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

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.

Impacting Readmission Rates and Patient Satisfaction: Results of a Discharge Pharmacist Pilot Program

2011 ◽  
Vol 46 (11) ◽  
pp. 876-883 ◽  
Author(s):  
Samaneh Tavalali Wilkinson ◽  
Pal Aroop ◽  
J. Couldry Richard
Keyword(s):  
Patient Satisfaction ◽  
High Risk ◽  
Readmission Rate ◽  
Medical Center ◽  
Academic Medical Center ◽  
Control Group ◽  
Unplanned Readmission ◽  
Discharge Process ◽  
Readmission Rates ◽  
The Impact

Background Readmission to a hospital within 30 days of discharge has become a key quality outcome measure. With an observed 30-day readmission rate as high as 20% and attributed costs of almost $17.4 billion a year for Medicare patients, the potential implications for patients and the entire health care system are significant. Medication-related complications have been shown to increase the risk for unplanned readmission. Pharmacists have an opportunity to impact quality and cost by risk stratifying and identify patients at high risk for hospital readmission. Objective To study the impact of a pharmacist-driven discharge counseling program for high-risk patients identified by BOOST (Better Outcomes for Older adults through Safe Transitions) criteria on 30-day readmission rates. Method This was a prospective, cohort, nonrandomized trial at a single medical-surgical unit with telemetry capability at a single academic medical center including 669 patients who were older than 18 years. Primary outcome was 30-day readmission rate. Secondary outcomes were the number and type of pharmacist interventions, cost avoidance, and patient satisfaction results. Results The readmission rate for patients counseled by a pharmacist during the discharge process was 15.7% compared to 21.6% for patients not counseled by a pharmacist on discharge (relative risk [RR] 0.728; 95% confidence interval [CI], 0.514–1.032; P = .04). The readmission rate for adult medicine patients not counseled at discharge by a pharmacist in the study was comparable to the readmission rates of a similar patient control group at 3 months and 1 year prior to the initiation of the study (18.7% and 19.1% vs 19.6%). Conclusions Pharmacists' support in the discharge process facilitated increased communication on the multidisciplinary team and resulted in a lower unplanned readmission rate for patients.

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

2020 ◽  
Vol 77 (3) ◽  
pp. 206-213
Author(s):  
Kisha A Dunkley ◽  
Doneisha Evelyn ◽  
Veronica Timmons ◽  
Tara T Feller
Keyword(s):  
Patient Education ◽  
Training Program ◽  
Medical Center ◽  
Academic Medical Center ◽  
Hospital Readmissions ◽  
Transitions Of Care ◽  
Johns Hopkins Hospital ◽  
Adult Inpatient ◽  
Education Training ◽  
Survey Responses

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.

scholarly journals “Brown Bag Clinic”: A Pharmacist-led Approach to Reduce Heart Failure Hospital Readmission

2021 ◽  
Vol 12 (4) ◽  
pp. 11
Author(s):  
Maggie N. Faraj ◽  
Ileana L. Piña ◽  
Candice Garwood
Keyword(s):  
Heart Failure ◽  
Medical Center ◽  
Academic Medical Center ◽  
Hospital Readmissions ◽  
Intervention Group ◽  
The United States ◽  
Control Group ◽  
Post Discharge ◽  
Academic Medical ◽  
The Impact

Objectives: Heart failure (HF) affects approximately 6 million in the United States and despite guideline-directed medical therapy (GDMT), still more than 20% of patients are readmitted within 30 days.1,2 This study evaluated the impact of a “pharmacist-led HF Brown Bag Clinic” (BBC) on HF patient outcomes including readmissions and mortality. Methods: This retrospective study, conducted at an academic medical center, included adult patients 18 to 89 years old with HF presenting to the BBC 7-14 days post HF hospitalization. Those failing to attend the BBC within 30 days of hospital discharge were in the control group. Our electronic medical records were used to capture patients’ baseline characteristics and describe pharmacists’ interventions. Thirty- and ninety-day post-discharge HF readmission and all-cause mortality were evaluated. Results: A total of 32 patients met the inclusion criteria; 15 receiving intervention and 17 controls. A total of 18 HF hospital readmissions occurred, 4 (22%) readmissions in the intervention group and 14 (78%) in the control group (p= 0.06). Hospital readmissions within 30 days and 90 days were greater in the control group compared with the intervention group (18% vs. 7% and 41% vs. 21% respectively). Conclusion: A pharmacist-led post-discharge clinic demonstrated numerically fewer HF hospital readmissions compared with a scheduled but “no show” control group.

