Outcomes associated with pharmacist participation in a heart failure transitional care clinic through medication reconciliation and education
Heart failure (HF) is a tremendous economic burden on the United States (US) healthcare system. With nearly 1 million hospital admissions annually, reducing admissions would have a considerable economic impact. The financial health of hospitals is directly tied to the quality of care provided such as hospital readmission rates. To curtail readmissions, organizations must find creative solutions to assist with the coordination and continuity of care for patients, such as implementing transitional care clinics to help people transition after hospitalization. A transitional care clinic staffed by nurse practitioners and pharmacists was implemented for heart failure patients who were discharged from Catholic Health Initiatives (CHI) St. Luke’s Health Baylor St. Luke’s Medical Center (BSLMC). The transitional care clinic (TCC) offered follow-up visits after patients were discharged from the hospital. The purpose of this study was to evaluate the impact of the pharmacist-provided medication reconciliation and education on heart failure patients’ readmission rates and emergency department visits as compared to those HF patients who were not seen by a pharmacist in the TCC within 7 days of discharge. A descriptive, retrospective, unmatched case control analysis of adult heart failure patients who were discharged from the study institution and seen within seven days of hospital discharge in the transitional care clinic was performed. A total of 322 patients were seen in the clinic within 7 days of discharge; 184 patients were in the pharmacist intervention group and 138 in the control group (only seen by a nurse practitioner). The 30-day readmission rate amongst the pharmacist intervention group was 13% as compared to 15.9% in the control group (p = 0.462). Nine patients in the pharmacist intervention group and 13 in the control group were seen in the Emergency Department (ED) (4.89% vs. 9.42%, P=0.111). There were 274 documented pharmacist interventions, which resulted in an estimated cost avoidance of $70,180. On average, the pharmacists documented 1.5 interventions per patient during the TCC visit with an estimated cost avoidance of $348 per patient. Sixty-seven percentage of the interventions related to medication education followed by 25 percent being medication reconciliation. From this study, even though it is not statistically significant between the two study groups, we can conclude that partnering a pharmacist with a nurse practitioner in a transitional care clinic decreases readmission rates and having pharmacist in transitional care clinics should be continued to improve patient care.^
Medicine|Health care management
Putney, Kimberly, "Outcomes associated with pharmacist participation in a heart failure transitional care clinic through medication reconciliation and education" (2016). Texas Medical Center Dissertations (via ProQuest). AAI10183279.