turning the tables: making your feedback matter PSW Milwaukee Meeting Oct – 2011

Sol Yoder, PharmD, BCOP

Rays of hope: a review and update of melanoma PSW Annual Meeting Aug – 2011


Implementation of a risk evaluation and mitigation strategy (REMS) program affecting erythropoiesiss stimulating agents


Apr – 2011


Bevacizumab update: controversies, indications, and impact on your patient

Clinical Forum Apr – 2011

Theresa Crnic, PharmD

Beyond metformin: the “other” agents in the management of diabetes mellitus, type 2

Clinical Forum Sep – 2011


Creating synergistic multi-hospital pharmacy organizations.

ASHP Midyear Dec – 2011


How state affiliates can optimize PPMI advancement (webinar)

ASHP Webinar Oct – 2011


Pharmacy workforce implications for health-systems PSW Annual Meeting Aug – 2011


Advancing the Pharmacy Practice Model Initiative in Wisconsin

PSW Educational Meeting

Apr – 2011


Residency training program development at Aurora Health Care

Pharmacy Residency Capacity Stakeholders Conference

Feb – 2011

Tom Woller, MS, RPH, FASHP

How state affiliates can optimize PPMI advancement 2011 ASHP Midyear Meeting

Dec – 2011

Wayne Esser, PharmD “Giving Your Patients a Boost: Importance of Care Transitions”

PSW Senior Care Conference

Mar – 2011



Title Venue Date

Jeff Augustine, PharmD

Pharmacologic Treatments for Septic Shock Regional ACCN Nov – 2011

Jeff Markoff, PharmD Cardiac Pharmacology / Drug Therapy for the Care of Open Heart Patients

Aurora ICU Nurse Inservice

2011


Analysis of medication administration documentation accuracy and billing pre- and post- implementation of barcode medication administration (BCMA)


Apr – 2011


Sedation in the intensive care unit from 2002 and beyond

Pharmacy Grand Rounds Oct – 2011

Jennifer Barker, PharmD, BCPS

Development of a medication safety dashboard Great Lakes Pharmacy Residency Conference

Apr – 2011

Jennifer Godden, PharmD,

Expanding outpatient pharmacy services in oncology throughout the Aurora Health Care system


Apr – 2011

Jennifer Halsey, MS, PharmD, CGP, BCPS

Update on IDSA guidelines: Catheter associated urinary tract infections


Apr – 2011

Jennifer Halsey, MS, PharmD, CGP, BCPS

Medications in Parkinson’s Disease PD Support Group Sep – 2011

Jennifer Halsey, PharmD, CGP, BCPS

Caring for two patients at once: critical care in pregnancy

Pharmacy Grand Rounds Nov – 2011

Jessica Wolf, PharmD Making an Impact on adherence PSW Educational Meeting

Apr – 2011

Joe Sterzinger, PharmD, BCPS

Pain Resource Nursing Course (presenter) Aurora CE course February 2011 October 2011

Jonathan Aubry, MBA Drug Shortages in Aurora Hospitals and Clinics Aurora Quality Round-table

Oct – 2011

Joseph Sweeney, PharmD

Opioid Dose Conversion Strategies for Palliative Care Patients

Palliative Care Transitions: A Community Provider Palliative Care Conference

Sep – 2011

Joseph Sweeney, PharmD

Comprehensive Review of Non-Opioid Pain Management

ALMC Nursing Facts and Snacks

Jun – 2011


Turning the tables: making your feedback matter PSW Milwaukee Meeting Oct – 2011

Julie Puotinen, PharmD, BCPS

System Alaris Analytics Aurora Quality Roundtable

Oct – 2011


“Giving Your Patients a Boost: Importance of Care Transitions”

PSW Senior Care Conference

Mar – 2011

Kelcy Johnson, PharmD

Continuous quality improvement of a pharmacist managed inpatient anticoagulation service


Apr – 2011

Lindsey VerBunker, PharmD

Fungus among us: management of endemic mycoses Clinical Forum Nov – 2011

Lynne Fehrenbacher, PharmD, BCPS

Antibiotic stewardship metrics: measuring impact of interventions

PSW Annual Meeting Aug – 2011


Ensuring compliance with critical practices and procedures throughout an integrated health system


Apr – 2011

Department of Pharmacy Services • Annual Report 2011 • 15 DeDepapartrtmementnt ooff PhPhararmamacycy SSerervivicecess •• AnAnnunualal RRepeporortt 20201111 •• 1155

Medication Packaging CenterThe Medication Packaging Center was established in 2008 as part of a strategic plan to barcode medications in preparation for conversion to bedside-barcode medication administration. Prior to 2008, each inpatient hospital pharmacy was packaging medications on their own, with or without a barcode. As of 2012, the packaging center prepares 350,000 doses monthly for 15 hospitals.

Some of the advantages of a centralized medication packaging center include a decreased inventory at each hospital pharmacy. The packaging center also purchases bulk oral solids, which saves about $250,000 annually. Other cost savings initiatives have been to unit-dose topical doses instead of purchasing commercially available products, and to prepare compounded oral liquids in lieu of the commercially available capsules.

The packaging center is equipped with a high-speed packager (McKesson PACMED packager), McKesson MedCarousel system, tabletop packager, over-wrappers and tadpole printers. These machines package oral solids, oral liquids, and unit-dose topicals. In addition, medications purchased without barcodes, such as nebulizer ampules, inhalers, bulk topical products, suppositories and eye drops are bar-coded with a tadpole-printed label in the packaging center. The packaging center also compounds common non-sterile medications and overwraps medications for the ROBOT-Rx system.

The majority of Aurora Health Care inpatient hospital pharmacies have centralized barcode dispensing via ROBOT-Rx, MedCarousel, IntelliShelf or a combination of automation. These devices are used for cartfi ll, fi rst doses, replenishment of Pyxis and inventory management.

