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Validation of a prioritization tool
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Validation of a prioritization tool
Hi,
I am an EM pharmacist in Montreal, Canada and we have developed a prioritization tool to identify patients that would most likely need pharmacist involvement during their stay. We have studied it at our sites and are we now at the validation step.
After evaluating it in close to 400 patients and adjusting the variables, we have a sensitivity of 0.74 and specificity of 0.9 within our two hospitals (one is a Level 1 Trauma center and the other is a transplant/onco/ECMO center) when comparing the tool to manual pharmacists’ prioritization.
Once we have identified participating sites in the US, I will provide you with a REB approved protocol from our hospital that will need to be approved at your site. Our research legal department will also be in contact with yours to organize data transfer contracts.
Potential benefits of the tool:
In EDs that do not have a pharmacist coverage 24/7, when you arrive in the morning with 60-100 patients, it is faster to prioritize your patients with the tool rather than looking manually at the list of patients. If you have 24/7 pharmacist coverage, the advantage may come from being able to prioritize new patients that arrived while you were in Resus (let’s say for the last 2-3 hours), you would then be able to run the tool and you will see if some of the new ones are coming up as top priority. It also helps with harmonizing patient identification.
What will be expected from the participating centers:
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- One person who will
be in charge of submitting for ethics, organizing the data
collection, gathering the reports, and sending them our way.
This person will be offered authorship for the publication of the
results.- Each
site will have to arrange a report with EPIC that includes all the
variables we had at the beginning of our project, so you remain
blinded to the one we kept, and the cutoffs chosen. The more than 60
variables used are a mix of vital signs, labs, PMHx and a few medications.
(We can discuss if you are not using EPIC and believe that you can
generate the necessary report)- Duration
of data collection will vary on the size of your site, but our
statistician calculated that 638 patients per center will need to be
prioritized (e.g. if you have 60 patients on stretchers that would be
10 days of data collection, not consecutive to avoid looking at the same
patient twice in a same visit)- Technically
it is a 3-person job, always the same 2 pharmacists prioritize the
patients independently in 3 groups (urgent (within the next 2 hours), to
be seen (at some point today), not prioritized) and a 3rd pharmacist
resolves the discrepancies without knowing the prioritization of the
2 other pharmacists. We do not have EPIC but it took us about 1-1.5 min
per patient.The goal is to validate in at least 3 American centers with various profiles (Teaching vs community hospitals, 24/7 vs 8 hrs per day)
The targeted timeline for data collection is during the summer/fall 2026 or earlier if ready (hopefully).
If you have questions or are interested
Eric Villeneuve BPharm, MSc, PharmD, ASHP accredited PGY2 (CC/EM)
Pharmacist – Clinical leader, Adult Emergency medicine
Pharmacy departmentCentre universitaire de santé McGill
McGill University Health Centre
Site Glen
1001 boul. Décarie, bureau CRC.6004
Montréal QC Canada H4A 3J1
Tél. 514-934-1934 ext. 66566 ou/or 23844
eric.villeneuve@muhc.mcgill.ca - One person who will
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