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We present a systematic approach to identify potential military cost-imposing actions and possible adversary responses. The cost imposition is evaluated in terms of budgets and resources over an extended period of time. Hence, the decision space for cost-imposing actions and responses are force mix choices and adopting new strategies that affect a potential future conflict. The cost imposer takes an initial action, such as deploying an advanced system with new technology, intended to cause the targeted opponent to expend more resources in countering this initiative. We estimate the extent of the adversary's response to maintain their overall effectiveness in the projected military campaign. We evaluate the ratios of costs for the adversary responses that are sufficient to achieve the original effectiveness over the cost of military actions of imposition; these ratios are the relative cost incurred. Ratios greater than 1 represent viable cost-imposing actions, with higher ratios being better for the cost imposer. [ABSTRACT FROM AUTHOR]

Background: Patients with palliative care needs are at high risk of medication errors during transitions of care (TOC). Palliative Care Pharmacist Interventions surrounding Medication Prescribing Across Care Transitions (IMPACT) program was developed to improve the TOC process from hospital to community setting for cancer patients followed by palliative care. We describe (1) the program and (2) pilot study feasibility and effectiveness data. Methods: We recorded pharmacist time, medication errors, drug therapy problems (DTPs), and palliative care provider satisfaction and compared 7- and 30-day readmissions and emergency department (ED) visits between IMPACT and usual care patients. Results: Forty-four patients were reached by the pharmacist. The pharmacist spent an average of 65 minutes per patient. An average of 14.9 medication reconciliation discrepancies per patient and a total 76 DTPs were identified. Seven-day readmissions were lower in the IMPACT group versus usual care; there were no differences in 30-day readmission or 7- or 30-day ED visits. Conclusion: Our pilot study demonstrates that integrating a pharmacist in TOC for seriously ill patients is feasible and valuable. [ABSTRACT FROM AUTHOR]