Inpatient pharmacists' patient referrals to a transitions-of-care pharmacist: Evaluation of an automated referral process

Journal of the American Pharmacists Association : JAPhA
Luiza KerstenetzkyDavid R Hager

Abstract

To evaluate the impact of a pharmacist screening and automated referral process that identifies patients at risk for readmission due to medication-related problems (MRPs). University of Wisconsin (UW) Hospital is 505-bed flagship hospital that is part of UW Health, an academic health system. The integrated pharmacy practice model at UW Health has inpatient pharmacists who perform discharge medication reconciliation. Before enhancing the screening and referral process, a transitions-of-care (TOC) pharmacist identified patients with the use of a low yield report and performed a second postdischarge medication reconciliation on selected patients. A screening process was developed to identify patients at risk for readmission due to MRPs and allow for direct referral from inpatient pharmacists to a TOC pharmacist for postdischarge follow-up. Patient characteristics, readmission risk, and readmission rate were compared between inpatient only (before referral) and inpatient plus second medication reconciliation (after referral). MRPs identified during medication reconciliation were quantified and categorized as provider or patient-associated. Before process improvement, 9 patients (5%) received a second medication reconciliation out o...Continue Reading

Citations

Feb 1, 2020·American Journal of Pharmaceutical Education·Philip D HallLynette R Bradley-Baker

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