Category: Professional Posters
Purpose: The integration and expansion of transitions of care into inpatient care is a key initiative in pharmacy practice. Non-compliance with filling prescriptions was identified as a top cause of readmissions (Rosen, et al). A partnership with an outpatient pharmacy was formed to dispense and transport discharge prescriptions to the hospital for decentralized pharmacists to deliver to patients and families. Patients and families were counseled on proper use, administration, monitoring, and possible side effects. This initiative was designed to safely dispense new medication therapy, deliver medications, and provide medication counseling prior to discharge.
Methods: By working in close collaboration with care–coordinated hospital teams, a new process was created that allowed patients to receive all discharge medications and bedside counseling prior to leaving the hospital. Providers, nurses, social workers, case managers, and pharmacy staff were educated about the Meds to Beds (M2B) program prior to the start. Fliers, power point presentations, and personal conversations were used for staff education. The M2B program went live on January 2019. Initially, a limited number of patient care units were piloted; after showing success, the M2B program was expanded to a majority of the pediatric inpatient departments. Medications were filled at University Hospital Outpatient Rainbow Pharmacy, located off site from the inpatient hospital. A final comprehensive review, bedside medication delivery, and counseling was provided by an inpatient pediatric pharmacist. Medication education including indication, administration, possible side effects and proper storage was provided to the patient and family. The family was given opportunities to ask additional questions. Documentation of medication counseling and additional interventions was completed prior to patient discharge.
Results: The M2B program started January 2019. Number of patients who participated in M2B were 180. Number of prescriptions filled during this time period 659. The amount of prior authorizations completed by pharmacy staff was 37 and patient experience, Consumer Assessment of Healthcare Providers and Systems (CAHPS), medication domain scores for the period were: January 76.61%, February 78.95%, March 83.94%, April 81.67%, and May 100%. The target CAHPS goals for 2019 were 79.59% with a benchmark of 81.19%.
121 patients using M2B services were tracked and monitored for readmission. Only 8 patients were re-admitted to the hospital 30 days after discharge. 95% of patients did not get hospitalized after 1 month. We did not included 58 patients that received M2B services in May since we would not able to check their readmission rate after 30 days.
Conclusion: The M2B program and medication discharge counseling was helpful in addressing patients’ needs and concerns prior to discharge. Significant interventions were made that addressed appropriate dose, frequency, and cost of medication. The feedback from providers, nurses, care coordinators, and families about M2B service was positive. Suggestions for improvement were addressed to improve the program in the future.