Implementation and Acceptance of a Pharmacist‐Initiated E‐Script Transcription Service for Discharge Prescriptions

Abstract

Aim To describe the implementation of pharmacist‐initiated e‐script transcription service (PETS) in a teaching hospital; to validate the service through process indicators; and to explore the views of stakeholders. Method Following an initial trial, PETS was implemented in 7 medical and surgical units at Frankston Hospital. Data were collected on activities and discharge prescription errors. Stakeholders' satisfaction was measured using a Likert scale based survey and group interviews. Transcripts of group interviews were analysed by informal word‐based techniques, noting words or synonyms used repeatedly to discover themes. Results During the implementation phase (8 to 29 February 2008), a daily average of 15 prescriptions (112 items) were prepared by the PETS pharmacist, i.e 30 to 60% of weekday discharge prescriptions. The discharge prescription error/amendment rate was 0.06 per patient. 163 respondents (92%) were satisfied or very satisfied with PETS. As a result of 3 group interviews of 10 doctors, 10 nurses and 10 pharmacists, several areas for enhancement were identified and implemented. Conclusion PETS has transitioned from trial to mainstream service, facilitating the discharge process and improving continuity of care.

Improved Medication Management With Introduction of a Perioperative and Prescribing Pharmacist Service

“…These outcomes have confirmed previous study results of PETS pharmacist prescription having reduced medication errors. [9][10][11] Control group results are comparable to error rates seen at preadmission, which can suggest that errors in the perioperative setting can translate to inpatient errors and subsequently discharge prescription errors, that ultimately leads to errors on the GP discharge summary. Complete and accurate documentation of a patient's medications is vital in communication between health-care professionals, especially around the time of surgery to clearly identify what has been ceased due to the surgery or suspended for a period of time due to surgical risks.…”

“…Studies conducted to evaluate the service showed a reduction in prescribing errors and a decrease in time taken to discharge patients when discharge prescriptions were prepared by PETS pharmacists instead of doctors. [9][10][11] To our knowledge, there is currently no study that closes the loop in surgical patient's medication management by a pharmacist, from perioperative period to discharge. Therefore, we combined the perioperative pharmacist role with PETS to create the PeRiopErative and Prescribing (PREP) pharmacist.…”

Implementation and evaluation of a collaborative clinical pharmacist's medications reconciliation and charting service for admitted medical inpatients in a metropolitan hospital

“…Previously, this 400‐bed Australian metropolitan hospital implemented a successful Pharmacist‐initiated e‐script Transcription Service whereby an experienced pharmacist undertook discharge medication reconciliation and generation of an electronic discharge prescription, which was printed and signed off by the referring medical officer. This project resulted in statistically significant improvements in the quality, accuracy ( P = 0·0005) and timeliness of discharge prescriptions ( P = 0·02) …”

Improving the accuracy of discharge medication documentation in people with kidney disease through pharmacist‐led partnered prescribing

“…Pharmacists are ideally placed to improve the accuracy of medication documentation, with previous studies showing improvement in accuracy both at discharge and at various timepoints in a patient's hospital journey. [12][13][14][15][16][17][18] Pharmacist input reduces medication errors and improves patient outcomes. 19,20 A pharmacist-led partnered prescribing (PPP) workflow was developed in response to an internal audit of our hospital network which found two-thirds of discharge summaries contained a medication documentation error.…”

“…Pharmacists are ideally placed to improve the accuracy of medication documentation, with previous studies showing improvement in accuracy both at discharge and at various timepoints in a patient's hospital journey 12–18 . Pharmacist input reduces medication errors and improves patient outcomes 19,20 …”