A descriptive report on the impact of pharmacy workflows in the operational success of hospital at home implementation at a county academic hospital system.

Abstract

Background: The hospital at home (HaH) model has become more prevalent in the American healthcare system due to its ability to decrease acute care costs and readmission risk. Recent publications have provided guidance on optimizing medication management and patient safety by leveraging clinical pharmacy services. There is limited data on pharmacoeconomic impact of HaH implementation, specifically in underinsured patients.

Objectives: To describe the development of HaH-related pharmacy workflows and evaluate the operational success of the program in an underinsured patient population.

Methods: This report describes HaH program implementation between August 1st, 2022, and March 19th, 2024. Patients were eligible for home treatment if they met geographic, clinical, financial, and social criteria.

Outcomes: The primary outcome measured was the quantity and cost of medication waste for patients treated at home. Secondary outcomes included HaH medication turnaround time, healthcare resource utilization, and patient safety. All study outcomes were reported using descriptive statistics.

Results: Out of 450 patients screened, 3 met criteria and provided consent for HaH enrollment. The total cost of medication waste for all 3 patients was $41.15, and 21 out of 53 dispensed doses (40 %) were wasted. The mean medication verification time was 8.1 min, and the mean medication preparation time was 50.2 min.

Conclusion: Study data provides insight into enhancing dispensing practices while establishing the benefits pharmacists bring to the HaH care team. Future research should elaborate on other measures of operational success to identify optimal performance metrics to support expanding pharmaceutical services within the HaH care model.