Background: Impact of medication-related problems (MRPs) on persistently high hospital readmission rates are not well described. Objective: The purpose of this study was to determine the rate and type of MRPs attributed to rehospitalization within 30 days of discharge from a general internal medicine hospitalists’ service at a nonacademic medical center. Methods: A retrospective cohort study was conducted evaluating consecutive patients readmitted within 30-days after discharge to home from an internal medicine hospitalist service. Readmissions attributed to MRPs in physician documentation were systematically classified as indication, effectiveness, adverse drug reaction, or nonadherence problems and evaluated for possible preventability. Descriptive statistics were used to describe the rate and type of MRP. Results: Evaluation of consecutive 30-day readmissions (n = 203) to a nonteaching community hospital identified 50.2% of admissions attributed to MRPs. MRPs (n = 102) were categorized as problems of indication (34.3%), efficacy (19.6%), adverse drug events (18.6%), and nonadherence (27.5%). One third of 30-day readmissions in this cohort were attributed to potentially preventable MRPs. Conclusion: MRPs are frequently implicated in 30-day hospital readmissions in a nonteaching community hospital representing an opportunity for context-specific improvements.

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The College of Veterinary Medicine and Biomedical Sciences (CVMBS) at Texas A&M University (TAMU) has developed a multifaceted program in partnership with the Brazos Animal Shelter to provide teaching opportunities with shelter animals during all four years of the professional curriculum. In the first three semesters of the professional program, students working in small groups spend two hours per semester at the shelter performing physical examinations, administering vaccinations and anthelmintics, completing heartworm or FeLV/FIV testing, and performing simple medical treatments. In an expanded fourth-year program, groups of six students spend 16 contact hours at the shelter during two-week rotations, completing similar tasks. Through this program, each student practices animal-handling skills and routine procedures on an average of 150 to 200 dogs and cats. In addition, during third- and fourth-year surgery courses, student teams spay or neuter an average of 12 to 18 dogs or cats each week. More than 800 animals are spayed/neutered annually through this program, and each student directly participates in 12 to 15 spay/neuter survival surgeries. The program represents a creative approach to veterinary training that conscientiously uses animal resources in a positive fashion. We believe that this is a successful partnership between a state-supported veterinary college and a non-profit shelter that benefits both agencies. We encourage other veterinary colleges to explore similar partnership opportunities to provide optimal training for professional students while using animal resources efficiently.

Teamwork is a necessary pharmacist skill, but early pharmacy and interprofessional education frequently lack direct instruction on conflict management skills within team communication. Mindset may also impact team functioning. The purpose of this study was to determine the impact of a teamwork workshop on growth mindset and team communication. Methods. A multi-week workshop was developed for first-year pharmacy students. The workshop included completion of StrengthFinders2.0, a session on identifying individual and team member strengths, a session on situational communication and conflict resolution models, and two pharmacy scenarios requiring conflict resolution. The workshop was delivered to two intervention groups (Fall2019 and Fall2018) and compared to a control group (Fall2017). A pre-post survey measured change in growth mindset and team communication utilizing the validated "Growth Mindset and Team Communication" (GMTC) tool. Data was analyzed using descriptive statistics, independent sample t-tests, and chi-square tests to compare difference and association. Focus groups were conducted in Fall2017 and Fall2018 to assess qualitative student views regarding teamwork. Results. Comparing pre-and post-survey assessments, the team communication subscale increased significantly for the intervention group compared to the control group which had no significant change. Qualitative results of focus groups reflected overall positive views of team communication and collaboration, which was contextualized by discussions of advantages and challenges during teamwork. Conclusion.The teamwork workshop affected team communication abilities. An early workshop may provide necessary teamwork skills for team improvement. Future work will focus on longitudinal measurement of self-views to determine the long-term impact of teamwork training interventions.

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