Jersey Shore University Medical Center (JSUMC) is a 691-bed non-profit, tertiary research and academic medical center located in Neptune Township, New Jersey, servicing coastal New Jersey and the Central Jersey area. JSUMC is the region’s only university-level academic medical center. The hospital is part of the Hackensack Meridian Health Health System and is the system's second largest hospital. JSUMC is affiliated with the Robert Wood Johnson Medical School of Rutgers University, and Hackensack Meridian School of Medicine at Seton Hall University. JSUMC is also an ACS designated level II trauma center with a rooftop helipad handling medevac patients. Attached to the medical center is the K. Hovnanian Children's Hospital that treats infants, children, adolescents, and young adults up to the age of 21. JSUMC is listed as a major teaching and tertiary care hospital and has a staff of 127 interns and residents. It is a member of the Council of Teaching Hospitals and Health Systems.
Key performance indicators (KPIs) are quantifiable measures that describe critical success factors of an organization. Their vital role in ensuring the delivery of quality health care services necessitates the development of KPIs relevant to inpatient clinical pharmacy practice. This opinion paper from the American College of Clinical Pharmacy (ACCP) Clinical Administration Practice and Research Network (CADM PRN) describes the rationale, methodology, and outcomes of a consensus process to identify a focused set of inpatient/acute care clinical pharmacy KPIs. Leveraging a modified Delphi approach, the CADM PRN convened an Expert Panel of clinical pharmacy leader members to build a consensus-driven set of KPIs reflecting clinical, operational, patient-centered, and financial contributions of clinical pharmacists in the inpatient/acute care setting. From a previous ACCP White Paper, a total of 15 KPIs were identified across four domains: (1) clinical practice and patient safety, (2) clinical outcomes and readmissions, (3) medication education and patient engagement, and (4) financial and operational value. The CADM PRN posits that the establishment and implementation of standardized KPIs are essential for measuring and demonstrating the value of clinical pharmacy services in modern health care, offers pragmatic, consensus-based KPIs for evaluating clinical pharmacy services supporting resource justification, and advancing the visibility and impact of pharmacists in acute care practice. As hospitals shift toward value-based care, robust KPI frameworks will be critical for optimizing patient outcomes, supporting financial sustainability, and justifying appropriate staffing. Future efforts should focus on pilot testing, addressing implementation barriers, and achieving broader acceptance for KPIs across the profession.
Gastrointestinal (GI) bleeds can pose significant life-threatening situations if not identified promptly, progressing to hemorrhagic shock. We discuss the case of a 60-year-old man presenting with an elusive GI bleed. Esophagogastroduodenoscopy, colonoscopy, Meckel's scan, and computed tomographic angiography were performed, which yielded no active bleed despite active hemorrhage. As a result, double-balloon computed tomography enterography was performed, demonstrating jejunal diverticula with angiodysplasia and arteriovenous malformations (AVMs), suspected to be the source of the elusive GI bleed. Clips were attempted at the sites of visible AVMs, but were unsuccessful. The diverticula were tattooed with a plan for an exploratory laparotomy for definitive treatment. The patient was ultimately discharged with no signs of active bleeding and an uncomplicated recovery. This case highlights the multifactorial management of a massive GI bleed with no identifiable source of bleeding upon admission, progressing into hemorrhagic shock.
