Abstract Aims The involvement of an inter-professional healthcare student team in the review of medications used by geriatric patients could not only provide patients with optimized therapy but also provide students with a valuable inter-professional learning experience. We describe and evaluate the clinical and learning outcomes of an inter-professional student-run mediation review program (ISP). Subject and method A variable team consisting of students in medicine, pharmacy, master advanced nursing practice, and master physician assistant reviewed the medication lists of patients attending a specialized geriatric outpatient clinic. Results During 32 outpatient visits, 188 medications were reviewed. The students identified 14 medication-related problems, of which 4 were not recognized by healthcare professionals. The ISP team advised 95 medication changes, of which 68 (71.6%) were directly implemented. Students evaluated this pilot program positively and considered it educational (median score 4 out of 5) and thought it would contribute to their future inter-professional relationships. Conclusion An inter-professional team of healthcare students is an innovative healthcare improvement for (academic) hospitals to increase medication safety. Most formulated advices were directly incorporated in daily practice and could prevent future medication-related harm. The ISP also offers students a first opportunity to work in an inter-professional manner and get insight into the perspectives and qualities of their future colleagues.
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Summary Project objectives This study fits into a larger research project on logistics collaboration and outsourcing decisions. The final objective of this larger project is to analyze the logistics collaboration decision in more detail to identify thresholds in these decisions. To reach the overall objectives, the first step is to get a clearer picture on the chemical and logistics service providers industry, sectors of our study, and on logistics collaboration in these sectors. The results of this first phase are presented in this report. Project Approach The study consists of two parts: literature review and five case studies within the chemical industry. The literature covers three topics: logistics collaboration, logistics outsourcing and purchasing of logistics services. The five case studies are used to refine the theoretical findings of the literature review. Conclusions Main observations during the case studies can be summarized as follows: Most analyzed collaborative relationships between shippers and logistics service providers in the chemical industry are still focused on operational execution of logistics activities with a short term horizon. Supply management design and control are often retained by the shippers. Despite the time and cost intensive character of a logistics service buying process, shippers tendering on a very regular basis. The decision to start a new tender project should more often be based on an integral approach that includes all tender related costs. A lower frequency of tendering could create more stability in supply chains. Beside, it will give both, shippers and LSPs, the possibility to improve the quality of the remaining projects. Price is still a dominating decision criterion in selecting a LSP. This is not an issue as long as the comparison of costs is based on an integral approach, and when shippers balance the cost criterion within their total set of criteria for sourcing logistics services. At the shippers' side there is an increased awareness of the need of more solid collaboration with logistics service providers. Nevertheless, in many cases this increased awareness does not actually result in the required actions to establish more intensive collaboration. Over the last years the logistics service providers industry was characterized by low profit margins, strong fragmentation and price competition. Nowadays, the market for LSPs is changing, because of an increasing demand for logistics services. To benefit from this situation a more pro-active role of the service providers is required in building stronger relationships with their customers. They should pay more attention on mid and long term possibilities in a collaborative relation, in stead of only be focused on running the daily operation.
ABSTRACT Background: We investigated if the addition of an inter-professional student-led medication review team (ISP-team) to standard care can increase the number of detected ADRs and reduce the number of ADRs 3 months after an outpatient visit. Research design and methods: In this controlled clinical trial, patients were allocated to standard care (control group) or standard care plus the ISP team (intervention group). The ISP team consisted of medical and pharmacy students and student nurse practitioners. The team performed a structured medication review and adjusted medication to reduce the number of ADRs. Three months after the outpatient visit, a clinical pharmacologist who was blinded for allocation performed a follow-up telephone interview to determine whether patients experienced ADRs. Results: During the outpatient clinic visit, significantly more (p < 0.001) ADRs were detected in the intervention group (n = 48) than in the control group (n = 10). In both groups, 60–63% of all detected ADRs were managed. Three months after the outpatient visit, significantly fewer (predominantly mild and moderately severe) ADRs related to benzodiazepine derivatives and antihypertensive causing dizziness were detected in the patients of the intervention group. Conclusions: An ISP team in addition to standard care increases the detection and management of ADRs in elderly patients resulting in fewer mild and moderately severe ADRs
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