Vi Gilmore1, Leigh Efird2, Denise Fu2, Yvonne LeBlanc2, Todd Nesbit2, Meghan Swarthout2. 1. Vi Gilmore, Pharm.D., BCPS, is Clinical Pharmacy Specialist, Internal Medicine; Leigh Efird, Pharm.D., BCPS, is Clinical Pharmacy Specialist, Internal Medicine; and Denise Fu, Pharm.D., BCACP, is Clinical Coordinator, Johns Hopkins Home Care Group, The Johns Hopkins Hospital, Baltimore, MD. Yvonne LeBlanc, Pharm.D., M.B.A., is Inpatient Pharmacist, Lahey Hospital and Medical Center, Burlington, MA; at the time of writing, she was Outpatient Clinical Programs Manager, Johns Hopkins Home Care Group. Todd Nesbit, Pharm.D., M.B.A., is Associate Director, Decentralized and Clinical Services, The Johns Hopkins Hospital. Meghan Swarthout, Pharm.D., M.B.A., BCPS, is Division Director, Ambulatory and Care Transitions, The Johns Hopkins Hospital, and Associate Director, Clinical Services, Johns Hopkins Outpatient Pharmacy, Johns Hopkins Home Care Group. vdo1@jhmi.edu. 2. Vi Gilmore, Pharm.D., BCPS, is Clinical Pharmacy Specialist, Internal Medicine; Leigh Efird, Pharm.D., BCPS, is Clinical Pharmacy Specialist, Internal Medicine; and Denise Fu, Pharm.D., BCACP, is Clinical Coordinator, Johns Hopkins Home Care Group, The Johns Hopkins Hospital, Baltimore, MD. Yvonne LeBlanc, Pharm.D., M.B.A., is Inpatient Pharmacist, Lahey Hospital and Medical Center, Burlington, MA; at the time of writing, she was Outpatient Clinical Programs Manager, Johns Hopkins Home Care Group. Todd Nesbit, Pharm.D., M.B.A., is Associate Director, Decentralized and Clinical Services, The Johns Hopkins Hospital. Meghan Swarthout, Pharm.D., M.B.A., BCPS, is Division Director, Ambulatory and Care Transitions, The Johns Hopkins Hospital, and Associate Director, Clinical Services, Johns Hopkins Outpatient Pharmacy, Johns Hopkins Home Care Group.
Abstract
PURPOSE: The implementation of a practice model designed to reduce hospital readmissions through optimal deployment of pharmacy staff on multidisciplinary care collaboration teams is described. SUMMARY: In response to Affordable Care Act provisions aimed at reducing preventable hospital readmissions, the pharmacy department at The Johns Hopkins Hospital (JHH) led the implementation of a new pharmacy services model spanning both inpatient and outpatient settings. Key components of the model include (1) increased pharmacist participation in multidisciplinary rounds, (2) targeted medication reconciliation and patient education, (3) postdischarge phone monitoring of selected patients, and (4) bedside discharge medication delivery performed by a "transitions pharmacist extender." Incorporation of care coordination activities into the daily workflow has increased the rate of patient education on high-risk medications and allowed for affordable and effective medication regimens to be designed and prescriptions to be filled prior to patient discharge. The ultimate goal is enhanced multidisciplinary collaboration to decrease hospital readmissions by increasing medication adherence and patients' understanding of medications. CONCLUSION: The inpatient and outpatient pharmacy teams at JHH collaborated to improve their understanding of patients' medication use prior to admission through targeted medication reconciliation, education of patients on high-risk medications initiated during admission, and development of affordable and practical medication regimens that patients would receive in hand on discharge. A pharmacy team model was developed to ensure that these services are adequately provided and enhance patient understanding of the importance of medications for acute and chronic disease state management.
PURPOSE: The implementation of a practice model designed to reduce hospital readmissions through optimal deployment of pharmacy staff on multidisciplinary care collaboration teams is described. SUMMARY: In response to Affordable Care Act provisions aimed at reducing preventable hospital readmissions, the pharmacy department at The Johns Hopkins Hospital (JHH) led the implementation of a new pharmacy services model spanning both inpatient and outpatient settings. Key components of the model include (1) increased pharmacist participation in multidisciplinary rounds, (2) targeted medication reconciliation and patient education, (3) postdischarge phone monitoring of selected patients, and (4) bedside discharge medication delivery performed by a "transitions pharmacist extender." Incorporation of care coordination activities into the daily workflow has increased the rate of patient education on high-risk medications and allowed for affordable and effective medication regimens to be designed and prescriptions to be filled prior to patient discharge. The ultimate goal is enhanced multidisciplinary collaboration to decrease hospital readmissions by increasing medication adherence and patients' understanding of medications. CONCLUSION: The inpatient and outpatient pharmacy teams at JHH collaborated to improve their understanding of patients' medication use prior to admission through targeted medication reconciliation, education of patients on high-risk medications initiated during admission, and development of affordable and practical medication regimens that patients would receive in hand on discharge. A pharmacy team model was developed to ensure that these services are adequately provided and enhance patient understanding of the importance of medications for acute and chronic disease state management.
Authors: Logan T Murry; Michelle S Keller; Joshua M Pevnick; Jeffrey L Schnipper; Korey A Kennelty Journal: BMC Health Serv Res Date: 2022-02-12 Impact factor: 2.908