Luiza Kerstenetzky1, Matthew J Birschbach2, Katherine F Beach3, David R Hager4, Korey A Kennelty5. 1. UW Health - Department of Pharmacy, 600 Highland Avenue, Madison, WI, 53792, United States. Electronic address: lkerstenetzky@uwhealth.org. 2. UW Health - Department of Pharmacy, 600 Highland Avenue, Madison, WI, 53792, United States; University of Wisconsin - Madison, School of Pharmacy, 777 Highland Avenue, Madison, WI, 53705, United States. Electronic address: mbirschbach@wisc.edu. 3. UW Health - Department of Pharmacy, 600 Highland Avenue, Madison, WI, 53792, United States; University of Wisconsin - Madison, School of Pharmacy, 777 Highland Avenue, Madison, WI, 53705, United States. Electronic address: kfbeach@wisc.edu. 4. UW Health - Department of Pharmacy, 600 Highland Avenue, Madison, WI, 53792, United States. Electronic address: dhager@uwhealth.org. 5. University of Wisconsin - Madison, School of Pharmacy, 777 Highland Avenue, Madison, WI, 53705, United States; Department of Pharmacy Practice and Science, University of Iowa, College of Pharmacy, 115 S Grand Ave, Iowa City, IA, 52242, United States. Electronic address: korey-kennelty@uiowa.edu.
Abstract
INTRODUCTION: Patients transitioning from the hospital to a skilled nursing home (SNF) are susceptible to medication-related errors resulting from fragmented communication between facilities. Through continuous process improvement efforts at the hospital, a targeted needs assessment was performed to understand the extent of medication-related issues when patients transition from the hospital into a SNF, and the gaps between the hospital's discharge process, and the needs of the SNF and long-term care (LTC) pharmacy. We report on the development of a logic model that will be used to explore methods for minimizing patient care medication delays and errors while further improving handoff communication to SNF and LTC pharmacy staff. METHODS: Applying the Intervention Mapping (IM) framework, a targeted needs assessment was performed using quantitative and qualitative methods. Using the hospital discharge medication list as reference, medication discrepancies in the SNF and LTC pharmacy lists were identified. SNF and LTC pharmacy staffs were also interviewed regarding the continuity of medication information post-discharge from the hospital. RESULTS: At least one medication discrepancy was discovered in 77.6% (n = 45/58) of SNF and 76.0% (n = 19/25) of LTC pharmacy medication lists. A total of 191 medication discrepancies were identified across all SNF and LTC pharmacy records. Of the 69 SNF staff interviewed, 20.3% (n = 14) reported patient care delays due to omitted documents during the hospital-to-SNF transition. During interviews, communication between the SNF/LTC pharmacy and the discharging hospital was described by facility staff as unidirectional with little opportunity for feedback on patient care concerns. CONCLUSIONS: The targeted needs assessment guided by the IM framework has lent to several planned process improvements initiatives to help reduce medication discrepancies during the hospital-to-SNF transition as well as improve communication between healthcare entities. Opening lines of communication along with aligning healthcare entity goals may help prevent medication-related errors.
INTRODUCTION:Patients transitioning from the hospital to a skilled nursing home (SNF) are susceptible to medication-related errors resulting from fragmented communication between facilities. Through continuous process improvement efforts at the hospital, a targeted needs assessment was performed to understand the extent of medication-related issues when patients transition from the hospital into a SNF, and the gaps between the hospital's discharge process, and the needs of the SNF and long-term care (LTC) pharmacy. We report on the development of a logic model that will be used to explore methods for minimizing patient care medication delays and errors while further improving handoff communication to SNF and LTC pharmacy staff. METHODS: Applying the Intervention Mapping (IM) framework, a targeted needs assessment was performed using quantitative and qualitative methods. Using the hospital discharge medication list as reference, medication discrepancies in the SNF and LTC pharmacy lists were identified. SNF and LTC pharmacy staffs were also interviewed regarding the continuity of medication information post-discharge from the hospital. RESULTS: At least one medication discrepancy was discovered in 77.6% (n = 45/58) of SNF and 76.0% (n = 19/25) of LTC pharmacy medication lists. A total of 191 medication discrepancies were identified across all SNF and LTC pharmacy records. Of the 69 SNF staff interviewed, 20.3% (n = 14) reported patient care delays due to omitted documents during the hospital-to-SNF transition. During interviews, communication between the SNF/LTC pharmacy and the discharging hospital was described by facility staff as unidirectional with little opportunity for feedback on patient care concerns. CONCLUSIONS: The targeted needs assessment guided by the IM framework has lent to several planned process improvements initiatives to help reduce medication discrepancies during the hospital-to-SNF transition as well as improve communication between healthcare entities. Opening lines of communication along with aligning healthcare entity goals may help prevent medication-related errors.
Authors: Pankdeep T Chhabra; Gail B Rattinger; Sarah K Dutcher; Melanie E Hare; Kelly L Parsons; Ilene H Zuckerman Journal: Res Social Adm Pharm Date: 2011-04-21
Authors: Momotazur Rahman; Andrew D Foster; David C Grabowski; Jacqueline S Zinn; Vincent Mor Journal: Health Serv Res Date: 2013-10-17 Impact factor: 3.402