All these devices work on a max/par system. The packaging center queries the hospital pharmacy devices to determine what medications are below par. The medications then are automatically sent to PACMED for packaging. The non-PACMED medications are printed on a barcoded report and are removed from MedCarousel. The packaging center works from a batch schedule, and batches are sent to the pharmacies via an Aurora-contracted courier service. The drug costs are transferred monthly from the packaging center to each inpatient hospital pharmacy.

During the past two years, the packaging center has become a depot for medications on nationwide back order. Aurora’s Pharmacy Supply Chain group has several methods for purchasing medications with shortage issues or purchasing alternatives; these medications then are distributed to

Aurora’s hospitals and clinics through the Medication Packaging Center. The Pharmacy Supply Chain group also has purchased large quantities of medications for cost savings, and these are housed and distributed from the packaging center as well.

Major 2011 accomplishments• Installed an IntelliShelf at Aurora Sheboygan Memorial

Medical Center, Aurora Medical Center Washington County, Aurora Medical Center Oshkosh, Aurora Lakeland Medical Center and Aurora Memorial Hospital Burlington

• Installed Pyxis A-systems Aurora Medical Center Kenosha, Aurora Memorial Hospital Burlington

• Installed various Pyxis Medstations at multiple facilities• Established data archive of Pyxis and McKesson data to

Aurora network• Established an automation technician team• Completed implementation of a standard Pyxis formulary,

overrides, user templates and device settings• Completed implementation of Pyxis barcode restocking• Provided support of Epic conversion at St. Luke’s Medical

Center• Implemented Lynx automation tool for inventory

management in the Aurora Advanced Oncology Clinics

2012 goals/initiatives• Implement a second McKesson PACMED packager at the

Medication Packaging Center• Relocate packaging center to a new central location• Provide support of Epic conversion at six hospitals• Sunset of Pyxis Connect at sites transitioning to

Epic system• Potential upgrade to McKesson 8.0 software• Install Pyxis Anesthesia System at Aurora Lakeland

Medical Center and at the Aurora Medical Center surgery center in Wauwatosa

• Install various Pyxis MedStation systems at multiple facilities

• Standardize site use of electronic UBC data monitoring tool

• Establish daily back up of Pyxis CIISafe to Aurora network• Implement IntelliShelf-Rx and Pyxis console at Aurora

Psyciatric Hospital


Aurora Health Care Inpatient Hospital PharmaciesAurora Health Care began with an affi liation between two Milwaukee hospitals in 1984 and now is a fully integrated health care provider with 15 hospitals, 155 clinics, more than 70 retail pharmacies, lab services, rehabilitation centers and home care. Inpatient hospital pharmacies operate as a single system department. Although each site works to achieve department strategic goals, sites each had diverse accomplishments during 2011. As a system, the aim is to further incorporate pharmacists into the health care team and increase direct patient involvement in 2012. Technician and pharmacy workfl ow will be a primary goal of many sites, as well as the expansion of technician roles beyond distributive functions. Also, optimization of pharmacy student teaching learning experiences and maximizing involvement in patient-care activities will be highlighted in the upcoming year.

Aurora St. Luke’s Medical Center2900 W. Oklahoma AvenueMilwaukee, WI 53215

Aurora St. Luke’s Medical Center is a 700-bed, tertiary-care hospital in Milwaukee, Wis., that serves patients in southeastern Wisconsin, as well as those traveling here from around the country – and the world.

Known for providing the highest acuity level of care, Aurora St. Luke’s is the only southeastern Wisconsin hospital named one of the top 100 hospitals for cardiovascular care. Aurora St. Luke’s also is only one of 26 hospitals awarded prestigious triple recognition by the American Heart Association and the American Stroke Association.

Aurora St. Luke’s also serves as a teaching hospital to many disciplines, pioneering numerous procedures and technologies while being known for the very specialized care it provides in areas such as cardiology, oncology, gastroenterology, transplant surgery and the neurosciences.

Department of Pharmacy ServicesThe Aurora St. Luke’s Department of Pharmacy Services offers comprehensive pharmaceutical services to patients 24 hours a day, seven days a week. In addition to its clinical staff, Aurora St. Luke’s has specialty coordinators in the following areas:• Cardiothoracic transplant• Cardiology• Oncology• Medical/Surgical• Drug information/investigational studies• Infectious disease• Abdominal transplant• Drug-use policy• Ambulatory services

With more than 180 pharmacy caregivers, including 29 pharmacists board certifi ed by the Board of Pharmacy Specialties, Aurora St. Luke’s Department of Pharmacy Services is dedicated to serving the needs of physicians and staff while providing patients with best care possible.

Major 2011 accomplishments• Successfully implemented Epic, Aurora’s new electronic

health record• Implemented Pyxis Anesthesia System in the

catheterization and EP labs• Expanded pharmacy residency program to include three

specialty PGY-2 programs• Added decentralized pharmacists in ED• Continued to support pharmacy students and enhance

relationship with Concordia University Wisconsin College of Pharmacy and Rosalind Franklin University

• Nine new pharmacists board certifi ed by the Board of Pharmacy Specialties

2012 goals• Continue optimization of Epic to maximize effi ciencies and

provide better patient care experience• Incorporation of Pharmacy Practice Model Initiative into

Aurora St. Luke’s pharmacy practice model• Utilize technician training and certifi cation program to

advance roles of pharmacy technicians


Presentations


Title Venue Date

Alicia Zhu, PharmD Clostridium difficile Infection (CDI): Review of the 2010 Treatment Guidelines and the Role of Fidaxomicin

Clinical Forum Oct – 2011

Amy Zynda, PharmD Parentral Nutrition WARM students Nov – 2011


Under Pressure: Is tight blood pressure control necessary in diabetic patients?

