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The EBM Information Quest: Is it true? Is it useful? Is it usable?™

Delfini Co-founders: Michael E Stuart MD, President & Medical Director . Sheri Ann Strite, Managing Director & Principal

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A Key Testimonial That Keeps Us Motivated, Inspired & Moving Ahead

...huge difference in my professional life...now have the confidence...your workshops help re-ignite for many the real reason they got involved in pharmacy and medicine in the first place...we definitely can make a difference!...

"I have been meaning to thank you and Mike for all of the training and insight that you have given me. It really has made a huge difference in my professional life. For example, this summer I tackled an important safety debate. It took me many hours, but at the end of the day, I concluded that we, as a company, needed to make new recommendations. Without my Delfini training, I would have never had the confidence, nor been able to develop a convincing case. I know sometimes the jaded medical world may feel that evidence-based medicine and critical evaluations are nice academic exercises that rarely, if ever, influence member safety. We know that this is not the case. Keep carrying the banner of enlightenment in 2011! Your workshops help re-ignite for many the real reason they got involved in pharmacy and medicine in the first place. We definitely can make a difference..." Name Held in Confidence
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State of Washington

...people are raving about your training...

"Mike and Sheri, I just wanted to thank you once again for the great job you did today, teaching our staff EBM assessment for validity and usefulness. You were inspiring to our staff. I just loved to see how attentive they were and to hear the great questions that were asked. They were getting your messages! Fantastic.

People are raving about your training. I just heard how professional that it was, that HRSA and the other agencies were represented in style and the staff really appreciated that. I believe they recognized that we brought the very best to them, showing that we value EBM and their work in this area.

Again, thanks so much. It was such a pleasure to work with you to make this day so special for our staff."
Siri

Siri Childs, Pharm D
Pharmacy Policy Office Chief
Department of Social & Health Services
Health & Recovery Services Administration
Division of Medical Benefits & Care Management
Medical Consulting & Pharmacy Policy Units
State of Washington

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And more from the State of Washington

...superb evidence reviews...

Link to Delfini Washington State Health Care Technology work.

State of Washington Health Care Authority

"Hello Sheri and Mike, thanks for shouting out to the Washington State Health Technology Clinical Committee. Along with the help of organizations like Delfini providing us with superb evidence reviews, we are showing a way that the US should follow, in my opinion. I appreciate your linking your contacts to our work. Best Wishes, Brian"

Brian R. Budenholzer, MD, FAAFP
Health Technology Clinical Committee Chair
Health Care Authority
State of Washington

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The Regence Group

...nobody does it better than Delfini!!!...wonderful program...been to many of your programs and continue to learn, be inspired and stretch...already incorporating the information as well as your tools into our processes...

Reference Letter from Chief Pharmacy Officer click here

"Dear Delfini (Mike/Sheri), Thank you for a wonderful two-day course on evidence-based medicine tools and applications. In an era of high tech, high cost medical technology and medications, Regence has made evidence-based medicine the core of its business model and guiding principle in making healthcare decisions.

Delfini has been both the inspiration and support in helping us build and evolve this foundation with their guidance, teachings, and EBM tools for ready application in critically appraising the literature. I want to complement Delfini on an outstanding presentation and the ability and flexibility to adapt and structure the presentation for a multi-disciplinary staff of healthcare professionals (medical directors, nurses, pharmacists, students), such that all benefit. I have attended several of your presentations and each time I attend there is always something new to learn or additional "pearls" of knowledge to add to my EBM tool kit. My staff has told me the same!

As always, we appreciate your time in working closely with us and customizing presentations to help meet the needs of our audience. Nobody does it better than Delfini!!!

Warmest regards, Lynn"
Lynn Nishida, R.Ph.
Director, Clinical Pharmacy Services

After Two Days Following A Delfini Training Retreat...
"Dr. Stuart and Sheri, I wanted to thank you both for the wonderful program you put together. I've heard all the same things echoed by the staff that were noted in the evaluations. For myself, I think I've been to more than six of your programs and I continue to be inspired and stretched each time. We are already incorporating the information you provided, as wells as your tools into our processes. We look forward to working with you again and further improving our processes with your knowledge and tools. Again, thanks for everything and have a great summer."
Helen Sherman, R.Ph., Pharm.D., Senior Director - Chief Pharmacy Officer Pharmacy Services, The Regence Group, Portland, OR

"I have seen your program 3 times (make that 4 times) and I learn something new (ok, a lot new) every time. I really appreciate the way you constantly update your material to be relevant. I would sit through a day of your seminar once or twice a year." Program Attendee

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David Holloway, MD
Senior Vice President & Chief Quality Officer
Parkview Health
Fort Wayne IN

...already using tools in real life...like the organized approach...helped us change...real success...improved patient care...help us use resources optimally...invaluable...

