Stacey Karl1, Jeffrey Walden2, Peter Koval3. 1. Cone Health, Greensboro, NC. 2. Cone Health Family Medicine Residency, Greensboro, NC. 3. Cone Health Family Medicine Residency.
Abstract
INTRODUCTION: As we move from a fee-for-service system to a value-based payment system, ongoing quality improvement projects have become the norm. We chose to evaluate whether academic detailing by a pharmacist is an effective means of increasing knowledge among family medicine residents of the need to monitor for iron deficiency in chronic heart failure (CHF) patients. METHODS: We identified the baseline number of iron levels obtained for CHF patients and surveyed all 24 residents to evaluate baseline knowledge of the association between iron deficiency and CHF. Residents met with a pharmacist on clinic days to discuss iron deficiency and CHF and received an educational handout and a list of their CHF patients. Periodic reminders were first sent electronically to residents followed by in-person reminders from the pharmacist for patients seen that day in clinic. RESULTS: At baseline, 16 (3%) of 488 CHF patients had an iron level collected within the past year. Initial survey results showed only one resident (4.2%) reported knowledge of monitoring iron in CHF patients. After academic detailing, residents ordered iron panels on 234 patients. Of these, 98 patients (42%) were found to be iron deficient. On postintervention analysis, all residents surveyed (20) reported that they would monitor iron in CHF patients (P<0.001). Residents were receptive to academic detailing and preferred it over EMR messages. CONCLUSION: Education from a pharmacist improved awareness of the necessity to evaluate for iron deficiency in CHF patients. Academic detailing with reminders is a viable option for improving quality and educating residents.
INTRODUCTION: As we move from a fee-for-service system to a value-based payment system, ongoing quality improvement projects have become the norm. We chose to evaluate whether academic detailing by a pharmacist is an effective means of increasing knowledge among family medicine residents of the need to monitor for iron deficiency in chronic heart failure (CHF) patients. METHODS: We identified the baseline number of iron levels obtained for CHF patients and surveyed all 24 residents to evaluate baseline knowledge of the association between iron deficiency and CHF. Residents met with a pharmacist on clinic days to discuss iron deficiency and CHF and received an educational handout and a list of their CHF patients. Periodic reminders were first sent electronically to residents followed by in-person reminders from the pharmacist for patients seen that day in clinic. RESULTS: At baseline, 16 (3%) of 488 CHF patients had an iron level collected within the past year. Initial survey results showed only one resident (4.2%) reported knowledge of monitoring iron in CHF patients. After academic detailing, residents ordered iron panels on 234 patients. Of these, 98 patients (42%) were found to be iron deficient. On postintervention analysis, all residents surveyed (20) reported that they would monitor iron in CHF patients (P<0.001). Residents were receptive to academic detailing and preferred it over EMR messages. CONCLUSION: Education from a pharmacist improved awareness of the necessity to evaluate for iron deficiency in CHF patients. Academic detailing with reminders is a viable option for improving quality and educating residents.
Authors: Lauren S Hughes; Michael Tuggy; Perry A Pugno; Lars E Peterson; Stacy H Brungardt; Grant Hoekzema; Samuel Jones; Jane Weida; Andrew Bazemore Journal: Fam Med Date: 2015-09 Impact factor: 1.756
Authors: M A O'Brien; S Rogers; G Jamtvedt; A D Oxman; J Odgaard-Jensen; D T Kristoffersen; L Forsetlund; D Bainbridge; N Freemantle; D A Davis; R B Haynes; E L Harvey Journal: Cochrane Database Syst Rev Date: 2007-10-17
Authors: Piotr Ponikowski; Adriaan A Voors; Stefan D Anker; Héctor Bueno; John G F Cleland; Andrew J S Coats; Volkmar Falk; José Ramón González-Juanatey; Veli-Pekka Harjola; Ewa A Jankowska; Mariell Jessup; Cecilia Linde; Petros Nihoyannopoulos; John T Parissis; Burkert Pieske; Jillian P Riley; Giuseppe M C Rosano; Luis M Ruilope; Frank Ruschitzka; Frans H Rutten; Peter van der Meer Journal: Eur Heart J Date: 2016-05-20 Impact factor: 29.983