Category: Federal Forum Posters
Purpose: Encouraging patient compliance and proper medication use during transitions of care has become a national focus to help minimize adverse health outcomes and reduce medical costs. In 2016 the University of Chicago Medicine Pharmacy Department implemented a Meds2Beds program to help assist with the medication component of the transitions in care process. The program delivers discharge prescriptions to patient’s bedside along with providing medication education by the pharmacist. The purpose of this descriptive, retrospective study is to determine the impact of implementing bedside medication delivery and pharmacist counseling on transitions of care.
Methods: This program operates as a separate entity in the hospital’s outpatient pharmacy. A team of three clinical pharmacists work with Advanced Medication Access Coordinators and pharmacy students to coordinate discharge prescription processing and delivery. The clinical pharmacists perform a clinical review of each patient’s medication therapy enrolled in the program by using an electronic health record (EHR) system. Student pharmacists also join in doing an extensive assessment of the patient’s medical history. Students are given an opportunity to demonstrate their knowledge and collectively decide with the pharmacist what counseling points are most important to discuss given the chosen medication regimen. Nurses, physicians, case managers, and social workers are encouraged to enroll patients into the program except those going to long-term care facilities, hospice centers or transplant patients. Once the patient is successfully enrolled in the program and the patient’s charts have been reviewed by both clinical pharmacists and student pharmacists, the prescriptions are then filled and delivered to bedside. If a patient is uninsured, a coordinator is able to provide medications for little to no cost using the hospital’s 340B plan.
After data from the program is collected and analyzed, a 15-minute meeting is held biweekly with the pharmacy manager and team to address issues or challenges and suggest solutions within the program. This concept of quality improvement (QI) adopts the Plan-Do-Study-Act cycle.
Results: Over the course of the program, enrollment has increased to roughly 200 to 400 patients being serviced a week. The increase in patient demand and discharges during the weekend has led the program to extend hours of operation from Monday through Friday to Monday through Saturday. Overall, the positive feedback from healthcare providers located in the hospital and patients being discharged has shown the program to be useful during transitions of care. Although there has not been any data to support an improvement in health outcomes such as a lower readmission rate, increased refills, or less adverse drug events there has been a significant increase in the outpatient pharmacy’s total revenue. As the program continues to grow data will be collected to show if there is an impact being made on health outcomes.
Conclusion: Many patients face barriers that can prevent them from filling their prescriptions after discharge, such as treatment cost, lack of transportation, and/or having a negative past experience with a medication. Implementation of bedside medication delivery and counseling prior to discharge resulted in lower medication costs for patient's, an increase in patient satisfaction and an increase in total revenue for the outpatient pharmacy.
Taylor Jones– Pharmacy Student Intern, University of Chicago Hospital, Chicago, IL