Evaluation of Targeted Pharmacist Interventions to Reduce Length of Stay in an Acute Care Practice Model

Abstract

Background: Despite widespread recognition of the need for innovative pharmacy practice approaches, the development and implementation of value-based outcomes remains difficult to achieve. Furthermore, gaps in the literature persist because the majority of available literature is retrospective in nature and describes only the clinical impact of pharmacists’ interventions. Objective: Length of stay (LOS) is a clinical outcome metric used to represent efficiency in health care. The objective of this study was to evaluate the impact of pharmacist-driven interventions on LOS in the acute care setting. Methods: A separate samples pretest-posttest design was utilized to compare the effect of pharmacist interventions across 3 practice areas (medicine, hematology/oncology, and pediatrics). Two time periods were evaluated: preimplementation (PRE) and a pilot period, postimplementation of interventions (POST). Interventions included targeted discharge services, such as discharge prescription writing (with provider cosignature). Participating pharmacists completed semistructured interviews following the pilot. Results: A total of 924 patients (466 PRE and 458 POST) were included in the analysis. The median LOS decreased from 4.95 (interquartile range = 3.24-8.5) to 4.12 (2.21-7.96) days from the PRE versus POST groups, respectively ( P < 0.011). There was no difference in readmission rates between groups (21% vs 19.1%, P = 0.7). Interviews revealed several themes, including positive impact on professional development. Conclusion and Relevance: This pilot study demonstrated the ability of pharmacist interventions to reduce LOS. Pharmacists identified time as the primary barrier and acknowledged the importance of leaders prioritizing pharmacists’ responsibilities. This study is novel in targeting LOS, providing a value-based outcome for clinical pharmacy services.

Adopting global tools for the advancement of pharmacy practice and workforce in Saudi Arabia

“…DG8 was also identified as a practice priority in Egypt ( International Pharmaceutical Federation, 2022 ). The added value of a pharmacist in multidisciplinary intra- and inter-professional healthcare teams was highlighted in several studies ( Bond and Raehl, 2007 , Leary et al, 2019 , Zhai et al, 2016 ). However, findings from the present study were similar to other studies in the region that showed the limited participation of pharmacists in multidisciplinary healthcare services ( Chamoun et al, 2020 ).…”

Effects of Targeted Intervention plus Comprehensive Nursing on the Quality of Life and Nursing Satisfaction in Multiple Traumas

“…In addition, psychological interventions effectively alleviate the pressure on patients and enhance their confidence in overcoming the disease. Results of LEARY demonstrated that targeted intervention plus comprehensive nursing enhances patients' treatment compliance, establishes a good nurse-patient relationship, and helps the patients cultivate a healthy lifestyle, which shows great prognosis benefits [ 19 ]. Clinical research has found a strong association between nursing satisfaction and the allocation of medical staff, which highlights the rational use of human resources to ensure the quality of care and improve nursing satisfaction [ 20 ].…”

Exploring the effect of perceived organizational support and resilience on Chinese pharmacists' engagement in stressful and competitive pharmaceutical work at hospitals

“…In addition to a broad range of hospital pharmaceutical services, clinical pharmaceutical service systems established by various countries, as exemplified by the systems established in developed countries such as the United States and Japan ( Pharmacy ACOC, 2008 , American College of Clinical P, 2014 , Zhu and Shang, 2015 , Shen, 2017 ), also administer community pharmacy services and derivative household pharmaceutical services ( Evans et al, 2017 ). Furthermore, by promoting rational drug use, pharmacists can reduce patients' risk of hospitalization and re-hospitalization, lessen risks of infection, and play an active role in diagnosis and treatment ( Leary et al, 2019 , Readdean et al, 2018 , Shao, 2008 ).…”