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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...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2020
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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. |
format | Online Article Text |
id | pubmed-7297402 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
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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