2008 Awards Recipients

• Recipient - Novant Health, Winston-Salem, North Carolina
• Finalist - Northwestern Memorial Hospital, Chicago, Illinois
• Finalist - Richard M. Ross Heart Hospital, The Ohio State University Medical Center, Columbus, Ohio

The recipient of this year's award was announced on Sunday, December 7, 2008, during the 2008 Excellence Awards Presentation & Luncheon in Orlando, Florida. The awards program and the Awards Presentation & Luncheon are sponsored by the Cardinal Health Foundation. For more information on each organization's medication-use safety initiative, keep reading!

2008 Recipient - Novant Health
Novant Health is a not-for-profit, integrated health care system based in North Carolina, serving more than 4 million people in 34 counties reaching from southern Virginia to northern South Carolina. The 2006 Institute of Medicine report, Preventing Medication Errors, motivated Novant to identify strategic opportunities to reduce adverse drug events (ADE) and harm.  Knowing that patients who are 65 years or older are seven times more likely to require hospitalization due to an ADE, Novant developed the Safe Med outpatient medication reconciliation program.

Through this program, pharmacists contact all patients who are 65 years or older within seven days of their discharge.  The pharmacists assess each patient’s medication regimen and provide education for safe adherence.  A reconciled list of medications is then provided to the patient and primary care provider after each encounter.  The Safe Med outpatient medication reconciliation program has reduced hospital admissions related to an ADE from 17.9 percent to 4 percent.  In addition, predictive models estimate that Safe Med patients have experienced a remarkable 29-percent reduction in overall hospital admissions.

Multidisciplinary Team
Terri B. Cardwell, Pharm.D.
Denise Segraves, B.S.N., R.N.
Nan Holland, R.N., B.S.N., M.P.H.
Jane Thompson, Pharm.D.
Rebecca Bean, Pharm.D., C.G.P.
Jennifer Rief, Pharm.D.
Diana Best, R.N., B.S.N., M.S.
James Lederer, M.D.
John F. Davis, M.D.

2008 Finalist - Northwestern Memorial Hospital
In a 2006 study supported by the Agency for Healthcare Research and Quality, Northwestern Memorial Hospital determined its initial medication reconciliation compliance was 40 percent. Surprisingly, 86 percent of prescription medication discrepancies originated in patients’ medication histories and impacted inpatient orders.  A multidisciplinary team, supported by hospital leadership, created the Medications at Transitions and Clinical Handoffs (MATCH) initiative to weave medication reconciliation into all points of patient care.

Clinician communication and poor cross-referencing were barriers that impeded medication reconciliation.  The initiative’s goal was to improve and maintain medication consistency through a streamlined process which involved all physicians, nurses and pharmacists and resulted in cohesive medication management.  

In addition to incorporating enhancements to the hospital’s electronic medical record system, the MATCH initiative also implemented mandatory, multidisciplinary training to ensure that physicians were aware of medication histories prior to placing orders, that nurses and pharmacists validated medication histories against active orders, and that pharmacists participated as the final points of reconciliation. As a result, Northwestern Memorial Hospital’s MATCH program raised medication reconciliation compliance rates above 90 percent.  Medication reconciliation is now an “always practice” and an integral part of clinicians’ workflow at Northwestern.

Multidisciplinary Leadership and Implementation Teams
Cynthia Barnard, M.B.A., MSJS, CPHQ
Julie Berggren, R.N.
Jillian Bergner, R.N., B.S.N.
Jennifer Bloomquist, B.S.E.
Helga Brake, Pharm.D., CPHQ
Daniel Derman, M.D.
James Foody, M.D.
Kristine Gleason, R.Ph.
Mary Lou Green, M.H.A.
Desi Kotis, Pharm.D.
Matthew Landler, M.D.
Kimberly Levasseur, Pharm.D., BCPS
David Liebovitz, M.D.
Jane Menendez, R.N.
Karen Nordstrom, R.Ph.
Gary Noskin, M.D.
Kevin O’Leary, M.D.
Carol Payson, M.S.N., R.N.
Michael Postelnick, R.Ph., BCPS
Bin Shen, M.S.
Nathaniel Soper, M.D.
Lydia Splan B.S.
Elizabeth Standardi, B.S.
Charles Watts, M.D.
Mark Williams, M.D., FACP

Medication Reconciliation Team
All NMH Physicians, Nurses and Pharmacists

2008 Finalist - Richard M. Ross Heart Hospital, The Ohio State University Medical Center
This continuous quality improvement project, which spanned nearly a decade, is the result of a pharmacist-led multidisciplinary team that focused on the safe administration of two different types of anticoagulant treatments during percutaneous coronary intervention (PCI): glycoprotein IIb/IIIa (GP IIb/IIIa) inhibitors and bivalirudin.  An initial evaluation of 285 PCI patients conducted in 2004 revealed that patients who received bivalirudin experienced  less total bleeding and stayed in the hospital fewer days versus patients who received GP IIb/IIIa inhibitors plus heparin. As a result of these findings, the Richard M. Ross Heart Hospital revised its practices and polices to ensure physicians, nurses and pharmacists received intensive education and training to safely incorporate bivalirudin as the preferred adjunct agent for PCI.

Following these interventions, an evaluation of 389 patients, performed in 2006-07, yielded striking results.  Total bleeding was significantly lower for patients who received bivalirudin when compared to the patients who received  GP IIb/IIIa inhibitors plus heparin, 2.9 percent versus 14.5 percent. Length of stay was also significantly lower with bivalirudin, 1.9 days versus 3.1 days. Compared with the previous data, both therapies showed a reduction in length of stay by approximately 50 percent.  Patients treated with bivalirudin also experienced a 79 percent reduction in bleeding incidence versus patients treated with GP IIb/IIIa inhibitors plus heparin, who experienced a 46-percent reduction in bleeding.  This initiative significantly improved medication safety in patients requiring PCI.

Multidisciplinary Team
Kerry Pickworth, Pharm.D.
Danielle Blais, Pharm.D.
John Lindsley, Pharm.D.
Charles A. Bush, M.D.
Raymond Magorien, M.D.
Glenn Plants, R.N., B.S.N.
Lisa Smith, R.N., B.S.N.
Trisha Jordan, Pharm.D., M.S.