139 A PHARMACIST-LED INTERVENTION TO IMPROVE QUALITY OF CARE AND REDUCE RISK OF RECURRENCE IN HOSPITALISED STROKE PATIENTS

Abstract

Abstract Background Stroke is the leading cause of acquired disability, and the 3rd leading cause of death, in Ireland. This Quality Improvement Project focused on improving the pathway of care provided to stroke inpatients in an acute general hospital admitting up to 60 stroke patients per annum. The care pathway of stroke patients should include specialist input from the wider Multi-Disciplinary Team (MDT), including pharmacists. Methods An audit collected data in 2 phases: (A) a retrospective data review looking for broader themes, and (B) a prospective data collection focused on primary drivers of quality care, including patient feedback questionnaires and follow-up phone calls to patients post-discharge. A Pharmacist Screening Tool was applied to individual patient data, and medication changes documented. Key drivers of improvement were identified Results Phase A of the audit included 20 patients with confirmed stroke, average age 66 years, all with ischaemic stroke. Phase B included 20 patients, average age 69 years, all with ischaemic stroke. Four primary drivers of quality were identified: (1) Lack of, or delayed, referral to the stroke specialist team; (2) Transcription/prescription errors; (3) Low rate of patient counselling on medications pre-discharge; (4) High rates of interventions and medication changes, with other complexities in medication regimens. Future audit cycles will implement (a) increased education of healthcare professionals about best-practice in stroke and (b) dedicated specialist pharmacist input for stroke inpatients. Conclusion Patient feedback highlighted that written information given on discharge was unclear; and errors in medication prescriptions or lack of specialist input were common. A focused, patient-centric approach can improve patient satisfaction, and overall outcomes post-stroke. Pharmacist-led interventions are a key part of the stroke bundle of care.