scholarly journals Seven Lessons in Partnership: How a Hospital and a Happiness Organization Teamed to Decrease Practitioner Burnout, Increase Practitioner Well-Being and Improve Patient Satisfaction

2016 ◽  
Vol 3 (2) ◽  
Author(s):  
Nancy O'Brien ◽  
Linda Saggau
Keyword(s):  
Emergency Department ◽  
Patient Satisfaction ◽  
Medical Center ◽  
Signs And Symptoms ◽  
Well Being ◽  
Urgent Care ◽  
Improve Patient Satisfaction ◽  
Hennepin County ◽  
Improve Patient

Nancy O’Brien and Linda Saggau, co-founders of Experience Happiness, LLC., and co-developers of The Happiness Practice™ (THP), share key discoveries derived from the partnership between Hennepin County Medical Center (HCMC) and Experience Happiness (EH) which focused on using THP as an intervention to increase Emergency Department and Urgent Care practitioner well-being and happiness in order to reduce the signs and symptoms of burnout and improve patient experience and satisfaction. This article includes a case study demonstrating the efficacy of the 6-month THP intervention, as well as an overview of THP and seven valuable partnership lessons to encourage and guide successful partnerships in healthcare and other systems.

Implementation of Daily Pharmacy Student New Medication Education During Hospitalization to Improve Patient Satisfaction

2021 ◽  
pp. 001857872110516
Author(s):  
Alexandra Whiddon Tatara ◽  
Christine Ji ◽  
Susan Jacob ◽  
John Marshall
Keyword(s):  
Patient Satisfaction ◽  
Hospital Readmissions ◽  
Control Unit ◽  
Pharmacy Students ◽  
Improve Patient Satisfaction ◽  
Quasi Experimental ◽  
To Receive ◽  
Inpatient Units ◽  
Intervention Unit ◽  
Improve Patient

Introduction: Studies have shown that patients would like to receive more medication education while hospitalized. Higher patient satisfaction has been correlated with lower mortality and fewer hospital readmissions. Methods: This was a quasi-experimental study. Four Doctor of Pharmacy students were assigned 1 medicine inpatient unit to provide education on new medications during the study period, June to September. The primary endpoint was the change in HCAHPS scores for the medication communication domain composite for the intervention unit and a similar control unit that was not receiving the intervention from the pre-intervention to the intervention periods. Results: A total of 124 patients were educated during the intervention period, with an average age of 65 and 2.2 new medications. Average HCAHPS scores for the medication communication domain for the intervention unit increased from 68% pre-intervention to 91% during the intervention ( P = .389) while the control unit remained unchanged at 78% both pre- and during the intervention ( P = .13). Conclusion: An increase in the medication communication HCAHPS score for the intervention unit was observed, while the control unit remained stable. This study has the potential to drive change by implementing pharmacy students throughout inpatient units to educate patients on new medications thereby improving patient satisfaction.

