Do Combined Pharmacist and Prescriber Efforts on Medication Reconciliation Reduce Postdischarge Patient Emergency Department Visits and Hospital Readmissions?

Baker, Michelle; Bell, Chaim M.; Xiong, Wei; Etchells, Edward; Shojania, Kaveh G; Lane, Kelly; Tripp, Tim; Lam, Mary; Tiwana, Kimindra; Leong, Derek; Wong, Gary; Huh, Jin-Hyeun; Musing, Emily; Fernandes, Olavo

doi:10.12788/jhm.2857

Cited by 11 publications

(12 citation statements)

References 29 publications

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“…Compared with the control, length of stay decreased by a mean of 0.73 days with the pharmacist‐hospitalist collaboration model ( P = .002). Findings from several studies describing interprofessional medication reconciliation teams have demonstrated mixed results with beneficial outcomes such as decreased medication errors, reduced hospitalist time on inpatient admissions, and significant cost avoidance, but no differences in 30‐day readmission rates 5‐8 …”

Section: Introductionmentioning

confidence: 99%

“…Findings from several studies describing interprofessional medication reconciliation teams have demonstrated mixed results with beneficial outcomes such as decreased medication errors, reduced hospitalist time on inpatient admissions, and significant cost avoidance, but no differences in 30-day readmission rates. [5][6][7][8] Since institutions have been employing hospitalists for years, it is…”

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confidence: 99%

“…The environment in which I collaborate as a (pharmacist/hospitalist) is truly a team-based approach to care 10 (1-10) 9 (3)(4)(5)(6)(7)(8)(9)(10) Patient care would be compromised without the work I do/without the work of the clinical pharmacist 10 (1-10) 8 (3)(4)(5)(6)(7)(8)(9)(10) The physician or providers I work with believe that my contributions to patient care are essential 9 (1-10) 10 (7-10)…”

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confidence: 99%

“…There are clear roles and expectations for the hospitalists/provider and me 8 (1-10) 9 (6)(7)(8)(9)(10) There is mutual trust between the hospitalist/pharmacist and me 9 (2-10) 9.3 (7)(8)(9)(10) My other job responsibilities hinder my ability to collaborate effectively with hospitalists/If pharmacists were allowed more time to care for my patients, I would find that beneficial As a clinical pharmacist, I could offer more for patient care if I were allowed to 7 (1-10)…”

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confidence: 99%

“…The health system in which I practice is more concerned about metrics (such as quality control or financial indicators) than about patient care I value the contributions of pharmacy students and pharmacy residents to the care of my patients 8 (3)(4)(5)(6)(7)(8)(9)(10) Note: Responses are expressed in a scale of 1 = strongly disagree to 10 = strongly agree.…”

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confidence: 99%

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Characterization of clinical pharmacist and hospitalist collaborative relationships

Olin

Anderson

Hellwig

et al. 2020

J Am Coll Clin Pharm

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Introduction: Hospitalists provide inpatient care including coordinating with other providers and transitioning care to the community. Clinical pharmacists interact with hospitalists, usually on multidisciplinary teams. A statement by the American Society of Health-System Pharmacists and the Society of Hospital Medicine promotes collaboration and encourages interdisciplinary optimization of patient care. However, literature detailing this collaboration is sparse. It is unclear how to utilize these joint working relationships most effectively. Objectives: The purpose of this study was to describe the environment of pharmacist and hospitalist collaborative relationships and activities of pharmacists practicing with hospitalists for foundational information. Methods: This was a cross-sectional study. An Institutional Review Board-approved survey was distributed to pharmacists and hospitalists via email. Questions considered the team and the environment, clinical pharmacist activities related to the pharmacists' patient care process, and perceived barriers to effective teamwork. Results were analyzed with descriptive statistics. Results: Seventy pharmacists and 25 hospitalists participated in the survey. Most were from the Midwest or Southeast United States and practicing up to 10 years in a large health care system. Pharmacists spent the most time on development of a therapeutic plan (1-5 ranking scale [1 = most, 5 = least time spent]; median 2; range 1-5.) There were variations in responses related to the institutional staffing model allowing for collaboration with hospitalists, whether technology enhanced collaboration and additional job responsibilities hindered collaboration, and whether absence of pharmacy participation on rounds was noticed. Most hospitalists (68%) initiated frequent communication with a pharmacist. Hospitalists (32%) would collaborate with a pharmacist more frequently if a specific individual was designated for the position.

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Section: Introductionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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Characterization of clinical pharmacist and hospitalist collaborative relationships

Olin

Anderson

Hellwig

et al. 2020

J Am Coll Clin Pharm

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The right time and place: the need for seven‐day pharmacist service models

Falconer

Snoswell

Morris

et al. 2021

Pharmacy Practice and Res

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Background: Medication safety is a World Health Organization health priority, with recognition that greater focus is needed to address this long-standing healthcare challenge. As medication management experts, hospital pharmacists support the safe and quality use of medications and are ideally positioned to optimise medication safety throughout a patient's hospital journey. However, hospital pharmacist services are commonly limited to business hours. Aim: To synthesise evidence for best practice hospital pharmacist services, with a focus on transitions of care, in support of an extended hours seven-day service model. Method: A literature search was conducted using PubMed, Embase and Google Scholar to identify studies that evaluated the provision of a seven-day hospital pharmacist service. Primary studies containing keywords '7-day service' OR 'after hours service' OR '24-h service' AND 'hospital pharmacist' OR 'clinical pharmacist' AND 'inpatient' OR 'hospital', and related synonyms in the title and/or abstract, published to December 2019, were identified. Additionally, highly cited studies related to hospital pharmacist services were also reviewed to evaluate benefits during hospitalisation. A narrative synthesis was conducted. Results: Only two studies have evaluated the benefits of seven-day services. A large number of studies, reporting hospital pharmacist services during inpatient admission support the need for pharmacist services beyond the 8-5 model. These studies demonstrate the vital role of pharmacists in medication management across the continuum of care. Conclusion: Hospital pharmacists are essential in ensuring optimal patient outcomes; however, few studies have appraised extended pharmacy services. To deliver equitable patient-centred care, a robust evaluation of seven-day services is needed.

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