After one month for a Pharmacy & Therapeutics Committee consultation for one of our clients...
"The evaluation results look very good. Proof of impact: people are already starting to use the tools and material in real life. 1) Parkview Hospital and Parkview North have already changed the way 'addition to formulary requests' are presented at their local PNT. The docs like the organized approach. 2) The three Community Hospitals approved the System PNT at their quarterly joint med staff officers meeting last week. We take the matter before Parkview Hospital next week, but don't think there will be any problems there. Well done. Yes, you can use this. You earned it!"

Six months later...
"It has been six months since the Delfini Group customized an evidence-based training program to help us change our processes for drug reviews. We have already experienced real success which we expect to be sustainable and which will improve the care we provide to our patients and our ability to use our resources optimally. The concepts and skills learned in the training—along with the tools and process steps - —were invaluable to us and have helped us transform our system. Highly recommended!"

One and a half years later...
Reference Provided by W. David Holloway, MD, Sr VP, Chief Quality Officer, Parkview Health
"Parkview Health has seven hospitals, five boards, four medical staffs and all of the inherent complexities of such a structure. Two years ago we consolidated our various hospital pharmacy operations into one system support function. One goal was to decrease variation within medication class; in other words, standardize the formulary across hospitals and medical staffs. An important milestone was creation of a System Pharmacy and Therapeutics Committee with physicians from the four staffs. That said, we took this opportunity to structure the new committee's decision-making around evidence and not just physician preference and advocacy, as had been the approach at the 'local' P & T's.

Mike and Sheri led a group of physicians, nurse, pharmacists and administrators through a one-day EBM course, tailored specifically to a system-level pharmacy and the types of decisions we might encounter. By the end of the day we had: 1) created the structure and function of the new committee, 2) general agreement of how we would use EBM in decision-making, and 3) a good understanding of the resources/functions needed from pharmacy to support the new committee. In addition, we introduced this core group of clinical leaders to the concepts and methods of EBM. This 'deep awareness' has helped many times in other areas, such as better clinical pathway development. This EBM training was a big 'ah ha' needed toward critical mass.

The System P & T is running well. Formulary variation is decreasing. New products must be accompanied by proper 'critical appraisal'. The committee can still decide to look beyond the evidence (we haven't banished politics from the planet...yet). But we are definitely making better decisions and we see fewer physicians willing to approach without good RCTs. Also, our flagship hospital (about 550 beds) decommissioned their separate P & T committee, choosing to cast its fate with the System group. This is a nice endorsement by the tertiary center..."

And EBM products...
"Mike, I want to thank you for the outstanding evidence review and synthesis Delfini did for our medical group on ACE inhibitors and angiotensin II receptor blockers ARBs in heart failure. When I presented the synthesis to our cardiologists they enthusiastically complimented Delfini. They uniformly felt the synthesis was extremely thorough, well-organized and highly useful evidence-based information. Another example of Delfini’s superb work – I can’t thank you enough for helping us navigate a challenging area."

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Nicole O'Kane, PharmD
InterHospital Physicians Association
Portland OR

...instrumental role in the enhancement of our processes...ideas to efficiently use available resources...improved our efficiency...

"I've been attending seminars with the Delfini Group since 2001. They have played an instrumental role in the enhancement of our P & T process. Their programs mix together an enthusiasm for evidence-based medicine with factual market-driven ideas to efficiently utilize the available resources. The Delfini programs motivated me to plan a health system retreat in 2002. The retreat was an opportunity for multiple P & T committee members (hospital, primary care clinics, health plan) and supporting staff to explore the importance of evidence-driven decisions in the P & T process. The program included Delfini presentations and working sections introducing tools to improve efficiency. Of course the retreat was just a beginning, a starting point to build upon. And build we have! Our P & T presentation format and discussions have become more efficient, and we have standardized decision algorithms that help during crossroad discussions for an individual therapy. The evidence will never have all the answers. But this process brings a framework of support that has improved efficiency and, I believe, a greater satisfaction for committee members with the difficult task of P & T therapy evaluations and literature review."
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Maribeth M. Bettarelli, PharmD
Clinical Associate, Clinical & Drug Information Resources Caremark Inc.
Northbrook IL

...invaluable guidelines and tools...used almost daily...wonderful assets...extremely useful...

"Hi, Mike and Sheri! I hope you're both doing well! If you don't remember me, I last saw you at the Clinical Practice Guidelines & Clinical Improvement Project Workshop...in Fort Lauderdale in May. Since then, I left Walgreens Health Initiatives and started in the new Drug Information Team at Caremark. I've been here since mid-August and have enjoyed it so far. My current position entails the review of off-label diagnoses for medications in our Prior Authorization program. (If you remember, I had asked about the evaluation of off-label diagnoses at the last workshop.) The guidelines and tools that you provided have been invaluable and are used on an almost daily basis as I review journal articles and consensus guidelines and write clinical consults. These references along with those found on the web site are wonderful assets and are extremely useful! I have shared this information with other members of my team as well as students whom I have precepted.

