Effects of a hospitalwide pharmacy practice model change on readmission and return to emergency department rates

Anderegg, Sammuel V.; Wilkinson, Samaneh T.; Couldry, Rick; Grauer, Dennis; Howser, Eric

doi:10.2146/ajhp130686

Cited by 69 publications

(81 citation statements)

References 16 publications

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“…A recently published article in the American Journal of Health-System Pharmacy describes the effects of a hospital-wide pharmacy practice model change on readmission rates at an academic medical center [7].…”

Section: Pharmacist Integration Into Transitions Of Care At a Communimentioning

confidence: 99%

Pharmacist Integration into Transitions of Care at a Community Hospital: Skilled Nursing Facility Discharges

Creek¹,

Marks²,

Newkirk³

et al. 2016

JPP

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Abstract:In 2012-2013, CMH (Community Memorial Hospital) had a 10.5% 30-day readmission rate from SNFs (skilled nursing facilities). The focus of the Connections of Care Coalition was to review the medication reconciliation process and to involve pharmacists in the transition of patients to SNFs. The objective of the project was to work as an interdisciplinary team to improve the communication during transitions of care from our hospital to local SNFs by identifying key issues and initiating pharmacy practice change. This quality improvement project had a pre-post study design. Patients older than 18 years of age discharged to SNFs and/or readmitted from SNFs within 30 days were included. Baseline data was collected, specific pharmacist interventions were identified, educated on and implemented, and post-implementation data was collected. The number of interventions made and documented by pharmacists for patients being discharged from CMH to local SNFs did not significantly change during this quality improvement study. Clinically significant interventions were made on high risk medications, such as warfarin. Finally, a newly redesigned SNF workflow was implemented to include pharmacy, nursing, social work/case management to improve patient care and safety for discharges to SNFs.

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Section: Pharmacist Integration Into Transitions Of Care At a Communimentioning

confidence: 99%

Pharmacist Integration into Transitions of Care at a Community Hospital: Skilled Nursing Facility Discharges

Creek¹,

Marks²,

Newkirk³

et al. 2016

JPP

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“…Transitions of care can contribute to occurrences of medication discrepancy . Pharmacists' interventions during transitions of care, such as medication reconciliation or counselling, reduce medication errors and improve clinical outcomes . Previous research has demonstrated that pharmacist‐led discharge counselling improves medication adherence and reduces medication errors, readmission rates, emergency department visits, and mortality, and consequently, promotes health care cost savings .…”

Section: Introductionmentioning

confidence: 99%

Pharmacist‐led discharge medication counselling: A scoping review

Bonetti

Reis

Lombardi

et al. 2018

Evaluation Clinical Practice

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Mapping the components of the pharmacist-led discharge counselling studies through a scoping review allowed us to reveal how this service is performed around the world. Wide variability in this process and poor reporting were identified. Future studies are needed to define the core outcome set of this clinical pharmacy service to allow the generation of robust evidence and reproducibility in clinical practice.

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“…Implementation of a pharmacist‐driven TOC process has been shown to reduce rates of medication errors and readmissions and has increased adherence and understanding of medications in patient populations including those with heart failure, chronic obstructive pulmonary disease (COPD), and those with high‐risk medication use . There is a wealth of data showing a reduction in readmission rates in heart failure patients with pharmacy TOC programs.…”

Section: Introductionmentioning

confidence: 99%

Impact of a pharmacist‐driven transition of care program for patients with acute coronary syndromes

Gorman

Brown

Costello

et al. 2018

J Am Coll Clin Pharm

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Background Pharmacist‐driven transition of care (TOC) initiatives have been shown to reduce rates of medication errors and readmission rates in several patient populations, including heart failure. Existing literature evaluating pharmacist‐driven TOC initiatives targeting patients with acute coronary syndromes (ACSs) are limited. Objective To assess the impact of a newly implemented pharmacist‐driven TOC initiative on readmission rates in patients with ACS. Methods This was a retrospective, single‐center, pre‐post observational cohort study. Institutional review board approval was obtained. Patients were matched for age, gender, and ACS type with a historical cohort who received no pharmacist TOC intervention. The primary outcome was the 90‐day all‐cause readmission rate. Secondary outcomes included 30‐ and 90‐day cardiovascular‐related readmission rates as well as the 30‐day all‐cause readmission rate. Individual components of a pharmacist‐driven TOC initiative were also evaluated to determine what, if any, aspect of the program had the greatest association with reduced readmission. Results A total of 300 patients were included in the study; 150 patients in the pharmacist TOC group and 150 patients in the historical control group. There was a statistically significant reduction in all readmissions at 90 days in the pharmacist TOC group compared with the historical control group (24.7% vs 13.3%, P = .0124). Cardiovascular‐related readmissions were also significantly reduced in the pharmacist TOC group at 30 days (11.3% vs 4.7%, P = .0333) and at 90 days (16.7% vs 8.0%, P = .0225). A higher percentage of patients who were not readmitted received pharmacist medication history and reconciliation compared with patients who were readmitted (129 [99.2%] vs 18 [90%], respectively, P = .046). Conclusions The implementation of a pharmacist‐driven TOC initiative targeting ACS patients was associated with reduced readmission rates.

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Effects of a hospitalwide pharmacy practice model change on readmission and return to emergency department rates

Abstract: Implementation of a team-based pharmacy practice model resulted in a significant decrease in the rate of 30-day readmissions for high-risk patients.

Cited by 69 publications

References 16 publications

Pharmacist Integration into Transitions of Care at a Community Hospital: Skilled Nursing Facility Discharges

Pharmacist Integration into Transitions of Care at a Community Hospital: Skilled Nursing Facility Discharges

Pharmacist‐led discharge medication counselling: A scoping review

Impact of a pharmacist‐driven transition of care program for patients with acute coronary syndromes

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