Pharmacists implementing transitions of care in inpatient, ambulatory and community practice settings

Abstract

*Objective: To introduce pharmacists to the process, challenges, and opportunities of creating transitions of care (TOC) models in the inpatient, ambulatory, and community practice settings. Methods: TOC literature and resources were obtained through searching PubMed, Ovid, and GoogleScholar. The pharmacist clinicians, who are the authors in this manuscript are reporting their experiences in the development, implementation of, and practice within the TOC models. Results: Pharmacists are an essential part of the multidisciplinary team and play a key role in providing care to patients as they move between health care settings or from a health care setting to home. Pharmacists can participate in many aspects of the inpatient, ambulatory care, and community pharmacy practice settings to implement and ensure optimal TOC processes. This article describes establishing the pharmacist's TOC role and practicing within multiple health care settings. In these models, pharmacists focus on medication reconciliation, discharge counseling, and optimization of medications. Additionally, a checklist has been created to assist other pharmacists in developing the pharmacist's TOC roles in a practice environment or incorporating more TOC elements in their practice setting. *

Attitudes, Opportunities, and Challenges for Clinical Pharmacy Services in Mizan-Tepi University Teaching Hospital, Southwest Ethiopia: Health Care Providers’ Perspective

“…e study tool was designed based on the instruments used in the previously conducted studies [5,[16][17][18]. It included six questions to measure health care providers' attitudes towards clinical pharmacy services and statements pertain to the opportunities and challenges for clinical pharmacy services.…”

“…A plethora of studies have explored opportunities for the clinical pharmacists [10,[16][17][18]. In contrary, the clinical pharmacists are facing many challenges while dispensing medications, counseling patients, and interacting with medicine prescribers [17][18][19][20][21]. A recent reform in hospital implementation guidelines of Ethiopia stated the importance of pharmacists and their incorporation into the health care team for the benefit of the patients [22].…”

Preventing medication errors in transitions of care: A patient case approach

“…Sen and colleagues have described use of a postacute care clinic (PACC) model to provide follow-up to patients transitioning to the outpatient setting after hospital discharge to address any issues that may contribute to inappropriate medication use. 43 This PACC model uses an interdisciplinary team approach involving a pharmacist, an attending physician, at least two internal medicine residents, and a social worker. The pharmacist's role within the team is to review medication changes throughout the full spectrum of transitions, evaluate for appropriate use, and ensure updated information is communicated both within the electronic health record and verbally with other health professionals.…”

“…In efforts to maximize limited time with patients, pharmacists may review medication lists and the discharge summary before meeting with the patient. 43 CPE TRANSITIONS OF CARE…”

“…In another model described by Sen and colleagues, a local community pharmacy collaborated with a community hospital to provide complete medication management postdischarge and complimentary delivery of medications to either the hospital or the patient's home. 43 Pharmacists then followed up within 72 hours to offer services and discuss any medication-related questions and adherence issues. If the patient agreed to the services, a pharmacist would have dedicated time with the patient to review the medication information thoroughly and provide individualized education that would then be electronically documented so the information could be communicated with the patient's primary care physician.…”