Pharmacist's Role in the Hospital Discharge Process

Abstract

Aim:To determine pharmacist involvement in the hospital discharge process and to explore the potential for further involvement. Method: Questionnaires were distributed to staff at participating hospitals with pharmacy departments and followed-up with focus groups to further explore relevant issues. Qualitative data were explored thematically. Results: 163 questionnaires were completed by pharmacists, nurses, doctors and administrators from 53 hospitals. Writing of discharge prescriptions was the problematic component of the discharge process and the pressure to discharge the patient contributed to errors. A range of solutions was discussed and it was generally noted that increased pharmacist involvement in the discharge process would improve efficiency. Conclusion: The increased involvement of pharmacists in the hospital discharge process by writing discharge prescriptions would benefit the health system, notwithstanding the need for legislative change and a commitment to systems and workforce reform.

Collaborative Prescribing: Views of SHPA Pharmacist Members

“…23 A second response is to consider the time saved by not having to wait for the prescription to be written or to contact the doctor for changes. 20 Transcribing with medical signature The existing level of de facto prescribing on discharge or in specialist settings (e.g. oncology) is high.…”

“…15 Marriott also identified that increased involvement of hospital pharmacists in the discharge process has system benefits. 20 The development of electronic prescribing systems could enhance the discharge transcribing role of pharmacists. 21,22 There can be debate on whether transcribing is actually prescribing or the authority to administer a medication.…”

Australian Hospital Pharmacists' Experiences of a UK Non‐Medical Prescribing Course

“…15 Supplementary prescribing in the UK and collaborative prescribing in Australia are seen as a natural progression for hospital pharmacists seeking to improve the efficiency and safety of patient care, enhance their clinical role and formalise what occurs day-to-day. [15][16][17][18] The demands placed on hospital pharmacists by high patient throughputs has contributed to 'de facto prescribing' by them. 15 Pharmacists undertaking prescribing as part of routine practice or in advanced practice settings need to underpin it with an accredited course and local governance structure.…”

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

“…1 A multidisciplinary survey identified that pharmacists could improve efficiencies in the discharge process if they were able to write discharge prescriptions. 2 Pharmacists could also optimise the discharge process by discontinuing medications no longer needed, adding therapy and adjusting dosages. 2 The survey also identified the potential for improved documentation of medication changes, less confusion and less preventable adverse medication events as well as opportunities for pharmacists to make a contribution to continuity of care.…”

“…2 Pharmacists could also optimise the discharge process by discontinuing medications no longer needed, adding therapy and adjusting dosages. 2 The survey also identified the potential for improved documentation of medication changes, less confusion and less preventable adverse medication events as well as opportunities for pharmacists to make a contribution to continuity of care. 2 At Frankston Hospital, the pharmacist-initiated escript transcription service (PETS) was trialled to facilitate the discharge process and reduce prescribing errors.…”