Clinical Forum Jan – 2011


Improving clinical monitoring through the development of an electronic patient acuity scoring tool


Apr – 2011

Anne Patten, PharmD, BCPS

Managing alcohol withdrawal in an acute care setting Pharmacy Grand Rounds Apr – 2011

Arlene Iglar, MS, RPH Medication histories collected by pharmacy technicians

PSW Annual Meeting Aug – 2011


Implementation and evaluation of an electronic medication use process within an ambulatory environment

Great Lakes Pharmacy Resident Conference

Apr – 2011

Carly Bates, PharmD Serotonin syndrome: too much of a good thing Clinical Forum Dec – 2011

Chad Smith, PharmD, BCPS, MBA

Evaluation of pharmacist order processing time at a community hospital before and after computerized provider order entry implementation


Apr – 2011


The Use of Non-Insulin Injectable Medications Clinical Forum Jan – 2011


Case based series: smoking cessation PSW Milwaukee Meeting Oct – 2011


Moderator – Hospital Pharmacy Leadership Forum PSW Educational Confer-ence

Apr – 2011


Moderator – Hospital Pharmacy Leadership Forum PSW Annual Meeting August, 2011


Drug Shortages in Aurora Hospitals and Clinics Aurora Quality Round-table

Oct – 2011


System Alaris Analytics Aurora Quality Round-table

Oct – 2011

Emma Hews, PharmD Leadership and Professional Development – Pharmacy Technicians

PSW Educational Confer-ence

Apr – 2011

Greg Weber, MS, RPH Drug Shortages in Aurora Hospitals and Clinics Aurora Quality Round-table

Oct – 2011

Jack Kampf, PharmD, BCPS, MS

Revamping pharmacy productivity metrics within a health care system


Apr – 2011

Jaclyn North, PharmD, BCPS

Evaluation and standardization of drug use procedures throughout the cardiac catheterization laboratories in a health care system


Apr – 2011

Jaclyn North, PharmD, BCPS

Management of Community Acquired Pneumonia Clinical Forum Mar – 2011


Publications

Caregiver Reference of publication

Barry McClain, PharmD, MS Anderson J, Gray J, McClain B, Spangler J. Wisconsin hospital pharmacy directors and managers exchange ideas at PSW conference. JPSW. Mar&Apr 2011; 4-6.

Bonnie Niemuth, CPhT Niemuth B, Zoltak D, Wucherer S, Cannon K. Rapid implementation of unit based cabinets in a multi hospital health system (abstract). JPSW. May&June 2011; 18-19.

Chris Lodl, RPH Lodl C. PPMI and technicians. TechLink PSW. March 2011.

Chris Lodl, RPH Lodl C. What are accountable care organizations? TechLink PSW. March 2011.

Chris Lodl, RPH Lodl C. Sunscreen basics. TechLink PSW. July 2011.

Chris Lodl, RPH Lodl C. Drug shortages – how can technicians help? TechLink PSW. July 2011.

Chris Lodl, RPH Lodl C. Flu 2011-2012, dispelling the myths. TechLink PSW. October 2011.

Chris Lodl, RPH Lodl C. Pharmacy celebrations. TechLink PSW. October 2011.

Chris Lodl, RPH Lodl C. Professionalism do’s and don’ts. TechLink PSW. October 2011.

Chris Lodl, RPH Lodl C. In the news… TechLink PSW. December 2011.

Chris Lodl, RPH Lodl C. Pearls of Professionalism. TechLink PSW. December 2011.

Dareen Bleibel, PharmD Bleibel D. Expansion of medication therapy management (MTM) services for eligible patients (abstract). JPSW. May&June 2011; 17.

Donna Zoltak, CPhT Niemuth B, Zoltak D, Wucherer S, Cannon K. Rapid implementation of unit based cabinets in a multi hospital health system (abstract). JPSW. May&June 2011; 18-19.

Greg Weber, MS, RPH Weber, G. Advocacy needed for 340B Program. Reproduced in Ladell N. 340B: Catching Wisconsin up. JPSW. May&June 2011; 24-27.

Jeffrey Zimmerman, PharmD Zimmerman J, Iglar A. Analysis of medication administration documentation accuracy and billing pre- and post-implementation of barcode medication administration (BCMA) (abstract). JPSW. May&June 2011; 18.

Jennifer Barker, PharmD, BCPS Barker J. Development of a medication safety dashboard (abstract). JPSW. May&June 2011; 20.

Jessica Wolf, PharmD Wolf J. Simple, yet profound: community pharmacist implementation of collaborative practice agreements. JPSW. Jan&Feb 2011; 32-34.

Jessica Wolf, PharmD Wolf J, Kieser MA, Pigarelli Dl, et al. Use of a virtual patient to prepare student pharmacists and pharmacists to conducet diabetes-specific medication therapy management (MTM) (abstract). JPSW. May&June 2011; 15.

Kristin Cannon, RPh Niemuth B, Zoltak D, Wucherer S, Cannon K. Rapid implementation of unit based cabinets in a multi hospital health system (abstract). JPSW. May&June 2011; 18-19.

Mike Grunske, PharmD, BCPS Grunske M. Are you a 9 to 5 pharmacist?. JPSW. Mar&Apr 2011; 60.

Nick Ladell, PharmD Ladell N. 340B: Catching Wisconsin up. JPSW. May&June 2011; 24-27.

Nick Van Gompel, PharmD Van Gompel N. Lean principles for streamlining medication preparation and distribution (abstract). JPSW. May&June 2011; 19-20.

Ryan Servias, PharmD, BCPS Servias R, Iglar A, Mathia J. Assessment of feasibility and potential implementation of pharmacy services in the emergency department of a tertiary care medical center (abstract). JPSW. May&June 2011; 16-17.

