Impact of a Unit-Based Clinical Pharmacist on Communication of Medication Information in an Orthopedic Hospital

Abstract

Background Medication management, a complex yet essential part of patient care, requires that clinicians and patients understand indication, dosage, frequency, and adverse effects in order to maximize benefits and minimize errors, as well as to transition patients from hospital to home. Clinical pharmacists improve care transitions and safety by interacting with patients, prescribers, and nurses on medication management and self-care. However, little is known on the use of clinical pharmacists on interdisciplinary teams at the unit level within orthopedics. Questions/Purposes This study sought to measure the impact of unit-based clinical pharmacists on patient perceptions of communication specific to medication during hospitalization at an orthopedic specialty hospital and on the frequency of medication errors. Methods A retrospective, quasi-experimental, two-group evaluative design with nonequivalent controls was used. Consumer Assessment of Healthcare Providers and Systems (HCAHPS) data on six inpatient units was analyzed 6 months before and 6 months after assignment of clinical pharmacists to half these units. Data specific to questions that measure quality of communication as well as medication understanding were analyzed. Additionally, data on medication error frequency were collected and compared between units with and without clinical pharmacists. Results A total of 2022 surveys were analyzed. The percentage of patients who reported receipt of medication information and medication understanding increased significantly after the implementation of unit-based clinical pharmacists. Comparison of intervention and non-intervention groups showed no statistically significant difference in the frequency of medication errors. Conclusion Results suggest that a clinical pharmacist assigned to an inpatient unit in orthopedics significantly influences patient perceptions of communication about and understanding of their medications.

Why Did New York State Hospitals Rank So Poorly?

“…For example, Barden et al 38 detail an evidence-based approach used by one of the largest NYS systems to significantly improved their “Quiet at Night” performance. Guerin et al 39 reported significant improvements in communication about medications after the assignment of unit-based clinical pharmacists on postsurgical units at an orthopedic hospital in New York City. In an observational study of physician-patient communication during rounding at a teaching hospital in upstate New York, Custer et al 40 reported multiple modifiable physician behaviors, such as addressing patients by name, were associated with higher HCAHPS scores.…”