Impact of an Integrated Pharmacy Transitions of Care Pilot Program in an Urban Hospital

2016 ◽  
Vol 29 (5) ◽  
pp. 490-494 ◽  
Author(s):  
Shannon Christy ◽  
Billy Sin ◽  
Suzanna Gim
Keyword(s):  
Patient Satisfaction ◽  
Medication Review ◽  
Positive Impact ◽  
Hospital Readmissions ◽  
Transitions Of Care ◽  
Pilot Program ◽  
Phone Calls ◽  
Discharge Medication ◽  
Significant Difference ◽  
Ed Visits

Purpose: To evaluate the effectiveness of an integrated Pharmacy Transitions of Care (PTC) pilot program on reducing hospital readmissions and improving patient satisfaction. Methods: This prospective observational cohort study compares patients who participated in the PTC program to a control of usual hospital discharged patients during January through April 2014. The PTC program provided discharge medication review, medication counseling, delivery of medications to bedside, clinic scheduling, and follow-up phone calls. The primary outcome measure was 30-day readmissions. Secondary outcomes included emergency department (ED) visits, pharmacist interventions, and patient satisfaction. Results: Seventy patients participated in the PTC program. Compared to the control (n = 725), the study group had decreased 30-day all-cause readmissions (5.7% vs 13.8%, P = .08), 30-day readmissions for the same diagnosis (2.9% vs 8.1%, P = .18), and ED visits (18.6% vs 25%, P = .82). Twenty-five interventions during discharge medication review included discontinuation of unnecessary medications and correction of medication dose or frequency. The majority of patients were satisfied with the medication education provided (94%) and the timely delivery of prescriptions to bedside (96%). Conclusion: There was no significant difference in 30-day readmission rates. However, pharmacists were able to make a positive impact on patient satisfaction and improve understanding of medications during discharge.

Implementation and Evaluation of a Smartphone Application for the Perioperative Care of Neurosurgery Patients at an Academic Medical Center: Implications for Patient Satisfaction, Surgery Cancelations, and Readmissions

2017 ◽  
Vol 14 (3) ◽  
pp. 303-311 ◽  
Author(s):  
Daniel R Felbaum ◽  
Jeffrey J Stewart ◽  
Amjad N Anaizi ◽  
Faheem A Sandhu ◽  
Mani N Nair ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Medical Center ◽  
Academic Medical Center ◽  
Smartphone Application ◽  
Control Group ◽  
Pain Scores ◽  
Phone Calls ◽  
Academic Medical ◽  
Number Of Patients ◽  
Before And After

Abstract BACKGROUND Smartphone applications (apps) in the health care arena are being increasingly developed with the aim of benefiting both patients and their physicians. The delivery of adequate instructions both before and after a procedure or surgery is of paramount importance in ensuring the best possible outcome for patients. OBJECTIVE To demonstrate that app-based instructions with built-in reminders may improve patient understanding and compliance and contribute to reducing the number of surgery cancellations and postoperative complications and readmissions. METHODS We prospectively accrued 56 patients undergoing routine neurosurgery procedures who subsequently downloaded the app. The median age was 54 (range 27-79). Patients were followed for successful registration and use of the app, compliance with reading instructions before and after surgery, and sending pain scores and/or wound images. The number of surgeries cancelled, postoperative complications, 30-d readmissions, and phone calls for surgery-related questions were examined. RESULTS Fifty-four of the 56 patients successfully registered, downloaded, and used the app and read and complied with instructions both before and after surgery. There were no cancelled surgeries. There was 1 postoperative complication. There were no readmissions. Eight of the 54 patients (14.8%) called the office on a single occasion for a surgery related question. CONCLUSION We demonstrate the utility of a smartphone application in the perioperative neurosurgical care setting with regard to patient compliance and satisfaction as well as surgery cancellations and readmissions. Further study of a larger number of patients with a control group is warranted.

scholarly journals Missing the Mark: Inaccuracy of administrative data in identification of hospitalized patients with pneumonia and results of a systematic clinical reclassification process on readmission rates

2017 ◽  
Vol 6 (6) ◽  
pp. 35
Author(s):  
Marcus D. Ruopp ◽  
Joel C. Boggan ◽  
Thomas L. Holland ◽  
Mary Jane Stillwagon ◽  
Joseph A. Govert ◽  
...  
Keyword(s):  
Administrative Data ◽  
Readmission Rate ◽  
Medical Center ◽  
Academic Medical Center ◽  
Hospital Readmissions ◽  
Final Diagnosis ◽  
Healthcare Systems ◽  
Readmission Rates ◽  
Control And Prevention ◽  
One Year

