SOS Rx

Consensus Retreat Work Group Report

September 23, 2003

I. Organizations Attending Work Group Meeting

Representatives from about a dozen organizations attended the first work group meeting on the consensus retreat on September 23, 2003. Organizations represented included the following – AHRQ, Visiting Nurses Association, Generics Pharmaceutical Association, American Society of Consultant Pharmacist, American Association of Colleges of Pharmacy, National Council on Aging, National Quality Forum, Center for Information Therapy, National Consumers League, and Express Scripts.

II. Objective of the Work Group Meeting

To help plan and shape the consensus retreat, November 9-11 at Aspen Institute, Wye Mills, Maryland. This retreat will gather about 35-40 experts in the area of patient safety to prioritize the system changes and consumer actions that will have the greatest impact on outpatient medication safety. A white paper, including an action agenda, will be produced after the retreat and distributed to the full SOS Rx coalition. The coalition will work toward implementing the action agenda in 2004.

III. Structure of Retreat

1) Facilitator – Hugh Tilson, Chair of the CERTS Steering Committee

2) Schedule – starting Sunday late afternoon till Tuesday noon, keynote speakers, and group working sessions. Currently working on finalizing keynote speaker(s).

3) Presenters – Recent research on outpatient safety; possibilities include CERTS, National Patient Safety Foundation, AHRQ, Institute for Safe Medication Practices

4) Attendees – discussed suggestion of experts from various fields that should be invited. The following groups should be represented – health care professionals, government, consumers, researchers, providers and health care industry.

National consumers League will make the final decision on which experts are invited. There is space for 35-40 people at Aspen Institute.

III. Discussion/Process at the retreat

1) The product - establishing the priority list of those consumer actions and system changes that will make the use of outpatient medications safer. It is important to realize the benefit of this diverse group of experts sifting through all the information and coming up with those actions that will have the biggest impact on outpatient medication safety. While these questions regarding medication safety have been asked before, they have not been discussed by such a diverse group of people whose goal is to reach consensus. The process should not just focus on the “low-hanging fruit” or those things that will be easiest to accomplish, but to really look at what will make an impact.

2) While the focus is NOT on the specific channels of communication to consumers or health care professionals, we could ask experts to keep in mind the strategies of how these changes can best be accomplished. Discussed the idea of a presentation at the retreat on what is known about changing consumer or health care professional behavior (the obstacles and challenges).

3) The consensus process should produce short and long term lists of the changes anticipated.

- Short term list – those changes more easily accomplished, lower cost, more easily implemented

- Long-term list - changes that are more costly, involve more players and therefore more difficult to implement

Can also sort suggested changes/actions by not only the importance but also the feasibility of the action or change.

4) Financing the anticipated changes – discussed idea of having a representative from a foundation or Congress at the retreat if there are issues on financing a systems change.

IV. Activity Beyond the Retreat

1) White paper – produce a paper summarizing the retreat proceedings, including an action agenda of the prioritized list of system changes and consumer actions that need to happen to make outpatient use of medications safer

2) SOS Rx coalition will sign off on the action agenda
3) Briefing of other parties that should be aware of the action agenda

4) Develop a strategy for implementing the action agenda

- Involvement of the boards of local and state organizations. Obtain their support of the action agenda

- A national campaign, with support from local, state and regional organizations

- Media and outreach campaign

V. Bibliography

In preparation of the retreat, develop a packet of resources on the evidence. AHRQ has volunteered to help with this. Could also ask the experts what they would include. There is already information/evidence on this issue, we need to build on what is already there by prioritizing the issues and implementing actions to make the use out outpatient medications safer.