Flip the Pharmacy Change Packages
A Change Package is an implementation guide, in which the FtP initiative aims to provide bite size chunks of best practices that pharmacies across the country have implemented and share those with all pharmacies in order to transform pharmacy practice from filling a prescription at a moment in time to caring for patients over time.
The Flip the Pharmacy Change Packages are updated on a monthly basis.
Opioid Progression Change Packages
Opioid Change Package: Domain 1 (June 2020)
June 2020 begins the launch of the Opioid Progression 2 Change Packages.
There are several significant reasons why you should focus on documenting care plans for patients receiving an opioid prescription. Within the Change Package listen in to hear from Joe Moose at Moose Pharmacy and Attorney Shawn Parker with CPESN® USA discuss best practices for opioid safety.
The goal of this month is to identify patients within the Appointment-Based Model who are taking opioid medications and begin documenting the indication and MME. During July, these patients will be followed-up with to discuss naloxone.
Best Practices & Additional Resources
Word document to print Avery labels, specifically Avery 5160 Peel Address Labels.
The label can be put on the back of opiate prescription hard copies, so that throughout the filling process, technicians and pharmacists can document:
who checked the pdmp
what the calculated MMEs are
if naloxone was offered to patient and if the patient accepted naloxone
Created a stepwise document for pharmacists, pharmacy technicians and cashiers to follow in order to complete the patient encounter documentation form for MME, indication, and pdmp check
Program Materials and Results
(click below to view/download)
Opioid Change Package: Domain 2 (July 2020)
The goal of this month is to follow up with patients or identify newly eligible patients for candidates of naloxone. If the pharmacy has not implemented a naloxone program, a guide to help is located within the change package.
Best Practices & Additional Resources
Kelley-Ross Pharmacy has created some great pharmacist and patient materials surrounding naloxone. Click the link to the left to view the website.
For implementing a naloxone program, click here to view numerous resources, including an implementation checklist for pharmacists, a blank naloxone collaborative drug therapy agreement, and FAQs
Moose Pharmacy created a staff training guide when the North Carolina Standing Order was signed in July 2016.
Create something similar to help your pharmacy staff understand their role and talking points with patients.
Ideas for Naloxone Distribution for Patients who Cannot Afford the Copay
Deborah Bowers at Yorkville Pharmacy in SC shared that many states have programs in place that you may not know about for patients to receive naloxone at no charge. She stated that in SC they also have grant funding for lock boxes and disposal bags.
Contact Community Anti-Drug Coalitions of America (CADCA) at 1-800-54-CADCa (1-800-542-2322) and ask for your local contact person. Describe to them your efforts in the opioid epidemic and ask if they have any offerings for your pharmacy and your patients.
COVID-19 Change Packages
Change Package #1 (3/24/2020)
Objective: Integral to community pharmacies currently is focusing on protecting pharmacy staff and patients. This requires new workflows (practice transformation). Simultaneously, pharmacies need to be communicating the changes to patients.
Change Package #3 (4/17/2020)
Objective: Helps to guide community pharmacies in applying for a CLIA Waiver in a straight-forward guidance document. *A how-to video is provided to help you fill out the form.*
Change Package #2 (4/8/2020)
Objective: This document is intended to provide a stepwise, workflow approach for triaging patients suspected of COVID-19 and to develop a care plan for those patients.
Change Package #4 (5/15/2020)
Objective: As community-based pharmacies consider reopening, learn what you need to consider when preparing to reopen your pharmacy to the patients you serve in your community while keeping pharmacy staff safe and healthy.
Hypertension Progression Change Packages
Change Package 1: Domain 1, Progression 1 (October 2019)
The focus of October 2019 is "Leveraging the Appointment Based Model (i.e., medication synchronization). Subject Matter Experts have stated that a great medication synchronization process is instrumental and necessary to begin transforming practice and documenting the care provided. Additionally, having a baseline of the pharmacy's current pharmacy practice is valuable to know which areas to focus on inititially and to reflect on improvement. Therefore, a pharmacy self-assessment is included in the change package as a link and you can click here to access the "Practice Transformation On-site Readiness Assessment for Coaches." Practice Transformation Coaches can be an external or internal source that will guide practice transformation efforts at the pharmacy.
The focus of November 2019 is "Improving Patient Follow-up and Monitoring," in which pharmacies are encouraged to continue enrolling patients into medication synchronization and following up on patients who previously received a care plan and have hypertension. Leading pharmacists stated that in order to be successful in this project, pharmacies must focus on certain health conditions. Beginning this month, the focus will be patients with hypertension. Included in this month's change package is a hypertension assessment for pharmacy staff members to ask patients who have hypertension during the follow up encounter. Additionally, the American Heart Association Blood Pressure Monitoring Training link is included for non-pharmacist staff members to get comfortable/knowledgeable about measuring blood pressure by December 2019.
The focus of December 2019 is "Developing New Roles for Non-Pharmacist Support Staff" and continuing to following-up with patients who have hypertension. The goal is to document blood pressure readings within the care plan. Blood pressure measurements can be done by any member of the pharmacy staff (non-pharmacists are encouraged to complete the AHA blood pressure monitoring training). Hear from your peers by listening to the podcast within the change package. The podcast is entitled "Progressive Staffing Models in Community Pharmacy Practice." View and complete the pharmacy reflection activity. The individual leading the pharmacy practice transformation efforts at your pharmacy is ideal for completing the activity. This information is intended to better help you think through your current workflow roles. In future months, the change package will be focused on improving these roles.
The focus of January is continuing to document blood pressure readings for patients – we completely understand that it is the first of the year so we want to continue documenting care plan components that we have seen before. Also, included in the change package are ideas for communication tools created by our friends with the ACT Collaborative and you can hear from peers about maximizing technology tools to build a more efficient pharmacy operations or workflow.
The focus of February is to establish and foster your relationship with one of your top prescribers for your mutual patients. This is a great time introduce your capabilities to the provider for mutual patients with hypertension. As you begin to start communicating medication related problems with providers through your preferred method, you can document those interactions under the care coordination notes within the eCare Plan.
The focus of the March Change Package is to is to help you better understand how community-based pharmacy fits in to measures that impact prescribers. Knowing this information will help you accomplish the ultimate goal of this Domain, which is to better understand your patient data within the pharmacy in a way that you may not have thought about before. In turn, the data and additional materials within the change package will help prescribers understand your value as you do so much more for patients that only dispensing their medications.
Resource for Current Flip the Pharmacy Practice Transformation Teams -
Ask a Question of the Coordinating Center
If you are currently participating in Flip the Pharmacy as a coach or pharmacy, please take your question to the Lead of your Practice Transformation Team.
If you are a PTT team Lead and you have a question for the coordinating center, please use this form to submit it instead of using email.
This form will allow the Flip the Pharmacy Coordinating Center to more efficiently route your question to the appropriate team member, and you will either receive a direct response via email or a response via the FtP listserv, if the Coordinating Center believes your question is relevant to all participants.
Your question may also be addressed on an upcoming program webinar.