Objective: Pneumonia readmissions carry financial ramifications under the Hospital Readmissions Reduction Program (HRRP). As readmission determination utilizes administrative data, healthcare systems should evaluate accuracy of pneumonia diagnoses. We sought to develop a systemic process for pneumonia classification review and determine potential effects on pneumonia readmissions in a tertiary academic medical center in the United States.Methods: We performed independent reviews of all pneumonia discharges within 48 hours of discharge over a one-year period. We reclassified all pneumonia discharges into four categories based on the Centers for Disease Control and Prevention reference standard. Secondary review of discordant classifications was performed by discharging providers to determine final diagnosis. The primary outcome was readmission rate within 30 days by pneumonia clinical classification category.Results: Two hundred seventy-eight discharges were reviewed, with overall readmission rate of 18.0%. Independent review confirmed 191 cases (68.7%) as definite or probable pneumonia, while 87 cases (31.3%) were classified as either probably not or not pneumonia. Readmission rates differed significantly between cases reviewed as pneumonia vs. those reviewed as unlikely to be pneumonia (14.1% vs. 26.4%, p < .02). Discharging attending physicians agreed with independent reviewers in 58/87 cases (66.6%), attenuating readmission differences (rate 16.8% for those finalized as pneumonia vs. 22.4% for another diagnosis, p = .32). Pneumonia readmissions were reduced by 1.2% using the classification standard.Conclusions: Complex conditions such as pneumonia may be inaccurately diagnosed in many patients, potentially affecting penalties associated with readmission rates. Therefore, it is imperative that healthcare systems adopt systematic review processes to standardize diagnoses and improve comparative administrative data.

Impact of discharge medication bedside delivery service on hospital reutilization

2019 ◽  
Vol 76 (23) ◽  
pp. 1951-1957 ◽  
Author(s):  
Avni Patel ◽  
Melanie A Dodd ◽  
Richard D'Angio ◽  
Robert Hellinga ◽  
Ali Ahmed ◽  
...  
Keyword(s):  
Academic Medical Center ◽  
Hospital Readmissions ◽  
Group Versus ◽  
Emergency Department Visits ◽  
Transitions Of Care ◽  
Control Group ◽  
Day Hospital ◽  
Index Visit ◽  
Significant Difference ◽  
The Impact

Abstract Purpose To evaluate the impact of a medication to bedside delivery (meds-to-beds) service on hospital reutilization in an adult population. Methods A retrospective, single-center, observational cohort study was conducted within a regional academic medical center from January 2017 to July 2017. Adult patients discharged from an internal medicine unit with at least one maintenance medication were evaluated. The primary outcome was the incidence of 30-day hospital reutilization between two groups: discharged patients who received meds-to-beds versus those who did not. Additionally, the incidence of 30-day hospital reutilization between the two groups was compared within predefined subgroup patient populations: polypharmacy, high-risk medication use, and patients with a principal discharge diagnosis meeting the criteria set by the Centers for Medicare and Medicaid Services 30-day risk standardized readmission measures. Results A total of 600 patients were included in the study (300 patients in the meds-to-beds group and 300 patients in the control group). The 30-day hospital reutilization (emergency department visits and/or hospital readmissions) related to the index visit was lower in the meds-to-beds group, but the difference was not statistically significant between the two groups (8.0% in the meds-to-beds group versus 10.0% in the control group; odds ratio, 0.78; 95% confidence interval, 0.45–1.37). There was no significant difference in the 30-day hospital reutilization related to the index visit between the control and meds-to-beds groups within the three subgroups analyzed. Conclusion There was no difference in 30-day hospital reutilization related to the index visit with the implementation of meds-to-beds service in the absence of other transitions-of-care interventions.

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