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Timely Delivery of Discharge Medications to Patients’ Bedsides: A Patient-centered Quality Improvement Project

INTRODUCTION: Patients who are unable to fill prescriptions after discharge are at risk of hospital readmission. Ensuring that patients have prescriptions in hand at the time of discharge is a critical component of a safe and effective discharge process. Using a “Meds to Beds” program, we aimed to i...

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Autores principales: Katz, Daphna T., Fernandez-Sanchez, Josaura V., Loeffler, Leah A., Chang, Simone M., Puertolas-Lopez, Mora V., Ramdial, Faizal R., Fisher, Gabrielle R., Gutierrez, Susan A., Mahajan, Neha, Keerthy, Divya R., Cavallaro, Stephania P., Landaeta, Claudia E., Pascall, Akilah S., Acevedo, Kristina T., Chan-Poon, Kwai T., Abraham, Benjamin R., Siri, Matthew, Reynolds, Kimberly L., Van Kirk, Kendra, Bayes Santos, Liz Y.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7297402/
https://www.ncbi.nlm.nih.gov/pubmed/32607457
http://dx.doi.org/10.1097/pq9.0000000000000297
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author Katz, Daphna T.
Fernandez-Sanchez, Josaura V.
Loeffler, Leah A.
Chang, Simone M.
Puertolas-Lopez, Mora V.
Ramdial, Faizal R.
Fisher, Gabrielle R.
Gutierrez, Susan A.
Mahajan, Neha
Keerthy, Divya R.
Cavallaro, Stephania P.
Landaeta, Claudia E.
Pascall, Akilah S.
Acevedo, Kristina T.
Chan-Poon, Kwai T.
Abraham, Benjamin R.
Siri, Matthew
Reynolds, Kimberly L.
Van Kirk, Kendra
Bayes Santos, Liz Y.
author_facet Katz, Daphna T.
Fernandez-Sanchez, Josaura V.
Loeffler, Leah A.
Chang, Simone M.
Puertolas-Lopez, Mora V.
Ramdial, Faizal R.
Fisher, Gabrielle R.
Gutierrez, Susan A.
Mahajan, Neha
Keerthy, Divya R.
Cavallaro, Stephania P.
Landaeta, Claudia E.
Pascall, Akilah S.
Acevedo, Kristina T.
Chan-Poon, Kwai T.
Abraham, Benjamin R.
Siri, Matthew
Reynolds, Kimberly L.
Van Kirk, Kendra
Bayes Santos, Liz Y.
author_sort Katz, Daphna T.
collection PubMed
description INTRODUCTION: Patients who are unable to fill prescriptions after discharge are at risk of hospital readmission. Ensuring that patients have prescriptions in hand at the time of discharge is a critical component of a safe and effective discharge process. Using a “Meds to Beds” program, we aimed to increase the percentage of patients discharged from Holtz Children’s Hospital with medications in hand from 49% to 80%, reduce turnaround time (TAT) from electronic prescription signature to bedside delivery from 4.9 hours (±2.6 hours) to 2 hours, and increase caregiver satisfaction. METHODS: We formed a multidisciplinary team and implemented 4 patient-centered interventions through iterative plan-do-study-act cycles. Statistical process control charts were used to understand the impact of the interventions over 10 months. Hospital length of stay and discharges before 2:00 pm were used as balancing measures. We measured caregiver satisfaction using a telephone survey administered by pediatric residents within 7 days after discharge. RESULTS: The mean percentage of patients discharged with medications in hand increased to 76%. TAT decreased to 3.5 hours (±1.8 hours). Length of stay did not significantly increase, whereas the percentage of patients discharged before 2:00 pm did. Caregivers of patients who had prescriptions delivered to their bedside reported high levels of satisfaction. CONCLUSIONS: Using a “Meds to Beds” program, we increased the percentage of patients discharged with medications in hand, decreased TAT with reduced variability, and achieved high levels of caregiver satisfaction. Importantly, there was a shift in the culture of the institution toward improved medication access for patients.
