Thursday, June 21, 2012

“If you can’t explain it to a 6-year-old...."

Posted by Anam Mian at Thursday, June 21, 2012


“If you can’t explain it to a 6-year-old, you don’t understand it yourself.” ~Albert Einstein

This has been my mantra of late. Over the course of my non-traditional rotation in Quality Management, I’ve often sat and pondered how I would explain what transpires in this office to my nieces and nephews should one of them ask me, “Anam Khala [Urdu for ‘Aunt’], now what do you do in school again?” as they occasionally do. This rotation has deeply increased my appreciation for the various tools and resources we have used along the course of our pharmacy training. To give you a better idea of what I mean, let me begin with the basics.

The Quality Management Program, or QMP, as it’s affectionately referred to around here, is the branch of the University Hospital that is responsible for all of the data that lives in the shadows of clinical care guidelines, pay-per-performance protocols, and medication adherence efforts. I share an office with clinical information analysts and programmers, allowing me to appreciate the diversity of skills required to impact healthcare. My preceptor, Dr. Annie Sy, is a clinical pharmacist who practiced in the hospital for 5 years before joined the Quality Improvement & Decision Support Team for the FGP Quality Management Program in 2007. Dr. Sy became the manager to this team 2 years ago. She currently works in an ambulatory care clinic for a portion of her week, and spends the rest of her time running the show at this office, where she divides her time between leading meetings, giving presentations, analyzing data for incentive programs such as FGP and BSCSM PGIP, helping to develop and maintain chronic disease registries and overseeing various programming protocols in preparation of the upcoming MiChart implementation. To give you an idea of what interns do on this rotation, some of the projects I have completed for Dr. Sy and her various committee leaders included helping to update the medication portion of the Asthma Clinical Care  Guideline, analyzing external data from the BSBSM PGIP Generic Dispensing Rate Initiative, performing medication reconciliation reviews on Careweb for an Accountable Care Organization initiative, and computing drug prices on the brand new CKD Clinical Care Guideline (coming soon a therapeutics class near you!). Another important part of what Dr. Sy does is to bring a pharmacy/clinical perspective to UMHS’ quality improvement efforts by sitting with physicians, nurses, social psychologists, and analysts on each of UMHS’ QI committees. These committees include but are not limited to the asthma, COPD, diabetes, heart failure, and controlled substance committees, the last of which I helped validate the opioid and benzodiazepine registries for while on rotation. As I’ve worked on my individual projects and attended various team planning and QI meetings, I have been grateful for the background in statistics and EBM that UM equips its Pharm D. students with, as both have been integral in helping me understand quality management.

In my years working in a community pharmacy and even now at my current job as an intern at an inpatient pharmacy, I’ve never experienced a working environment quite like this. For one, I’m far removed from the usual hustle and bustle of a pharmacy, but rather spend most of my day working on projects in my cubicle, whence I emergeth occasionally for meetings. :) In a pharmacy there is a constant stream of new faces, but here I am part of a team of only about 15 people whom I see every day, and whom, by the way, have truly gone out of their way to make me feel at home. Last week, for example, I participated in a taco salad potluck. I was touched when the kind officemate of mine who was coordinating it correctly extrapolated from the way I choose to dress that I might appreciate some Muslim-friendly meal options. She then took it upon herself to bring non-pork-containing refried beans (I signed up for the gelatin-free sour cream :)). One of my favorite things is watching my officemates pick each other’s brains at meetings when they are presenting their individual projects to the group. A spreadsheet that looks like hieroglyphics to me, for example, might elicit a string of very technical questions from a colleague, which are answered with just as much detail. As you can imagine, my role in these particular meetings is usually silent observation, except days like when the word “membranoproliferative glomerulonephritis” appeared in someone’s research and all eyes in the room simultaneously turned to me to pronounce it.  

I purposely waited until the end to write this post so that I could do this rotation justice in my reporting, and I’m glad I did because each day has brought forth exposure to new topics and increased my appreciation for the field. With that in mind, readers, for you I have done my best to accurately express what this rotation is all about. For my nieces and nephews, I think I’ll stick to, “We use computers to make sure sick people are taken care of in the best way possible.”

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