Ryan Servais, PharmD, BCPS Servais R and Carver L. Should I Stay or Should I Go? Factors to Consider in the Pursuit of Postgraduate Year Two (PGY2) Residency Training. JPSW. Nov&Dec 2011; 24-25.

Sarah Ray, PharmD, BCPS Ray S. Finding the cutting edge. Pharmacy Today APhA. Jan 2011; 10-12.


Aurora Sinai Medical Center945 N. 12th Street Milwaukee, WI 53233

Aurora Sinai Medical Center, located in downtown Milwaukee, serves as a community-teaching center. It offers comprehensive health care services, including women’s health services, acute care for the elderly, sports medicine and oncology services. In 2010, Aurora Sinai Medical Center was ranked as one of the best hospitals in the metro-Milwaukee area by U.S. News and World Report in the areas of gynecology, orthopedics, kidney disorders and geriatrics.

Department of Pharmacy ServicesThe Department of Pharmacy Services is comprised of 13 full-time clinical pharmacists and 16 full-time pharmacy technicians. The department provides both clinical and medication distributive functions in the hospital, as well as cart-fi ll support for multiple sites. The department also supports the pharmacy residency program by providing two residents staffi ng opportunities, as well as many hospital-based rotations.

Major 2011 accomplishments• Continue to serve as clinical instructors for pharmacy

students of Concordia University Wisconsin School of Pharmacy to develop future clinical pharmacists

• Collaborated with nursing services to develop pharmacists involvement in discharge medication reconciliation and discharge counseling on new medications to improve outcomes, reduce readmissions and improve patient care experience

• Implemented third-shift pharmacy technician led medication history-taking process

2012 goals• Implement technician-check-technician program for unit-

based cabinet medication restocks • Develop processes in collaboration with hospital

departments to ensure successful implementation of EPIC at the medical center, and successful anticipated accreditation by The Joint Commission

• Expand pharmacists role in anticoagulation monitoring and hospital-wide education


Aurora Psychiatric Hospital1220 Dewey AvenueWauwatosa, WI 53213

Aurora Psychiatric Hospital is located in Wauwatosa, Wis., and offers a full continuum of behavioral-health options, including inpatient partial hospitalization, residential treatment and intensive outpatient programming. The hospital also offers programs such as eating disorder services, an opiate recovery program and adult substance abuse program.

Department of Pharmacy ServicesThe Department of Pharmacy Services provides inpatient pharmacy services (clinical, distributive and automation from an acute-care hospital standpoint) and outpatient pharmacy services through a traditional outpatient pharmacy. The pharmacy department is viewed by other disciplines as a cohesive team working toward better and effective patient care.

Major 2011 accomplishments• Developed professional relationships with Concordia

University Wisconsin School of Pharmacy through didactic lectures for pharmacy students

• Collaborated with nursing services to develop medication reconciliation competencies as it relates to behavioral health patients

• Participated in patient care rounding on nursing units to support best patient experience

• Improved inpatient discharge process through discharge medication counseling and improved prescription capture to provide effective patient care across the continuum

2012 goals• Implement IntelliShelf-Rx technology in inpatient

pharmacy to improve patient safety and better manage drug inventory

• Implement technician-check-technician program for unit-based cabinet medication restocks once IntelliShelf-Rx is implemented

• Implement pharmacists’ role in adherence clinic in facility’s day treatment program to identify critical patient-specifi c issues and reduce readmissions

Outpatient Hospital Visits

1.36 1.44

1.69

2009 2010 2011( )(In Millions)

Emergency Visits

258 938258,938249,492

239,401

2009 2010 2011

Department of Pharmacy Services financial performance

Inpatient Discharges

93,804

91,01791,960

2009 2010 2011

Surgical Cases

110,881

95,260

115,299

2009 2010 2011

Nursery Days

36,589

39,425,

2010 2011

Inventory Assessment$9.80$

$8.87

2010 2011(In Millions)(In Millions)

Inpatient Days

407,407 405,758410,872

2009 2010 2011

(non-nursery)

Drug Spend

$89.43

$93 63$93.63

2010 2011(In Millions)



Aurora West Allis Medical Center8901 W. Lincoln AvenueWest Allis, WI 53227

Aurora West Allis Medical Center is a 250-bed hospital located in the heart of West Allis, Wis. The medical center offers range of primary and acute care programs. Aurora West Allis also is home to Aurora Women’s Pavilion, which provides comprehensive women’s health services and houses a neonatal intensive care unit. The medical center also provides laparoscopic and robotic surgeries for gynecological and urologic patients.

Department of Pharmacy ServicesThe Department of Pharmacy Services offers on-site pharmaceutical services 24 hours a day. The staff is comprised of 14 clinical pharmacists and 15 pharmacy technicians that work cohesively to provide excellent patient care.

Major 2011 accomplishments• Implemented pilot with pharmacists involvement in

discharge medication reconciliation with discharge teaching through the BOOST grant program

• Provided on-site pharmacy orientation to newly hired nurses

2012 goals• Implement technician-check-technician process for

medications stocked in nursing unit-based cabinets• Collaborate with hospital departments to ensure successful

implementation of Epic


Aurora Medical Center1032 E. Sumner StreetHartford, WI 53027

Aurora Medical Center in Washington County has been providing health care to area residents for more than 85 years. In addition to being a fully accredited general acute-care hospital, Aurora Medical Center is a Level III Trauma Center and recently added telestroke technology to its long list of services. The medical center’s wound care and hyperbaric oxygen therapy program is accredited with distinction – one of only 37 nationwide to have achieved this recognition. And, in 2011, Aurora Medical Center in Washington County was accredited by The Joint Commission for outstanding services in total joint replacement. Implementation of Epic in January 2012 will further support the quality care that residents in this area have come to expect.

