Impact of pharmacist-led discharge medication reconciliation on error and patient harm prevention at a large academic medical center

IF 1.3 Q4 PHARMACOLOGY & PHARMACY Journal of the American College of Clinical Pharmacy : JACCP Pub Date : 2024-06-04 DOI:10.1002/jac5.1980
Linda Zheng Pharm.D., Tiffany Pon Pharm.D., Sarah Bajorek Pharm.D., Kathie Le Pharm.D., Rebecca Hluhanich Pharm.D., Yunyi Ren M.S., Machelle Wilson Ph.D.
{"title":"Impact of pharmacist-led discharge medication reconciliation on error and patient harm prevention at a large academic medical center","authors":"Linda Zheng Pharm.D.,&nbsp;Tiffany Pon Pharm.D.,&nbsp;Sarah Bajorek Pharm.D.,&nbsp;Kathie Le Pharm.D.,&nbsp;Rebecca Hluhanich Pharm.D.,&nbsp;Yunyi Ren M.S.,&nbsp;Machelle Wilson Ph.D.","doi":"10.1002/jac5.1980","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>Medication errors during hospital discharge can lead to adverse outcomes, medication-related readmissions, and increased health care costs. Pharmacist-led medication reconciliation at discharge is a potential solution to mitigate poor outcomes and optimize medication safety.</p>\n </section>\n \n <section>\n \n <h3> Objectives</h3>\n \n <p>This study aimed to quantify medication errors identified at discharge and characterize the severity of patient harm prevented following pharmacist-led discharge medication reconciliation. Cost avoidance analysis was conducted to determine its associated financial impact.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Patients, who were discharged from an adult internal medicine service during October 2022, were included in this one-month pilot prospective quality improvement study. The number of errors at discharge were documented, categorized by type, and adjudicated for severity of potential harm. Error severity was classified based on a modified National Coordinating Council for Medication Error Reporting and Prevention Medication Error Index. Cost avoidance was calculated based on whether each error would have resulted in additional medical encounters and length of stay.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Thirty-one patients were included in the analysis. Forty errors were identified by pharmacist-led medication reconciliation at discharge, with a mean of 1.3 ± 1.9 errors per patient and 68% of patients having at least one error. The most common errors were duplication of therapy (25%) and medication access barriers at discharge (25%). The severity of errors included low (22.5%), serious (75%), and life-threatening harm (2.5%). Thirty-five percent of errors could have led to emergency visits or hospital readmissions. The estimated total cost for errors was $25 600. Pharmacist labor cost for reconciliation was $816. Cost avoidance was $24 784 from the 14 errors at discharge that could have resulted in additional emergency or inpatient visits.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Pharmacist-led medication reconciliation at discharge may prevent harm from reaching patients, decrease cost from unnecessary health encounters, and stop the error from continuing across transitions of care.</p>\n </section>\n </div>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jac5.1980","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the American College of Clinical Pharmacy : JACCP","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/jac5.1980","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction

Medication errors during hospital discharge can lead to adverse outcomes, medication-related readmissions, and increased health care costs. Pharmacist-led medication reconciliation at discharge is a potential solution to mitigate poor outcomes and optimize medication safety.

Objectives

This study aimed to quantify medication errors identified at discharge and characterize the severity of patient harm prevented following pharmacist-led discharge medication reconciliation. Cost avoidance analysis was conducted to determine its associated financial impact.

Methods

Patients, who were discharged from an adult internal medicine service during October 2022, were included in this one-month pilot prospective quality improvement study. The number of errors at discharge were documented, categorized by type, and adjudicated for severity of potential harm. Error severity was classified based on a modified National Coordinating Council for Medication Error Reporting and Prevention Medication Error Index. Cost avoidance was calculated based on whether each error would have resulted in additional medical encounters and length of stay.

Results

Thirty-one patients were included in the analysis. Forty errors were identified by pharmacist-led medication reconciliation at discharge, with a mean of 1.3 ± 1.9 errors per patient and 68% of patients having at least one error. The most common errors were duplication of therapy (25%) and medication access barriers at discharge (25%). The severity of errors included low (22.5%), serious (75%), and life-threatening harm (2.5%). Thirty-five percent of errors could have led to emergency visits or hospital readmissions. The estimated total cost for errors was $25 600. Pharmacist labor cost for reconciliation was $816. Cost avoidance was $24 784 from the 14 errors at discharge that could have resulted in additional emergency or inpatient visits.

Conclusion

Pharmacist-led medication reconciliation at discharge may prevent harm from reaching patients, decrease cost from unnecessary health encounters, and stop the error from continuing across transitions of care.

Abstract Image

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
药剂师主导的出院用药核对对一家大型学术医疗中心预防差错和患者伤害的影响
出院时的用药错误会导致不良后果、与用药相关的再入院率以及医疗费用的增加。本研究旨在量化出院时发现的用药错误,并描述药剂师指导的出院用药协调所避免的患者伤害的严重程度。这项为期一个月的前瞻性质量改进试点研究纳入了 2022 年 10 月期间从成人内科出院的患者。记录出院时的错误数量,按类型进行分类,并根据潜在危害的严重程度进行判定。错误严重程度是根据修改后的国家用药错误报告和预防协调委员会用药错误指数进行分类的。根据每个错误是否会导致额外的就诊次数和住院时间来计算避免的成本。出院时,药剂师指导的用药核对发现了 40 处错误,平均每名患者有 1.3 ± 1.9 处错误,68% 的患者至少有一处错误。最常见的错误是重复治疗(25%)和出院时用药障碍(25%)。错误的严重程度包括轻微(22.5%)、严重(75%)和危及生命(2.5%)。35%的错误可能会导致急诊或再次入院。错误的总成本估计为 25600 美元。药剂师用于调节的人工成本为 816 美元。由药剂师主导的出院时用药核对工作可避免对患者造成伤害,降低不必要的就医成本,并阻止错误在护理过程中继续发生。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
CiteScore
2.70
自引率
0.00%
发文量
0
期刊最新文献
Issue Information A tale of two bills: Lessons learned in expanding pharmacist-led HIV pre-exposure and post-exposure prophylaxis Serving as a professional association board member: Benefits to leaders and their employers Unique model for pharmacist cross-coverage in the ambulatory care setting Issue Information
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1