Vivian Tsoi1, Norman Dewhurst2, Elaine Tom3. 1. , PharmD, was, at the time this manuscript was written, a student in the Leslie Dan Faculty of Pharmacy, University of Toronto, on a pharmacy research rotation at St Michael's Hospital, Toronto, Ontario. She is currently a Pharmacy Resident at London Health Sciences Centre, London, Ontario. 2. , BScPhm, PharmD, ACPR, is a Clinical Pharmacy Specialist/Leader, Critical Care at St Michael's Hospital, Toronto, Ontario. 3. , BScPhm, is a Clinical Pharmacy Specialist/Leader, Professional Practice at St Michael's Hospital, Toronto, Ontario.
Abstract
BACKGROUND: A compelling body of evidence supports the notion that transfer of accountability (TOA) improves communication, continuity of care, and patient safety. TOA involves the transmission and receipt of information between clinicians at each transition of care. Without a notification system alerting pharmacists to patient transfers, pharmacists' ability to seek out and complete TOA may be hindered. A standardized policy and process for TOA, with automated workflow, was implemented at the study hospital in 2015, to ensure consistency and timeliness of documentation by pharmacists. OBJECTIVE: To evaluate pharmacists' adherence to and satisfaction with the TOA policy and process. METHODS: A retrospective audit was conducted, using a random sample of individuals who were inpatients between June 2014 and February 2016. Transition points for TOA were identified, and the computerized pharmacy system was reviewed to determine whether TOA had been documented at each transition point. After the audit, an online survey was distributed to assess pharmacists' response to and satisfaction with the TOA policy and workflow. RESULTS: Before the TOA workflow was implemented, TOA documentation by pharmacists ranged from 11% (10/93) to 43% (48/111) of transitions. Eight months after implementation of the workflow, the rate of TOA documentation was 87% (68/78), exceeding the institution's target of 70%. Of the 32 pharmacists surveyed, most were satisfied with the TOA policy and agreed that the standardized workflow was simple to use, increased the number of TOAs provided and received, and improved the quality of completed TOAs. Respondents also indicated that the TOA workflow had improved patient care (mean score 4.09/5, standard deviation 0.64). CONCLUSIONS: The standardized TOA policy and process were well received by pharmacists, and resulted in consistent TOA documentation and a TOA documentation rate that exceeded the institutional target.
BACKGROUND: A compelling body of evidence supports the notion that transfer of accountability (TOA) improves communication, continuity of care, and patient safety. TOA involves the transmission and receipt of information between clinicians at each transition of care. Without a notification system alerting pharmacists to patient transfers, pharmacists' ability to seek out and complete TOA may be hindered. A standardized policy and process for TOA, with automated workflow, was implemented at the study hospital in 2015, to ensure consistency and timeliness of documentation by pharmacists. OBJECTIVE: To evaluate pharmacists' adherence to and satisfaction with the TOA policy and process. METHODS: A retrospective audit was conducted, using a random sample of individuals who were inpatients between June 2014 and February 2016. Transition points for TOA were identified, and the computerized pharmacy system was reviewed to determine whether TOA had been documented at each transition point. After the audit, an online survey was distributed to assess pharmacists' response to and satisfaction with the TOA policy and workflow. RESULTS: Before the TOA workflow was implemented, TOA documentation by pharmacists ranged from 11% (10/93) to 43% (48/111) of transitions. Eight months after implementation of the workflow, the rate of TOA documentation was 87% (68/78), exceeding the institution's target of 70%. Of the 32 pharmacists surveyed, most were satisfied with the TOA policy and agreed that the standardized workflow was simple to use, increased the number of TOAs provided and received, and improved the quality of completed TOAs. Respondents also indicated that the TOA workflow had improved patient care (mean score 4.09/5, standard deviation 0.64). CONCLUSIONS: The standardized TOA policy and process were well received by pharmacists, and resulted in consistent TOA documentation and a TOA documentation rate that exceeded the institutional target.
Entities:
Keywords:
documentation; pharmacist; policy; standardization; transfer of accountability
Authors: Jennifer Kirwin; Ann E Canales; Michael L Bentley; Kathy Bungay; Tammy Chan; Erica Dobson; Renee M Holder; Daniel Johnson; Andrea Lilliston; Rima A Mohammad; Sarah A Spinler Journal: Pharmacotherapy Date: 2012-10-26 Impact factor: 4.705
Authors: Anne L Hume; Jennifer Kirwin; Heather L Bieber; Rachel L Couchenour; Deanne L Hall; Amy K Kennedy; Nancy M Allen LaPointe; Crystal D O Burkhardt; Kathleen Schilli; Terry Seaton; Jennifer Trujillo; Barbara Wiggins Journal: Pharmacotherapy Date: 2012-10-26 Impact factor: 4.705