Medication Stewardship for the Medical Director
By Dallas Nelson MD CMD, Professor of Medicine, University of Rochester
In the nursing home setting of care, ensuring the appropriate use of medication is incorporated throughout the regulations. Despite the regulations, polypharmacy is still rampant in many nursing homes.
More regulations will never sufficiently optimize medication prescribing. Medication stewardship will require the active participation of the interdisciplinary team including pharmacists, nursing, and medical providers. The medical director can be an important leader in the medication optimization program.
The consultant pharmacist reviews provide needed information due to the regulation on psychotropic utilization, antipsychotic prescribing and as needed psychotropic prescriptions. They also provide feedback on the building’s antibiotic utilization. Hopefully, the pharmacist provides information of antibiotic days of therapy and the class of antibiotics used. If not delivered regularly and with context, the efforts and information provided will not necessarily have the intended impact on prescribing. The medical director can help by ensuring that the entire medical team is aware of regulations and the expected response to pharmacist feedback. The medical director can assist the pharmacist and nursing leadership design tracking systems that provides actionable information to the interdisciplinary team.
At the meetings to review prescribing patterns, such as a pharmacy and therapeutic committee, psychotropic review committee, or antibiotics stewardship the medical director can ensure that the team understands the current practice standards and expectations. The medical director can use the time to grow the team’s knowledge about medication effects, interactions, and side effects. The medical director is best accepted when a discussion about unwarranted variation found in the data.
One of the main positive outcomes of the medication review meetings is to strengthen the team’s collaboration and functioning. The medical director needs to approach variation with humility. Instead of taking over the prescribing for the attending physician, it is better to do a case based discussion. The medical provider has the opportunity to explain their clinical decisions makings. Well thought out variation should be allowed due to the complex nature of the residents. Excellence adherence to standards should be highlighted during the meeting to encourage continued good practice in the home.
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Job Bank
Community LIFE is a program of all-inclusive care for the elderly, committed to empowering older adults to remain at home while preserving their dignity, independence, and quality of life. Our program brings the region’s experts in geriatric medicine and care together to work as a team in specialized Day Centers. Our wide range of services are designed to meet the varied needs of seniors, and include medical care, social services, meals, activities, transportation and much more.
Shift: Mon-Fri, 7:30am-4:00pm
Location: Pittsburgh, PA
We are seeking an MD or DO for periodic and episodic assessment and management of geriatric participants’ medical conditions, and for oversight of their use of medical specialists and inpatient care.
Required Education: Graduate of an accredited school of medicine. Completion of residency in Internal Medicine or Family Medicine. Fellowship training in geriatrics preferred.
Required Licensure: Must have a current license to practice medicine in Pennsylvania (MD or DO), current DEA license, Medicare provider enrollment, and a valid PA driver’s license.
Required Experience: A minimum of one year of primary care experience with a frail or elderly population.
Benefits:
Community LIFE offers a generous benefit package, including Medical, Dental and Vision insurance, Life insurance, Short Term & Long Term Disability insurance, 5 weeks Paid Vacation, Paid Holidays, Company contribution to a 403(b) retirement plan, Tuition Reimbursement, Mileage Reimbursement, Employee Appreciation events, and more!
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Register for PALTC24 by January 4 to Take Advantage of the Early Bird Rate
Embark on a memorable journey in San Antonio, TX, where you'll have the opportunity to fully engage in a dynamic program offering valuable sessions, stimulating discussions, and ample networking opportunities. View Full Program.
While you're in San Antonio, immerse yourself in the city's rich heritage by exploring iconic sites like the Alamo and indulge your tastebuds in the vibrant Tex-Mex culinary scene. Experience the enchanting River Walk, where lively restaurants and shops line the scenic waterways.
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Introducing Leading With Purpose
To complement the More of a Good Thing discussions, JoAnne Reifsnyder, PhD, MSN, MBA, FAAN, professor of health services leadership and management at the University of Maryland School of Nursing, will lead a series of eight 30-minute virtual sessions on leadership strategies that can help facility leaders assess their strengths, lead change, cultivate a positive work culture, and ultimately retain and recruit new members to their teams. The monthly sessions will begin on January 18, 2024.
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Giving Thanks for Post-Acute and Long-Term Care Medicine Campaign
The Foundation for Post-Acute and Long-Term Care Medicine has created a special way to honor a family member, co-worker, mentor, facility, or friend with gratitude while benefitting the Foundation’s national mission—the “Giving Thanks for Post-Acute and Long-Term Care Medicine Campaign.”
This campaign provides a unique way for you to honor those who provide inspiration. With your gift, you may honor or remember someone with a special Gratitude Card being mailed to the honoree, their family, or their nursing facility. In addition, your gift will place these individuals’ names with yours on the Foundation’s website on the Wall of Caring and Honor.
This is a unique way to celebrate someone with gratitude while supporting others in their service to our field. Please make a gift today on the Foundation website.
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