Department of Pharmacy ServicesThe Department of Pharmacy Services is comprised of three clinical pharmacists and four certifi ed pharmacy technicians, with an average length of service of more than 19 years. The primary focus of the department is to provide medication and clinical services to patients in a timely and effi cient manner. Using a multitude of technologies, pharmacy staff screens all medication orders for appropriateness and patient safety. Clinical pharmacists work in close proximity with physicians and nurses to monitor patients’ medications for effectiveness and safety.

Major 2011 accomplishments• Continued to work toward expanding decentralized clinical

pharmacist role on patient care areas by participating in daily patient rounds

• Successful implementation of technician-check-technician program on medications stocked in unit-based cabinets and cart-fi ll medications

• Implemented pharmacy technician medication history-taking process on inpatients admitted to the medical center, working in collaboration with clinical pharmacists to complete medication reconciliation on admission

• Successful implementation of IntelliShelf-Rx technology to improve medication safety and better manage pharmacy drug inventory

• Improved operational effi ciencies by focused work on unit-based cabinet dispensing to accelerate timely provision of critical medications

• Continued to support introductory pharmacy practice experience students from Concordia University Wisconsin School of Pharmacy

2012 goals• Continue to maintain technician-check-technician program

by completing necessary validation requirements • Work with hospital departments to plan successful

implementation of Epic • Continue to improve operational effi ciencies to maximize

pharmacists involvement in patient care activities


Aurora Medical Center10400 75th StreetKenosha, WI 53142

Aurora Medical Center in Kenosha, Wis., opened in February 1999 and expanded in 2004 as a facility designed around patient-centered care. There are several outreach programs that address teen pregnancy, as well as alcohol and drug-abuse issues in the community. In 2011, Aurora Medical Center was recertifi ed and designated as an Outstanding Cancer Program by the American College of Surgeons Commission on Cancer. The program was honored as one of the top 10 percent in the nation. In addition, the medical center’s breast cancer program has earned accreditation for its quality, care and outcomes. The hospital also is a Certifi ed Stroke Center, with the latest survey taking place in August 2011.

Department of Pharmacy ServicesThe Department of Pharmacy Services has a total of 21 caregivers on staff, with approximately eight full-time pharmacists, including the pharmacy manager, and fi ve to six full-time pharmacy technicians. Pharmacy services include outcome facilitated team attendance, IV to PO conversion, renal dose adjustment, anticoagulation monitoring, pharmacokinetic dosing service and TPN monitoring.

Major 2011 accomplishments• Continued to support pharmacy students by serving as

clinical instructors at Concordia University Wisconsin, Midwestern University (Downers Grove, Ill., and Glendale, Ariz.), Rosalind Franklin University, South University, University of Minnesota, Creighton University and University of Wisconsin – Madison

• Early stages of developing technician-check-technician process for medication provided via cart-fi ll and Pyxis medication stations

• Expansion of clinical pharmacists activities to patient care rounding with multidisciplinary teams

• Collaborated with outpatient pharmacy to establish discharge medication program on obstetrics and orthopedics nursing units to improve transition of care

• Trained pharmacy staff in EPIC technology to aid successful implementation at other medical centers

• Collaborated with nursing services to form Medication/Patient Safety Committee to increase awareness and reporting of medication events and adverse drug effects reporting to formulate patient safety strategies

• Implemented Pyxis Anesthesia System dispensing machines in all operating rooms, C-section room, Racine surgery center and the Racine pain clinic for increased patient safety, work-fl ow improvement, improved medication control and safety

• Increased involvement and visibility in hospital committees such as Code 4, Stroke Committee and the site cancer committee to improve patient care

2012 goals• Implement a clinical coordinator position with Rosalind

Franklin School of Pharmacy• Implement around-the-clock on-site pharmacy services to

provide better patient care experience• Fully develop technician-check-technician process for

medications provided through cart-fi ll and Pyxis machines • Plan processes to integrate pharmacists in anticoagulation

dosing, monitoring and education of inpatients• Enroll clinical pharmacists in antimicrobial stewardship

program offered by University of Wisconsin• Work in collaboration with hospital departments to

ensure successful implementation of Epic in July 2012, and a successful anticipated accreditation by The Joint Commission.


Aurora Medical Center855 N. Westhaven DriveOshkosh, WI 54904

Aurora Medical Center in Oshkosh, Wis., is a regional medical center in the Fox Valley. The medical center offers a full array of medical and surgical services, including cancer care, cardiac care, diagnostic services, emergency services, neuroscience care, physical medicine and rehabilitation, surgery, orthopedics and women’s health. Aurora Medical Center in Oshkosh is accredited by the American College of Surgeons National Accreditation Program for Breast Centers and was the fi rst nationally accredited breast care center in the Fox Valley. Aurora Medical Center in Oshkosh was also the fi rst center in the Fox Valley to earn certifi cation by The Joint Commission for the stroke program. Aurora Medical Center has been granted the designation of Accredited Chest Pain Center by the Society of Chest Pain Centers, and was the 13th hospital in the state to earn this designation.

Department of Pharmacy ServicesThe pharmacy services department is comprised of fi ve clinical pharmacists and seven pharmacy technicians. The department provides both on-site centralized and decentralized pharmacy services from 10 a.m. to 6 p.m. daily. The department also supports computerized physician order entry and order verifi cation.

