Campaign for Meds Management Resource Page 26

Provider > General Meds Management

ADE Data Collection Tools

ADE Data Collection Tool | Instructions Document

Source: HSAG - Mary Andrawis

The ADE Data Collection Tool and associated instructions for use can be used by any healthcare professional. The tool is designed to be completed after performing medication reconciliation, medication therapy management (MTM), medication screening report, and/​or chart review.

Brown Bag Materials

Brown Bag Checkup – Participant Evaluation

Source: Atlantic Quality Innovation Network

This is a participant survey from the brown bag event.

Brown Bag Checkup – Review Form

Source: Atlantic Quality Innovation Network

This is a review form for participants of the brown bag medicine event.

Brown Bag Medicine Information Sheet

Source: Atlantic Quality Innovation Network

This is a handout with information to remember from the brown bag event.

Brown Bag Medicine Review Day

Source: Atlantic Quality Innovation Network

This is a guidance document for conducting a brown bag medicine event.

Chronic Care Management (CCM)

CCM Health Care Professional Toolkit

Source: CMS

This toolkit includes information for health care professionals, including tips for getting started, fact sheets on the requirements for implementing a CCM program, and educational materials to share with patients.

CCM in Practice

Source: APhA

Learn about how Michelle Thomas, pharmacist at Chickahominy Family Physicians in Virginia, has integrated CCM into her pharmacy practice.

Chronic Care Management (CCM): An Overview for Pharmacists

Source: APhA & Health Quality Innovators & Delmarva

This guide describes the requirements for CCM and how pharmacists may play a role as clinical staff.

Chronic Care Management (CCM) Patient Consent Checklist PDF (for Printing) | Electronic Version

Source: Telligen QIN NCC & APhA

Use this document to help guide members of the Chronic Care Management (CCM) care team collect necessary information for patient consent to participate in CCM services.

Chronic Care Management Services Changes for 2017

Source: MLN

This document outlines specific changes to CCM services for 2017.

Chronic Care Management (CCM) Services in Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs)

Source: MLN

This document outlines specifics and addresses frequently asked questions about CCM in RHCs and FQHCs.

MLN Document on Chronic Care Management Services

Source: MLN

This fact sheet provides background on payable CCM service codes, identifies eligible practitioners and patients, and details the Medicare PFS billing requirements.

Template CCM Patient Consent Agreement

Source: and APhA

This is a template that practitioners can use to collect written consent from patients and caregivers who agree to CCM services.

Pharmacist and Provider Collaboration

Embedding Pharmacists in the Practice

Source: American Medical Association (AMA)

This resource, created and promoted by the American Medical Association, outlines how embedding a pharmacist within your practice can improve the quality of care you provide for your patients, also touching on work with community pharmacists and pharmacy technicians, as these may be a better fit for some practices depending on practice needs. This module contains a downloadable tools that will help determine pharmacy needs and identify the right type of support for a practice.

Medication Management Recommendation Template

Source: University of Hawai'i College of Pharmacy, Pharm2Pharm

This fillable document provides a template for pharmacists to use when communicating with prescribers about recommendations on medication changes.

Medication Management Recommendation Training Document - Pharm2Pharm

Source: University of Hawai'i College of Pharmacy, Pharm2Pharm

This document provides education to pharmacists on how best to communicate with prescribers with recommendations on medication changes.

Online CPE Module: "Identifying & Resolving Drug Therapy Problems Across the Continuum of Care"

Source: University of Hawai'i at Hilo College of Pharmacy

Upon completion of this activity, participants should be better able to:

  • Identify patients at risk of medication-related hospitalization and emergency department use
  • List the clinical goals for each medication for each patient at risk
  • Identify drug therapy problems for each patient at risk
  • Implement solutions to resolve drug therapy problems

Pharm2Pharm - Provider and Patient Testimonial Video #1

Source: University of Hawai'i at Hilo College of Pharmacy

This short video explains the Pharm2Pharm intervention with testimonials from both providers and patients who experience it.

Pharm2Pharm - Provider and Patient Testimonial Video #2

Source: University of Hawai'i at Hilo College of Pharmacy

This video has testimonials from providers and patients who experienced the Pharm2Pharm intervention.

Pharm2Pharm Standard Operating Procedures (SOP)

Source: University of Hawai'i at Hilo College of Pharmacy, Center for Rural Health Science

The purpose of the Pharm2Pharm Standard Operating Procedures (SOPs) is:

  • To ensure standardized and consistently high quality care is provided to patients enrolled in the Pharm2Pharm service.
  • To optimize efficiency and effectiveness of the Pharm2Pharm service.
  • To facilitate the training of pharmacists involved in delivering the Pharm2Pharm service.
  • To support the roll-out of the Pharm2Pharm service model in other communities.