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spelling pubmed-72974022020-06-29 Timely Delivery of Discharge Medications to Patients’ Bedsides: A Patient-centered Quality Improvement Project Katz, Daphna T. Fernandez-Sanchez, Josaura V. Loeffler, Leah A. Chang, Simone M. Puertolas-Lopez, Mora V. Ramdial, Faizal R. Fisher, Gabrielle R. Gutierrez, Susan A. Mahajan, Neha Keerthy, Divya R. Cavallaro, Stephania P. Landaeta, Claudia E. Pascall, Akilah S. Acevedo, Kristina T. Chan-Poon, Kwai T. Abraham, Benjamin R. Siri, Matthew Reynolds, Kimberly L. Van Kirk, Kendra Bayes Santos, Liz Y. Pediatr Qual Saf Individual QI Projects from Single Institutions INTRODUCTION: Patients who are unable to fill prescriptions after discharge are at risk of hospital readmission. Ensuring that patients have prescriptions in hand at the time of discharge is a critical component of a safe and effective discharge process. Using a “Meds to Beds” program, we aimed to increase the percentage of patients discharged from Holtz Children’s Hospital with medications in hand from 49% to 80%, reduce turnaround time (TAT) from electronic prescription signature to bedside delivery from 4.9 hours (±2.6 hours) to 2 hours, and increase caregiver satisfaction. METHODS: We formed a multidisciplinary team and implemented 4 patient-centered interventions through iterative plan-do-study-act cycles. Statistical process control charts were used to understand the impact of the interventions over 10 months. Hospital length of stay and discharges before 2:00 pm were used as balancing measures. We measured caregiver satisfaction using a telephone survey administered by pediatric residents within 7 days after discharge. RESULTS: The mean percentage of patients discharged with medications in hand increased to 76%. TAT decreased to 3.5 hours (±1.8 hours). Length of stay did not significantly increase, whereas the percentage of patients discharged before 2:00 pm did. Caregivers of patients who had prescriptions delivered to their bedside reported high levels of satisfaction. CONCLUSIONS: Using a “Meds to Beds” program, we increased the percentage of patients discharged with medications in hand, decreased TAT with reduced variability, and achieved high levels of caregiver satisfaction. Importantly, there was a shift in the culture of the institution toward improved medication access for patients. Wolters Kluwer Health 2020-05-08 /pmc/articles/PMC7297402/ /pubmed/32607457 http://dx.doi.org/10.1097/pq9.0000000000000297 Text en Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Individual QI Projects from Single Institutions
Katz, Daphna T.
Fernandez-Sanchez, Josaura V.
Loeffler, Leah A.
Chang, Simone M.
Puertolas-Lopez, Mora V.
Ramdial, Faizal R.
Fisher, Gabrielle R.
Gutierrez, Susan A.
Mahajan, Neha
Keerthy, Divya R.
Cavallaro, Stephania P.
Landaeta, Claudia E.
Pascall, Akilah S.
Acevedo, Kristina T.
Chan-Poon, Kwai T.
Abraham, Benjamin R.
Siri, Matthew
Reynolds, Kimberly L.
Van Kirk, Kendra
Bayes Santos, Liz Y.
Timely Delivery of Discharge Medications to Patients’ Bedsides: A Patient-centered Quality Improvement Project
title Timely Delivery of Discharge Medications to Patients’ Bedsides: A Patient-centered Quality Improvement Project
title_full Timely Delivery of Discharge Medications to Patients’ Bedsides: A Patient-centered Quality Improvement Project
title_fullStr Timely Delivery of Discharge Medications to Patients’ Bedsides: A Patient-centered Quality Improvement Project
title_full_unstemmed Timely Delivery of Discharge Medications to Patients’ Bedsides: A Patient-centered Quality Improvement Project
title_short Timely Delivery of Discharge Medications to Patients’ Bedsides: A Patient-centered Quality Improvement Project
title_sort timely delivery of discharge medications to patients’ bedsides: a patient-centered quality improvement project
topic Individual QI Projects from Single Institutions
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7297402/
https://www.ncbi.nlm.nih.gov/pubmed/32607457
http://dx.doi.org/10.1097/pq9.0000000000000297
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