Major 2011 accomplishments• Implemented decentralized pharmacy services to provide

better patient care experience through participation in patient care rounding

• Implemented pharmacy technician-check-technician on medications stocked in Pyxis machines in the medical center to improve medication availability

• Implemented and applauded for initiation of pharmacy technician-led medication history-taking process on all patients admitted

• Successful implementation of IntelliShelf-Rx technology to improve patient medication safety and pharmacy operational effi ciency

2012 goals• Expand pharmacy technician roles in the medical center

through improvement in medication history-taking process, assistance with inpatient discharge process and expansion of technician-check-technician process to medications provided through cart-fi ll

• Participate in proactive planning for successful implementation of Epic technology in 2013

• Continue to collaborate with nursing services to improve medication security, improve timely medication availability for patient care and reduce medication-administration errors

• Implement pharmacists and dietary involvement in inpatient warfarin counseling

• Participate in multidisciplinary teams to prepare for anticipated 2012 survey by The Joint Commission


Aurora Sheboygan Memorial Medical Center 2629 N. 7th StreetSheboygan, WI 53083

Aurora Sheboygan Memorial Medical Center provides health care to residents in Sheboygan County. The medical center has earned several recognition awards, including the Everest Award as a result of consistent fi ve-year improvement rates on performance measures in clinical quality. The medical center offers full cardiac-care services, cancer care, spine care and sports medicine.

Department of Pharmacy ServicesThe primary focus of the Department of Pharmacy Services is to provide medications and clinical services to all its patients in a timely and effi cient manner. The department is comprised of seven pharmacists and nine pharmacy technicians. Using a multitude of technologies, pharmacy staff screens all medication orders for appropriateness and safety. Clinical pharmacists work in close proximity with lab caregivers, physicians and nursing staff to monitor patients’ medications effectiveness and safety.

Major 2011 accomplishments• Continue to work toward expanding decentralized clinical

pharmacist role on patient care areas• Successful implementation pharmacy technician-check-

technician on medications stocked in Pyxis machines and on medications available through cart-fi ll

• Successful implementation of IntelliShelf-Rx technology to improve patient medication safety and pharmacy operational effi ciency

• Signifi cant work toward implementation of 340B program in medical center and the cancer clinic associated with the hospital

2012 goals• Expand pharmacy technician roles in the medical center

through improvement technician-check-technician program and implementing pharmacy technician-led medication history-taking process

• Prepare for successful implementation of Epic technology at the medical center

• Participate in multidisciplinary teams to increase medication event reporting, improve medication reconciliation process

• Collaborate with all departments within the medical center in anticipation of stroke and hip/knee/spine certifi cation


Aurora Memorial Hospital of Burlington252 McHenry StreetBurlington, WI 53105

Aurora Memorial Hospital of Burlington is a fully accredited, general acute-care hospital offering 24-hour care and extensive diagnostic and surgical services to Burlington and surrounding communities. The medical center offers emergency services, cardiac services, diagnostic imaging, inpatient and outpatient surgery, an intensive care unit, stereotactic breast biopsy, GI services, orthopedics, urology services, a hospitalist program, wound care, acute care for the elderly, and a women’s care center. Aurora Memorial Hospital of Burlington has been recognized for care provided in 2010 to heart attack, pneumonia and surgical patients. This places Aurora Memorial Hospital of Burlington in a small group of hospitals who met 95-percent performance threshold in these three areas of care.

Department of Pharmacy ServicesThe Department of Pharmacy Services is comprised of fi ve full-time pharmacists, including the pharmacy manager, and four full-time pharmacy technicians. The pharmacy department works cohesively toward advancing patient care through maximizing pharmaceutical clinical activities and expanding the roles of pharmacy technicians. The department’s caregivers have been recognized on multiple occasions by nursing and medical staff at the medical center for providing excellent patient care. Clinical pharmacists activities include, but are not limited to, IV to PO conversion, renal dose adjustment, anticoagulation monitoring, pharmacokinetic dosing service and TPN monitoring.

Major 2011 accomplishments• Implemented technician-check-technician program on

medications provided via cart-fi ll• Expanded the role of pharmacists to include patient-care

rounding on patient units in multidisciplinary teams to provide best patient experience

• Supported successful EPIC technology implementation at other medical centers in the system

• Collaborated with nursing staff in training caregivers to proactively increase medication event reporting to strategize new patient safety measures

• Implemented Pyxis Anesthesia System dispensing machines in all operating rooms, catheterization lab, and C-section operating room for increased patient safety, work-fl ow improvement, improved medication control and safety

• Converted to a dual chamber isolator hood in the IV room to meet USP 797 standards

• Formed a Medication/Patient Safety Committee with involvement of Aurora Lakeland Medical Center to address and share patient-safety strategies

2012 goals• Maintain technician-check-technician cart-fi ll process

through routine validation and implement technician-check-technician process on medications available through Pyxis machines on patient care units.

• Increase medication event reporting rate to the central electronic monitoring program

• Continue joint efforts with Aurora Lakeland Medical Center in reviewing medication events and adverse drug events to proactively formulate strategies to prevent critical medication events and adverse effects

• Collaborate with hospital departments to plan successful implementation of Epic


Aurora Medical Center36500 Aurora DriveSummit, WI 53066

Aurora Medical Center in Summit, Wis., opened in spring 2010. It is a 110-bed, state-of-the-art regional medical center offering a full range of health care services. The regional medical center provides cardiovascular services, including heart catheterizations and electrophysiology. The medicalcenter also has a Level IIB neonatal intensive care unit andpediatric unit. The center provides comprehensive cancercare, including radiation oncology and a Vince LombardiCancer Clinic.

Department of Pharmacy ServicesThe inpatient pharmacy at Aurora Medical Center in Summitconsists of seven clinical pharmacists and 10 pharmacytechnicians. The department is involved in providing a widerange of clinical services including, but not limited to, IVto PO conversion, renal dose adjustment, anticoagulationmonitoring, pharmacokinetic dosing service and TPNmonitoring. Pharmacists have been involved with steeringthe system clinical pharmacy practice.

