Pharmacist–Physician Collaboration to Improve the Accuracy of Medication Information in Electronic Medical Discharge Summaries: Effectiveness and Sustainability
| Autor: | Michael I Dorevitch, Francine Tanner, Yixin Tan, Vincent Chan, Rohan A. Elliott, Belinda Richardson |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Patient Discharge Summaries pharmacists Pharmacist lcsh:RS1-441 Audit 030226 pharmacology & pharmacy Article care transition lcsh:Pharmacy and materia medica 03 medical and health sciences 0302 clinical medicine Medication information Intervention (counseling) medicine Pharmacology (medical) 030212 general & internal medicine General Pharmacology Toxicology and Pharmaceutics patient discharge summaries business.industry Workload Emergency medicine Public hospital business Medication list patient transfer |
| Zdroj: | Pharmacy, Vol 8, Iss 1, p 2 (2019) Pharmacy: Journal of Pharmacy Education and Practice Pharmacy Volume 8 Issue 1 |
| ISSN: | 2226-4787 |
| DOI: | 10.3390/pharmacy8010002 |
| Popis: | Inaccurate or missing medication information in medical discharge summaries is a widespread and intractable problem. This study evaluated the effectiveness and sustainability of an intervention in which ward-based hospital pharmacists reviewed, contributed and verified medication information in electronic discharge summaries (EDSs) in collaboration with physicians. Retrospective audits of randomly selected EDSs were conducted on seven wards at a major public hospital before and after implementation of the intervention and repeated two years later on four wards where the intervention was incorporated into usual pharmacist care. EDSs for 265 patients (prescribed a median of nine discharge medications) were assessed across the three time points. Pharmacists verified the EDSs for 47% patients in the first post-intervention audit and 68% patients in the second post-intervention audit. Following the intervention, the proportion of patients with one or more clinically significant discharge medication list discrepancy fell from 40/93 (43%) to 14/92 (15%), p < 0.001. The proportion of clinically significant medication changes stated in the EDSs increased from 222/417 (53%) to 296/366 (81%), p < 0.001, and the proportion both stated and explained increased from 206/417 (49%) to 245/366 (67%), p < 0.001. Significant improvements were still evident after two years. Pharmacists spent a median of 5 (range 2&ndash 16) minutes per patient contributing to EDSs. Logistics, timing and pharmacist workload were barriers to delivering the intervention. Additional staff resources is needed to enable pharmacists to consistently deliver this effective intervention. |
| Databáze: | OpenAIRE |
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