Implementation of a medication education training program for student pharmacists employed within an academic medical center

Abstract Purpose To describe the implementation of a student pharmacist medication education training program (the REWARDS Method), to determine if training was effective in preparing employed student pharmacists to provide medication education, and to assess medication education completion rates. Summary Hospital readmissions are often attributable to poor transitions of care (TOC), and medication education prior to discharge may improve TOC. To expand upon existing medication education efforts, the Johns Hopkins Hospital Adult Inpatient Pharmacy (AIP) designed and implemented the REWARDS Method, a training program to prepare employed second- and third-year student pharmacists to provide medication education. The REWARDS Method includes 6 distinct steps, which incorporate student self-directed and pharmacist-facilitated learning. Students were trained to provide patient education targeting 4 classes of high-risk medications (anticoagulants, inhalers, insulin, and naloxone) on multiple inpatient units served by the AIP. A total of 43 hours of pharmacist time was needed to complete training for the 10 employed student pharmacists. A survey was used to assess preparedness for completing medication education. Survey responses indicated that participants were sufficiently to exceedingly prepared to perform medication education. The division’s completion rate for patients requiring education was 79% in 2017, compared to 86% in 2018 (p = 0.006). Conclusion The REWARDS Method is an effective training program that successfully incorporated employed student pharmacists into medication education efforts. Our study demonstrated high rates of students successfully completing training and an increase in the rate of patient education completion.

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Pharmacist Transition-of-Care Services Improve Patient Satisfaction and Decrease Hospital Readmissions

Journal of Pharmacy Practice ◽

10.1177/0897190020958264 ◽

2020 ◽

pp. 089719002095826

Author(s):

Katherine L. March ◽

Michael J. Peters ◽

Christopher K. Finch ◽

Lauchland A. Roberts ◽

Katie M. McLean ◽

...

Keyword(s):

Patient Satisfaction ◽

Medical Center ◽

Academic Medical Center ◽

Hospital Readmissions ◽

Transitions Of Care ◽

Control Group ◽

Readmission Rates ◽

Improve Patient Satisfaction ◽

Phone Calls ◽

Improve Patient

Background: Pharmacists ability to directly impact patient satisfaction through increases in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys utilizing transitions-of-care (TOC) services is unclear. Methods: Retrospective analysis of TOC patients from 07/01/2018 to 03/31/2019 was conducted. Intervention (INV) patients received pharmacist medication reconciliation and education prior to discharge and post-discharge telephone follow-up. All other patients served as control group (CON). Primary outcome: Evaluate impact of TOC services on HCAHPS scores for “Communication about Medicines” and “Care Transitions.” Secondary outcomes: 30-day readmissions, quantification of prevented potential safety events, assessment of discharge prescriptions sent to the academic medical center outpatient pharmacy (MOP) for TOC patients. Results: Of 1,728 patients screened, 414 patients met inclusion criteria (INV = 414, CON = 1314). A significant improvement (14.7%; p = <0.0001) in overall medication-related HCAHPS results was seen when comparing pre- vs post-implementation of the TOC service. Statistically significant increases for individual questions “staff told you what the medicine was for” (14.2%; p = 0.018), “staff describe possible effects” (21.2%; p = 0.004), and “understood the purpose of taking medications” (11.4%; p = 0.035) were observed. A non-significant decrease in 30-day readmission rates for the groups was observed (CON 16.4%, INV 13.3%; p = 0.133); however, an unplanned subgroup analysis evaluating impact of discharge phone calls on 30-day readmission rates revealed a significant reduction of 17.3% to 12.4% (p = 0.007). One hundred forty-three medication safety event(s) were potentially prevented by the TOC pharmacist. Lastly, 562 prescriptions were captured at the MOP as a result of the TOC initiative. Conclusions: Pharmacy-based TOC models can improve patient satisfaction, prevent hospital readmissions, and generate revenue.

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Many Neurology Readmissions Are Nonpreventable

The Neurohospitalist ◽

10.1177/1941874416674409 ◽

2016 ◽

Vol 7 (2) ◽

pp. 61-69 ◽

Cited By ~ 4

Author(s):

Sidney T. Le ◽

S. Andrew Josephson ◽

Hans A. Puttgen ◽

Lorrie Gibson ◽

Elan L. Guterman ◽

...