Major 2011 accomplishments• Implemented PharmEd program with focus on discharge

teaching and transitions of care from inpatient to the outpatient setting in collaboration with outpatient pharmacy

• Piloted eMedRec and built online tools to documentpharmacist-patient encounters

• Improved clinical monitoring through formalizing polypharmacy reviews and initiating discharge rounding with hospitalist team

• Two new pharmacists board certifi ed by the Board of Pharmacy Specialties

2012 goals• Implement technician-check-technician process for

medications available through cart-fi ll and Pyxis machines on patient fl oors

• Establish anticoagulation services• Ensure successful hospital stroke certifi cation


Aurora Medical Center975 Port Washington RoadGrafton, WI 53024

Aurora Medical Center in Grafton, Wis., is a 120-bed tertiary care hospital serving Ozaukee, Washington and Sheboygan counties. The medical center opened during the fall 2010. Aurora Medical Center in Grafton is the only medical center in Wisconsin built to LEED certifi cation specifi cations. LEED is an internationally recognized environmental building certifi cation system. It verifi es a building was designed and built using strategies aimed at improving energy savings, water effi ciency, CO2 emissions reduction, improved indoor environmental quality and stewardship of resources. Aurora Medical Center’s primary services include emergency care, interventional cardiac services, electrophysiology, women’s health, orthopedics, general surgery and general medicine. The medical center also a Level III Trauma Center and provides Level II neonatal intensive care. The electronic health record was completely integrated with ambulatory clinics and the health center is more than 99-percent integrated with computerized physician order entry, and operates on barcode medication administration.

Department of Pharmacy ServicesThe Department of Pharmacy Services is comprised of seven clinical pharmacists and eight pharmacy technicians who work in collaboration with nursing and medical staff to provide on-site pharmacy services 24 hours a day. The department provides both centralized and decentralized services, including medication distribution, medication reconciliation, discharge coordination and a pharmacist-managed anticoagulation clinic.

Major 2011 accomplishments• Continued to support Concordia University Wisconsin

School of Pharmacy growth through participation in teaching didactic classes and admission committees

• Implemented pharmacy technician-check-technician on medications stocked in Pyxis machines

• Implemented pharmacy technician-led medication history-taking process on all patients admitted to the medical center, who then work in collaboration with clinical pharmacists to complete medication reconciliation on admission

• Piloted pharmacist-managed anticoagulation for all inpatients

• Collaborated with Epic Willow Team to improve electronic clinical monitoring tool to provide best patient experience

• Participated in successful implementation of Epic technology at other medical centers in Aurora system

• Continued improvement with effi ciencies in stocking medications in Pyxis machines to improve medication availability for all patients

• Involved with patient advisory committee for improved inpatient discharge process

2012 goals• Expand technician-check-technician program for

medications provided through cart-fi ll• Collaborate with outpatient pharmacy to facilitate patients’

transition of care from inpatient to outpatient setting through discharge teaching

• Implement pharmacy involvement in obtaining medication histories in presurgical patients who are not admitted via Emergency Department

• Facilitate Pyxis installment at Mayfair surgery center• Implementation of ambulatory anticoagulation clinic

and facilitation transitions for warfarin patients between inpatient and outpatient care settings

• Continue to monitor compliance with current clinical programs and improve outcomes in pharmacist-managed anticoagulation, antibiotics dosing and selection based on Centers for Medicare and Medicaid Services criteria, IV to PO compliance and monitoring infl uenza/pneumococcal vaccine in all inpatients


Aurora BayCare Medical Center2845 Greenbrier RoadGreen Bay, WI 54311

Aurora BayCare Medical Center is a 167-bed tertiary care hospital serving northeast Wisconsin and the Greater Green Bay area. Aurora BayCare opened in September 2001 as a joint effort of Aurora Health Care and BayCare Clinic. Aurora BayCare and other Aurora hospitals are among the 250 health systems and hospitals nationwide participating in the national CMS/Premier Hospital Quality Incentive Demonstration project. Aurora BayCare was named the top-performing hospital in this nationwide demonstration project. Aurora BayCare features many “centers of excellence,” including cancer care services, a cartilage center, a heart, lung and vascular center, neuro-care brain and spine center, orthopedic services, sports medicine and performance-enhancement center, and a women’s center featuring minimally invasive gynecological surgery.

Department of Pharmacy ServicesThe Department of Pharmacy Services is comprised of 16 clinical pharmacists and 15 pharmacy technicians. The department provides medication distributive functions and clinical services throughout the hospital, 24 hours a day to inpatient and outpatient departments. Outpatient services include IV therapy and serving the Vince Lombardi Cancer Clinic. Pharmacy services are divided into central and decentralized services. All clinical pharmacists are involved in monitoring and adjusting dosing of vancomycin, aminoglycosides, renally excreted medications, warfarin, parenteral nutrition, and other medications as asked by medical staff. Quality measures supported by the department include VTE prophylaxis, antibiotic stewardship, and tracking appropriate acute myocardial infarction and heart-failure therapy.

Major 2011 accomplishments• Integrated of pharmacy students into the department’s

work fl ow to provide clinical services, such as patient medication monitoring, clinical and medication related inquiries, pharmacy drug-related presentations to pharmacy and medical staff, and complete several high-priority pharmacy departmental projects

• Implemented technician-check-technician process for all medication doses stocked in Pyxis machines and medication dosages provided in cart-fi ll

• Implemented process of obtaining accurate patient medication histories by qualifi ed pharmacy technicians

• Collaborated with several nursing units to improve quality and patient safety via several collaborative pland-do-study-act (PDSA) evaluations: medication reconciliation process, drug shortages, improving preoperative appropriate antibiotic selection, post-anesthesia care unit communication, concentrated insulin U-500, DVT prophylaxis, increasing medication-event reporting

• Improved patient care on intensive care unit through participation in multidisciplinary rounding with physicians, nurses, social worker, etc.

