Perspectives about Pharmacy Champions for Medication Safety for Veterans

ANJU SAHAY, PhD
Veterans Affairs Palo Alto Health Care System

The focus of the Department of Veteran Affairs’ (VA) Medication Safety QUERI Program is to reduce potentially unsafe or unnecessary medications for the Veterans. VA facilities (sites) use strategies to implement VA Pharmacy Benefits Management (PBM) Services initiatives and VISN (region) measures. The Medication Safety QUERI Program aimed to understand the role and use of champions in promoting select strategies to optimize medication safety for Veterans which included provider education, academic detailing, electronic reminders, patient specific care plan, draft orders, patient mailings and calling patients.

Participants were two pharmacists from each of the 18 VISNs (N=36). The VISN Pharmacy Executives (VISN-level PBM Leads) identified these pharmacists from their own VISN.

In Summer 2018 we conducted semi-structured phone interviews with these pharmacists. Participants were asked “…is there is a “Champion” such as a VA provider, pharmacist, administrator, or someone else who is leading or promoting the efforts to implement these strategies at your facility?” and if yes, participants were asked to respond regarding the champion’s location at the facility, VISN or both levels. All interviews were recorded and then transcribed for coding and analysis. An open iterative process was used to create the codebook which was then applied by a trained qualitative coder who adjudicated content as needed.

Sixteen participants (44.4%) said they have champion(s) leading or promoting effective implementation strategies, while the remaining majority of participants (55.6%) said they do not have such a champion. Among those participants who reported having champion(s), the number of champions ranged from having one champion (n=8), two champions (n=3) to multiple champions (n=5). These champions were located at their own local level (n=11), at their own region(n=2) and both at their own local and own regional levels (n=3).
 
Participants identified qualities in a ‘champion’ as one who encourages strategy utilization, is willing to listen and have regular communications such as hosting monthly phone calls and VISN meetings, addresses potential barriers encountered by the providers, encourages provider education about best practices and assists with the development, implementation and on-going oversight of initiatives and measures at their facility.
 
These champions were described as “…he really is overseeing and helping us throughout the entire process” and “…has been more than willing to listen to our recommendations, provide feedback, kind of go out on a limb…to discuss these issues with a provider that may not be seeing eye-to-eye with us and recommend what can we do to resolve this issue and keep the patient safe and provide good care…”.