A discharge clinic, staffed with a pharmacist and nurse practitioner who meet with patients after their release from the hospital, has helped Mercy Hospital & Medical Center in Chicago cut its readmission rates, according to an article in Hospitals and Health Networks Daily.
Medication management issues are one of the primary reasons behind preventable readmissions, according to authors Daniel Vicencio, M.D., medical director of Mercy Family Health Center in Chicago, Steven Silverstein, the pharmacy health system director, and Andrius Cepenas, a clinical pharmacy specialist, ambulatory care pharmacy coordinator. Silverstein and Cepenas both work with Comprehensive Pharmacy Services in Memphis, Tennessee, which manages Mercy's pharmacy-related services.
In another example of the growing role pharmacists play in healthcare, they credit the success of the program to the participation of a pharmacists, who conduct a comprehensive medication history and hospital course evaluation on patients.
The discharge clinic opened in October 2013 and is housed at Mercy's affiliate, the Mercy Family Health Center, a community-based outpatient facility. Mercy's mission includes providing care for Chicago's underserved population, including 300,000 uninsured, and it admits many high-risk patients, a group in jeopardy of being readmitted after discharge.
The hospital wanted to improve access to follow-up care to reduce those unnecessary readmissions and repeat emergency department visits. A pharmacy leadership team proposed opening the discharge clinic as a pilot program, offering 30-minute patient appointments half a day for six days a week, with a pharmacist available on three of the days. When the pharmacist was not scheduled, the nurse practitioner performed both a physical assessment and did the medication history and evaluation.
Results posted within the first month of operation exceeded expectations. The readmission rates of patients seen by the nurse practitioner decreased. However, readmissions were reduced even more significantly when patients were seen by both the nurse practitioner and pharmacist, the authors wrote. As a whole, the discharge clinic saw readmission rates for all patients decrease from 7 percent in its first quarter to 1 percent a year later.
The pilot program was so successful, Mercy has increased staff for the clinic, expanded the pharmacist availability to all six days, and extended access to the clinic to all patients discharged from Mercy Hospital.
To learn more:
- read the article
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