Impact of a transition-of-care pharmacist during hospital discharge

Balling, Lauren; Erstad, Brian L.; Weibel, Kurt

doi:10.1331/japha.2015.14087

Cited by 33 publications

(41 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The beneficial effects of patient discharge counselling on patient outcomes include decreased adverse drug events and 30 day readmission rates. 4,66,67 Amy, relayed an incident of helping a patient understand the rationale for their medication and the patient's appreciation of this knowledge.…”

Section: Improving Patients' Experiences Health and Safetymentioning

confidence: 99%

Hospital pharmacists' perceptions of medication counseling: A focus group study

Chevalier

Watson

Barras

et al. 2016

Research in Social and Administrative Pharmacy

View full text Add to dashboard Cite

BackgroundMedication counselling sessions are key times for a pharmacist to speak to patients about their medications and the changes made to their therapies during their hospital stay. ObjectivesTo explore hospital pharmacists' perceptions of their roles and goals in patient medication counselling, and perceived barriers and facilitators to achieving their goals. MethodsHospital pharmacist focus groups were held in two tertiary referral hospitals. Eligible pharmacists had provided medication counselling within the previous six months in inpatient and/or outpatient settings. Interested pharmacists attended a focus group designed to elicit their opinions and perceptions of patient medication counselling. Focus groups were audio recorded and transcribed verbatim. Inductive thematic analysis was applied to the data to identify initial patterns (codes) which were then organized into common overarching themes using NVivo ® software. The codes were reviewed for reliability by pharmacists independent of the focus groups. ResultsSix, one-hour focus groups were conducted with a total of 24 pharmacists participating. Saturation of information was determined after four focus groups. Greater than 80% consensus was achieved for reliability of the identified codes. A number of themes emerged from these codes around the goals, roles, and the barriers and facilitators to meeting these goals. Pharmacists' patient-centred goals in medication counselling were to build rapport, to empower patients and to improve patients' experience, health and safety. These goals would be accomplished through specific roles such as being an assessor, educator and problem-solver. Pharmacists frequently cited time pressures caused by systemic (hospital), and pharmacy specific processes as key challenges to achieving their goals. Factors that enabled pharmacists to meet their goals were those related to effective interprofessional collaboration and the quality of professional practice (such as training, expanded roles and advanced planning for discharge). ConclusionsHospital pharmacists emphasised patient-centred goals in medication counselling and outlined the challenges to meet those goals. The findings from this study will be used to develop strategies for effective communication and inform pharmacy practice changes to improve patient care. Key Words Hospital pharmacist Focus group Goal Role Communication M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPTPage 2 of 27 IntroductionDischarge from hospital to community or to other healthcare facilities marks an important transition in care for patients. Discharge and other transitions such as admission to hospital or transfers within a hospital have been identified as particular times when patients may be at risk of experiencing medication errors and adverse events. 1-3 Medication counselling opportunities are key times for pharmacists to speak to patients about their medications and the changes made to their therapies during their hospital stay. 2,[4][5][6][7] Failure by a hospital phar...

show abstract

Section: Improving Patients' Experiences Health and Safetymentioning

confidence: 99%

Hospital pharmacists' perceptions of medication counseling: A focus group study

Chevalier

Watson

Barras

et al. 2016

Research in Social and Administrative Pharmacy

View full text Add to dashboard Cite

show abstract

“…It is estimated that over 60% of medication errors occur during times of care transition [2]. As medication experts, pharmacists have a responsibility to provide counseling and sufficient medication reconciliation throughout the spectrum of care.…”

mentioning

confidence: 99%

“…As medication experts, pharmacists have a responsibility to provide counseling and sufficient medication reconciliation throughout the spectrum of care. However, pharmacists are currently underused in this regard [2,3]. A review of pharmacists' services in US hospitals revealed only 5% performed admission histories, and only 49% provided medication counseling.…”

mentioning

confidence: 99%

“…The opportunity for pharmacist-driven improvements in quality and cost-effective outcomes is evident in a recent single-center prospective cohort study of readmission rates. Over a year's time, a pharmacist was involved in the education of over 1,000 patients and performed 452 documented interventions [2]. Readmission rates were significantly lower in those patients that received discharge education compared to those that did not.…”

mentioning

confidence: 99%

“…Readmission rates were significantly lower in those patients that received discharge education compared to those that did not. Starting an omitted medication, preventing multiple discharge problems, avoiding duplication of therapy, and correcting insurance issues related to medication coverage were the most common pharmacist interventions in the study [2].…”

mentioning

confidence: 99%

See 2 more Smart Citations

Health Care Systems and Transitions of Care

Bush

Daniels

2017

North Carolina Medical Journal

View full text Add to dashboard Cite

Effect of extended pharmacist involvement in discharge transitions of care on hospital readmission rates: Prospective, randomized, parallel arm design trial

Tasseff,

Axtell,

Nixon

2023

J Am Coll Clin Pharm

View full text Add to dashboard Cite

Pharmacist involvement in transitions of care has been shown to improve patient outcomes and reduce readmission rates. Pharmacists reduce medication errors at discharge by ensuring all home medications continued are appropriate, provide pharmacist discharge patient medication education on new and existing medications therapies, and evaluate the safety and efficacy of the patient's medication therapy in order to decrease readmission rates. Results from this study may provide a financial benefit for hospital reimbursement by reducing 30 day readmission rates. The primary outcome was the comparison of composite emergency department (ED) and hospital 30 day readmission rates for patients that have extended pharmacist intervention at discharge versus standard of care. Patients 18 years of age and older with a readmission risk score of 25 or greater, and admitted on general medicine floors from November 1, 2022 through February 28, 2023 were included. Patients were randomized into a standard of care (SOC) or extended SOC group. The primary outcome was the comparison of composite ED and hospital 30 day readmission rates for patients that have extended pharmacist intervention at discharge versus SOC. A key secondary outcome included number of drug‐related problems identified and resolved. The primary outcome was analyzed using chi‐squared analysis (alpha of 0.05) and secondary outcomes as descriptive statistics. Data was analyzed using Stata® 16.1 statistical software. Two hundred and ninety‐six patients were included for analysis with 148 patients in both extended SOC and SOC groups. Extended SOC decreased the composite 30 day ED visit and hospital readmission rate by 7% (p = 0.63). Extended SOC group decreased 30 day ED visits by 4.9% and inpatient 30 day readmissions by 8.2% analyzed using descriptive statistics. Patients in extended SOC group resulted in a non‐statistical decrease in ED visits and inpatient readmissions 30 days after discharge compared to SOC group.

show abstract

Impact of a transition-of-care pharmacist during hospital discharge

Cited by 33 publications

References 10 publications

Hospital pharmacists' perceptions of medication counseling: A focus group study

Hospital pharmacists' perceptions of medication counseling: A focus group study

Health Care Systems and Transitions of Care

Effect of extended pharmacist involvement in discharge transitions of care on hospital readmission rates: Prospective, randomized, parallel arm design trial

Contact Info

Product

Resources

About