Thanks again for the wonderful program. It was so nice to hang out and get to know you better, too! Best regards, Maribeth"

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Chris McFarland, PharmD
Ambulatory Care Pharmacist
Departments of Internal Medicine &
Family Practice
Lovelace at Journal Center
Albuquerque NM

...will become immediately embedded in our strategies...will utilize the tools...more worthwhile 2 days than any week-long program I've attended...spectacular!...

Two years later...
...highly applicable...other courses and seminars covered much but left me with little...Delfini's was comprehensive and practical...superbly taught...rich with information...drove home key concepts...able to apply...tool easily incorporated into practice...my highest recommendation...Delfini offers something quite unique...

“The information gathered from this meeting will become immediately embedded in our clinical practice strategies. I will be able to utilize these tools in our evolving Journal Clubs (both clinicians and students/residents) as well as in my own presentations to the Medical Staff. To take this knowledge a step further even, I plan to discuss this meeting during our upcoming Preceptor’s Conference with our College of Pharmacy (and beg them to include such material in their curriculum!)

Thanks so much for a meeting that was more worthwhile in two days than any week-long meeting I have ever attended. The program was spectacular, free of commercial bias, and comprehensive, despite the short duration. I hope to be able to attend future programs you put on, as I think you are both a dynamic speaker and basically a fun person to be in the same room with!”

Two years later...
"I attended two courses 2 years in a row, and subsequently sent our residents last year. I found the seminar to be highly applicable across all stages of EBM understanding. Historically, I had participated in other courses and seminars that covered much but left me with little. If you can't walk away with something — some tool — in hand to use, then what would be the worth? The Delfini Group provided a comprehensive – and practical – approach to interpreting EBM, but most importantly, they provided a tool that I was able to easily incorporate into my practice. The two-day course provided a hands-on workshop environment that drove home key concepts of EBM. Participants were able to apply what they learned in several sessions, using the tools that we ultimately were given. The group even received software that assisted in using the principles that were taught. I found it to be quite practical, superbly taught and facilitated, and comprehensive in its applicability…I sincerely believe that the Delfini group offers something quite unique, and not only that, they practice what they preach and are always available afterwards…they get my highest recommendations…the sessions are rich with information..."
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George Alexis M.S.,R.Ph.
Clinical Pharmacy Manager
Veterans Affairs
Boston Healthcare System

...excellent...very useful program...quality content...expert speakers...custom tailored to meet our needs...

"Dear Sheri and Mike, I want to thank you personally and on behalf of all the participants for an excellent and very useful program. The following day we had a scheduled meeting and I received many personal thanks for not only setting up the program but also the quality of the content and expertise of the speakers. As I explained to them the thanks goes to Mike and you who were willing to take the time to work closely with me to custom tailor the program to meet our needs."
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Jim Shahriar, M.S., R.Ph.
Clinical Pharmacist, Quality Programs
Blue Shield Pharmacy Services
San Francisco CA

...a pleasure...new insights...wonderful job...

"Dear Michael and Sheri, it was a pleasure to meet you and attend the EBM course on February 28 and March 1, 2003. Although I had studied the course material in my graduate courses, the EBM program was very helpful and gave me new insights in how to approach and evaluate literature effectively. In fact, your two-day course reviewed two of my gradutate courses. Thank you for such a wonderful job and please keep up the good work."

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Rosa Sanchez, Pharm D
Retrospective Drug Utilization Review Clinical Pharmacist
Walgreen's Health Initiatives
Deerfield IL

...great program...especially enjoyed information and decision aids...help us better communicate with patients...

"I just want to thank you again for the great program you presented last week in Ft. Lauderdale. The information presented will be very helpful, I especially enjoyed the portion on 'Information and Decision Aids.' The information provided will help us better communicate patient-related clinical information to maximize our retrospective drug utilization review interventions."
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Tanner Odom, PharmD
Care Management Pharmacist
Clinical Services Department
Walgreens Health Initiatives
Deerfield IL

...without a doubt the best meeting I've ever attended...extremely relevant...couldn't wait to get started the next morning...so useful...

“I wanted to thank you very much for the opportunity to attend the Clinical Practice Guidelines Workshop this past week. This meeting was without a doubt the best meeting I've ever attended. The information provided was extremely relevant and will prove to be very useful for the rest of my professional career. Never have I attended a meeting where I couldn't wait to get started the next morning following the completion of that days’ session. This information is so useful, that we are looking to do some sort of a miniature workshop to share this information with the entire Clinical Services group.”

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