Keyword(s):

Length Of Stay ◽

San Francisco ◽

Chart Review ◽

Medical Center ◽

Hospital Readmissions ◽

Johns Hopkins Hospital ◽

Unplanned Readmission ◽

Neurosurgical Procedures ◽

Patient Age ◽

Patient Âgé

Introduction: Reducing unplanned hospital readmissions has become a national focus due to the Centers for Medicare and Medicaid Services’ (CMS) penalties for hospitals with high rates. A first step in reducing unplanned readmission is to understand which patients are at high risk for readmission, which readmissions are planned, and how well planned readmissions are currently captured in comparison to patient-level chart review. Methods: We examined all 5455 inpatient neurology admissions over a 2-year period to University of California San Francisco Medical Center and Johns Hopkins Hospital via chart review. We collected information such as patient age, procedure codes, diagnosis codes, all-payer diagnosis-related group, observed length of stay (oLOS), and expected length of stay. We performed multivariate logistic modeling to determine predictors of readmission. Discharge summaries were reviewed for evidence that a subsequent readmission was planned. Results: A total of 353 (6.5%) discharges were readmitted within 30 days. Fifty-five (15.6%) of the 353 readmissions were planned, most often for a neurosurgical procedure (41.8%) or immunotherapy (23.6%). Only 8 of these readmissions would have been classified as planned using current CMS methodology. Patient age (odds ratio [OR] = 1.01 for each 10-year increase, P < .001) and estimated length of stay (OR = 1.04, P = .002) were associated with a greater likelihood of readmission, whereas index admission oLOS was not. Conclusions: Many neurologic readmissions are planned; however, these are often classified by current CMS methodology as unplanned and penalized accordingly. Modifications of the CMS lists for potentially planned neurological and neurosurgical procedures and for acute discharge neurologic diagnoses should be considered.

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Impact of a transitions of care pilot service established by pharmacy residents within an academic medical center

Journal of the American Pharmacists Association ◽

10.1016/j.japh.2019.09.018 ◽

2020 ◽

Vol 60 (1) ◽

pp. 87-92.e2 ◽

Cited By ~ 1

Author(s):

Emily A. O'Reilly ◽

Amanda K. Kuszmaul ◽

Andrea M. Carter ◽

Kayla N. Kreft ◽

Catherine A. Spencer

Keyword(s):

Medical Center ◽

Academic Medical Center ◽

Transitions Of Care ◽

Academic Medical

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Assessment of Patient Satisfaction With Dermatology Clinics According to Clinic Type: Mixed Methods Study (Preprint)

10.2196/preprints.17171 ◽

2019 ◽

Author(s):

Jennifer Costigan ◽

Sue S Feldman ◽

Mark Lemak

Keyword(s):

Patient Satisfaction ◽

Mixed Methods ◽

Medical Center ◽

Academic Medical Center ◽

University Of Alabama ◽

Contributing Factors ◽

Rapid Access ◽

Academic Medical ◽

Survey Responses ◽

The University

BACKGROUND Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey responses are considered significant indicators of the quality of care and patient satisfaction. There is a pressing need to improve patient satisfaction rates as CAHPS survey responses are considered when determining the amount a facility will be reimbursed by the Centers of Medicare and Medicaid each year. Low overall CAHPS scores for an academic medical center’s dermatology clinics were anecdotally attributed to clinic type. However, it was unclear whether clinic type was contributing to the low scores or whether there were other factors. OBJECTIVE This study aimed to determine where the efforts of patient satisfaction improvement should be focused for two different types of dermatology clinics (private and rapid access clinics). METHODS This study used a concurrent mixed methods design. Secondary data derived from the University of Alabama at Birmingham Hospital’s Press Ganey website were analyzed for clinic type comparisons and unstructured data were qualitatively analyzed to further enrich the quantitative findings. The University of Alabama at Birmingham Hospital is an academic medical center. The data were analyzed to determine the contributors responsible for each clinic not meeting national benchmarks. Thereafter, a review of these contributing factors was further performed to assess the difference in CAHPS scores between the private and rapid access clinics to determine if clinic type was a contributing factor to the overall scores. RESULTS The data sample included 821 responses from May 2017 to May 2018. Overall, when both private clinics and rapid access clinics were viewed collectively, majority of the patients reported stewardship of patient resources as the most poorly rated factor (367/549, 66.8%) and physician communication quality as the most positively rated factor (581/638, 91.0%). However, when private clinics and rapid access clinics were viewed individually, rapid access clinics contributed slightly to the overall lower dermatology scores at the academic medical center. CONCLUSIONS This study determined that different factors were responsible for lower CAHPS scores for the two different dermatology clinics. Some of the contributing factors were associated with the mission of the clinic. It was suspected that the mission had not been properly communicated to patients, leading to misaligned expectations of care at each clinic.

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