• Initiated antimicrobial stewardship program with pharmacist restriction to specifi c antibiotics

2012 goals• Continue to improve antimicrobial stewardship program

hospitalwide• Implement a process to improve communication with

anticoagulation clinic by providing discharge information on inpatient anticoagulation monitoring and dosing

• Collaborate with nursing services to improve timely provision of medications to prevent delay in patient care

• Implement MedCarousel technology in inpatient pharmacy to further assist with pharmaceutical distributive functions


Aurora St. Luke’s South Shore5900 S. Lake DriveCudahy, WI 53110

Aurora St. Luke’s South Shore is located Cudahy, Wis., in the heart of Milwaukee’s south shore area. The hospital offers a range of primary and acute-care services. The hospital has been awarded with the Gold Plus Performance Award for Stroke Care, the highest achievement award given, and Magnet Recognition Program from the American Nurses Credentialing Center. Aurora St. Luke’s South Shore provides an array of services, including cardiology, radiology, surgery services (inpatient and outpatient based), and houses a Vince Lombardi Cancer Clinic.

Department of Pharmacy ServicesThe Department of Pharmacy Services has a total of 14 caregivers on staff, with seven full-time pharmacists, including the pharmacy manager, and seven full-time pharmacy technicians. The department is involved in providing a wide range of clinical services including, but not limited to, IV to PO conversion, renal dose adjustment, anticoagulation monitoring, pharmacokinetic dosing service and TPN monitoring.

Major 2011 accomplishments• Registered clinical pharmacists serving as as clinical

instructors at Concordia University Wisconsin College of Pharmacy

• Continued support for pharmacy technician students of Milwaukee Area Technical College, serving as a rotation site

• Implemented pharmacy technician-led medication history taking in the Emergency Department and electronic processing of medication information to ensure patients have accurate medication list across the continuum of care

• Implemented pain management rounding in collaboration with patients, families, physicians and nurses to improve patient outcomes

• Developed strategies to demonstrate increased compliance with Centers for Medicare and Medicaid Services best-practice guidelines

• Implemented Talyst split-billing software to facilitate 340B cost savings initiative

2012 goals• Develop technician-check-technician program for fi rst

doses and unit-based cabinet restocks• Develop processes to integrate hospital departments to

successfully implement EPIC technology at the medical center

• Work in collaboration with hospital departments to ensure successful anticipated accreditation by The Joint Commission

• Implement new event reporting software and develop strategies to increase medication event and adverse drug effects reporting


Aurora Lakeland Medical Center W3985 County Road NNElkhorn, WI 53121

Aurora Lakeland Medical Center in Elkhorn, Wis., has been providing medical services to Walworth County since 1917. The medical center offers comprehensive health care services through continued investment in state-of-the-art diagnostic and surgical services. Aurora Lakeland Medical Center was recognized as a top performer among the Premier Healthcare Alliance’s national QUEST collaborative, a voluntary program that supports individual hospitals in delivering the best care possible.

Department of Pharmacy ServicesThe inpatient pharmacy at Aurora Lakeland Medical Center consists of 10 full-time pharmacy caregivers, with an average length of service of almost 15 years. The pharmacy team is a dedicated group that is always involved in learning new information, implementing new technologies and fi nding better, more effi cient ways to provide the best patient care experience.

Major 2011 accomplishments• Implemented technician-check-technician program on

medications provided via cart-fi ll and Pyxis machines• Implemented pharmacist involvement in medication

reconciliation process on admission for inpatients• Partnership with Aurora outpatient pharmacy to improve

transitions of care through appropriate bedside medication discharge counseling

• Successful implementation of IntelliShelf-Rx technology to improve medication safety and better manage pharmacy drug inventory

• Improved operational effi ciencies by focused work on unit-based cabinet dispensing of fi rst doses and one time doses to accelerate timely provision of critical medications

• Collaborated with Aurora Memorial Hospital of Burlington to form a joint Medication/Patient Safety Committee to proactively study medication event trends at the two medical centers

2012 goals• Collaborate with Aurora Pharmacy (retail/outpatient) to

improve operational effi ciencies in providing inpatient discharge counseling

• Implement Pyxis Anesthesia System in operating rooms to improve surveillance of controlled substances and capture any lost charges

• Continue joint efforts with Aurora Memorial Hospital of Burlington to advance patient safety initiatives through a combined Patient/Medication Safety Committee

• Participation of clinical pharmacists in nurse resource program (Nurses Improving Care for Health System Elders) to provide better care to the elderly patient population

• Work with hospital departments to plan successful implementation of Epic technology

• Continue to maintain technician-check-technician program by completing necessary validation requirements


Aurora Medical Center5000 Memorial DriveTwo Rivers, WI 54241

Aurora Medical Center in Manitowoc County, located in Two Rivers, is a 69-bed hospital located on the shores of Lake Michigan. It is the only hospital in the county with certifi cation by The Joint Commission for its stroke program. In 2009, the medical center was honored with outstanding achievement cancer accreditation program and achieved cardiac rehabilitation certifi cation the following year.

Department of Pharmacy ServicesThe Department of Pharmacy Services is comprised of three pharmacists and three pharmacy technicians, and works closely with medical staff, nursing and other health care professionals to provide an exceptional patient care experience.

Major 2011 accomplishments• Participated in hospital-based data analysis team to

review and analyze Peminic incident reviews (including medication errors and adverse drug events) with increased focus on root cause analysis and prevention

• Completed Institute for Safe Medication Practices survey gap analysis and worked in conjunction with hospital-based patient-safety committee to ensure safe patient practices

• Continued to support pharmacy technician students from Lakeshore Technical College to enhance their practical experience and learning

• Participated in inpatient diabetes teaching to increase disease state awareness and promote appropriate use of medications

2012 goals• Implement technician-check-technician for medication

dosages provided through cart-fi ll• Participate in system efforts for centralized order entry• Continue to increase efforts on documentation of

medication events and adverse drug events to identify and maximize patient-safety practices

Documents

x44968 pharmacy services ap 2011 - ASHP Media · X44968 (05/12) ©AHC Department of Pharmacy Services Annual Report 2011 Department of Pharmacy Services