1011. Outcomes Associated with the Creation of a Pharmacy-led Outpatient Parenteral Antimicrobial Therapy (OPAT) Service to Facilitate Transitions of Care

Abstract

Abstract Background We previously demonstrated that standardizing the documentation of the outpatient parenteral antimicrobial therapy (OPAT) plan led to improved post-discharge outcomes. This study investigated whether centralizing the OPAT documentation to an infectious diseases (ID) pharmacist would lead to improved documentation quality and further improvements in post-discharge outcomes. Methods We conducted a single-center, retrospective study to evaluate outcomes associated with the centralization of the OPAT plan documentation to an ID pharmacist. The study was a multiphase quality improvement study consisting of a pre-intervention period and two intervention periods on each of the General ID consult services (first on Team 1 then on Team 2). The scope of the intervention was focused on the timeliness and completeness of OPAT note documentation, while other workflow processes involving OPAT remained unchanged. The primary objective was to compare hospital length of stay (LOS) between patients with OPAT Notes documented by an ID pharmacist versus ID providers. Secondary objectives were to compare post-discharge outcomes. Results A total of 350 patients met inclusion criteria; baseline characteristics were similar between the pharmacist and provider groups (Table 1). OPAT note documentation quality improved during the pharmacist intervention phases for each General ID team (Figure 1). The median LOS was 7.9 days in the pharmacist documentation group compared to 6.8 days in the provider group [Median difference, 1.1; 95% Confidence Interval (CI), -0.4 - 3.7]. Laboratory monitoring within 10 days of discharge, 30- and 60-day death or readmission rates, and late ID visit cancellations between the two groups were comparable (Table 2). ID clinic no show appointments occurred less often in the pharmacist documentation patients. Table 1:Baseline DemographicsFigure 1:Control Chart Comparisons of OPAT Notes Without All “Perfect Care” ElementsTable 2:Post-discharge outcomes for pharmacist compared to provider documentation patientsa: Pharmacist note patients are the reference for all comparisonsb: Adjusted for discharge destination and primary payorc: Adjusted for Charlson comorbidity indexd: Adjusted for age and primary payor Conclusion Improved OPAT note documentation did not translate into shorter hospital LOS. Post-discharge outcomes were similar between pharmacist and provider patients, although no show visits occurred less often when pharmacists documented the OPAT plan. Disclosures Russell J. Benefield, PharmD, BCPS-AQ ID, Paratek Pharmaceuticals: Grant/Research Support.