Impact of an Advanced Pharmacy Practice Experience Student-Run “Meds 2 Beds” and Discharge Counseling Program on Quality of Care

Abstract

Purpose: As health care progresses toward pay for performance reimbursement models and focus is placed on the patient as a consumer, health care systems must adapt by initiating new programs and services. This institution responded by implementing a “Meds 2 Beds” program integrating clinical services with dispensing and medication delivery during transitions of care. This study evaluates outcomes relevant to patients, health care providers, pharmacists, and administrators. Methods: This observational chart review evaluated the effectiveness of a “Meds 2 Beds” program from May 1, 2014, through December 1, 2015. Patients who participated in this program were matched 1:1 with controls who did not. The primary outcome was 30-day hospital readmission. Secondary outcomes included 30-day emergency department (ED) visits, patient satisfaction, and financial impact. Results: In this sample, 185 “Meds 2 Beds” patients were matched to 185 controls. Thirty day readmission occurred in 16 (8.7%) “Meds 2 Beds” cases and 19 (10.3%) controls ( P = .71). Rates of 30-day ED visits were nonsignificantly reduced in cases (22 [11.9%] vs 33 [18.1%]; odds ratio = 0.62, P = .11) and occurred significantly later (11 vs 7 days, P = .03). Conclusions: This study showcases a creative medication delivery and discharge counseling program. The program provides financial benefit to the institution creating a direct revenue stream from prescription dispensing while highlighting a potential for reduced readmissions and ED visits (although a statistically significant difference was not demonstrated in this analysis). A similar model can be adopted by other health care institutions to improve the quality of patient care.

Evaluation of pharmacy students’ knowledge and perceptions of transitions of care services

“…Incorporating pharmacy students into TOC services can result in positive economic outcomes for the institution offering this service. This can be done by increasing prescription capture rates of discharge prescriptions, decreasing emergency room visits, and helping patients and healthcare institutions with cost savings through reduced length of hospital stay and reductions in hospital readmissions (Conliffe et al, 2019). John Hopkins Health System has implemented a model which includes pharmacy services employed by a pharmacist, fourth-year pharmacy student, and a pharmacy technician in the TOC process to enhance multidisciplinary collaboration and decrease hospital readmissions (Gilmore et al, 2015).…”

Black lives matter … in the cath lab, too! A proposal for the interventional cardiology community to counteract bias and racism

“…A "Meds to Beds" program that supplies medications to patients on the day of discharge has shown promise in individual and regional health systems. 20 We recommend that interventional programs (1) collaborate with their inpatient pharmacy teams to tailor similar programs to ensure that all patients leave the hospital with antiplatelet therapy, statins, and other guideline-directed medications in hand, and (2) consider utilizing tools via electronic medical records that link discharge to automatic referrals to cardiac rehab. Physicians and programs should consider the impact of transportation and cost, on patients' ability to adhere to cardiac rehabilitation programs.…”

“…Strategies to increase the proportion of Black patients discharged with guideline‐directed medications should help ameliorate these disparities. A “Meds to Beds” program that supplies medications to patients on the day of discharge has shown promise in individual and regional health systems 20 . We recommend that interventional programs (1) collaborate with their inpatient pharmacy teams to tailor similar programs to ensure that all patients leave the hospital with antiplatelet therapy, statins, and other guideline‐directed medications in hand, and (2) consider utilizing tools via electronic medical records that link discharge to automatic referrals to cardiac rehab.…”