At Virginia Commonwealth University, pharmacists had a problem.
Even though they are a key part of the discharge process, they had limited information on which patients were closest to being sent home. Clinicians often submitted requests simply marked ASAP, interrupting the pharmacists several times a day to fill prescriptions, even if many of those patients were actually hours from discharge.
"There was really no logical order," Kelley Barry, senior clinical applications analyst at VCU Health, told FierceHealthcare in an interview.
So, Barry and her team built a new indicator for its patient tracking system for the discharge pharmacy. In addition to allowing pharmacists to better prioritize the prescriptions as they came in, the tool allows clinicians on inpatient units to track if a prescription is being filled or if there's a delay.
The tool will also provide details on what's causing the delay as well, such as a copay or prior authorization issue.
It was a key example of how the pharmacy became a clear place for improvement as VCU Health sought ways to boost efficiency and streamline discharges in recent months.
Discharge is a critical time for patients, particularly the elderly, and research shows that a more efficient, coordinated approach can ease the transition from hospital to home. Providers have adopted a number of strategies to ensure patients are discharged smoothly, including email follow-ups and other tech solutions.
Improved discharge planning can also boost patient satisfaction, in addition to improving safety.
For VCU Health, Barry said it was crucial to break down silos between the pharmacy and inpatient units to address the backups.
"If you're not all working toward the same goal, you'll never meet it," Barry said. "If we all join in on the conversation in real time, it makes things more efficient."
In the last several months, VCU Health as a whole has seen an increase in discharges before noon, and patients are more informed about their timelines, she said. They have also seen a significant decrease in calls from its units to the discharge pharmacy, which speeds up their ability to fill prescriptions.
Barry said a crucial key to finding success in the initiative was getting buy-in from the pharmacists, and they were on-board right away. Not only was the old system more time-consuming, it also led to sharing outdated or incomplete information, so "our support services were begging for a tool" that would improve communication.
"That's what everybody really wants," she said. "How do we respect everyone's time and give the most updated information that everyone can act on?"