Quick Facts and Tools

ADEs Top Ten Checklist

Source: TMF Quality Innovation Network

This checklist focuses on the main issues to be addressed in the hospital setting to reduce adverse drug events.

Healthcare Provider Medication Management Checklist

Source: QIN NCC

This checklist was developed during Phase 1 of Campaign for Meds Management to help providers identify challenges experienced by their patients and resources to overcome those challenges.

Health Literacy Tools for Providers of Medication Therapy Management

Source: AHRQ

Medication Therapy Management (MTM) is a patient-centric and comprehensive approach to improve medication use, reduce the risk of adverse events, and improve medication adherence. The following health literacy tools can improve communication with MTM patients.

Interaction Checker

Source: RxISK

This tool allows you to look up your drug name and learn about interactions your drug might have with other drugs.

Medicine Review -Tip Sheet

Source: Michael Crooks

This document is used to promote medicine reviews and reconciliation. It serves as a call to action and guide for beneficiaries and families, provides tips for practitioners to conduct reviews, and reminds providers of quality measures and services involving medication reviews.


Source: AQIN (Delmarva)

This tool was designed to be used for chart sampling to assess med reconciliation completion – we ask for 10 charts/​records review per month.

Provider ADE Causality Flowchart

Source: QIN NCC (Adapted from the Liverpool ADR Causality Assessment Tool)

This tool can be used by a provider to determine if a patient is experiencing an adverse drug event (ADE).

Teach Back Cards

Source: Quality Insights Quality Innovation Network

Use these cards as a reference for using the teach-back method in practices.

The Big 3 of Adverse Drug Events

Source: Quality Insights Quality Innovation Network

This flyer was created as an advertisement for the initiative to lower ADEs.

Templates, Testimonials, and Toolkits

Facility to Hospital Transfer Form 1.18.2017

Source: HSAG

This form is meant to facilitate communication between providers when a patient is transferred from SNF to ED.

Medication Safety and Adverse Drug Event Prevention Toolkit

Source: AQIN

This is a compilation of tools and strategies for improvement.

Preventing ADEs Change Package

Source: Health Research & Educational Trust

This change package for hospitals participating in the Hospital Improvement Innovation Network (HIIN) project, led by the Centers for Medicare & Medicaid Services (CMS) and Partnership for Patients (PFP), is meant to be a tool to help make patient care safer and improve care transitions.

Project BOOST® Implementation Toolkit

Source: Society of Hospital Medicine

This is an innovative toolkit for addressing care transitions and assessing risk for an adverse drug event.

Resources, Guides, and Assistance Sites

AWARXE Prescription Drug Safety Program

Source: National Associations of Boards of Pharmacy (NABP)

The AWARXE® Prescription Drug Safety Program encourages consumers all over the US to find permanent drug disposal sites using its Drug Disposal Locator Tool.

Guide for Identifying and Resolving Discharge Medication Accessibility Problems in New York State

Source: Atlantic Quality Improvement Network

Use this PDF guide to find resources for resolving medication accessibility issues, including affordability, insurance coverage, and copayments. Note: this was created for use in New York State.

Pharmacy’s Appointment-Based Model Implementation Guide for Pharmacy Practices

Source: APhA Foundation

The Appointment-Based Model (ABM) is a patient care service designed to improve patients’ adherence to medications and build efficiencies in pharmacy operations. This document provides guidance for pharmacies on implementing the ABM model of care.

.Pharmacy Verified Website Program

Source: National Association of Boards of Pharmacy (NABP)

Finding a safe and trustworthy medication-related website is as easy as looking for “.pharmacy” in a website address/​URL.

In an effort to ensure the safety of consumers who buy medications online, NABP created the .Pharmacy Verified Websites Program. Online pharmacies and related entities that have a .pharmacy domain name stand out against the overwhelming number of websites selling medicine illegally, including substandard and counterfeit products. The .pharmacy domain name identifies legitimately operating pharmacies for consumers, advertisers, and search engine companies by incorporating the seal of approval” into the domain name.

What Can Your Pharmacist Do For You?

Source: Student Society of Health-System Pharmacists

This brochure can be used by patients and caregivers to better understand what services their pharmacist or community pharmacy may provide. Physicians, pharmacists, nurses and other healthcare provider may also use this brochure to promote pharmacy services.

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