Abstract
Purpose: The purpose of this study is to determine if daily pharmacist counseling improves Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) medication scores in a 25 bed medical surgical unit. Secondary objectives included determination of Full-time equivalent (FTE) hours required to complete the task of a pharmacist completing daily counseling and medication reconciliation for each patient on a 25 bed hospital unit, as well as determining if medication reconciliation performed on each patient improved satisfaction survey scores among staff. Methods: This was a single center, controlled, parallel study in two medical surgical units. Patients included were those admitted to the control or intervention unit and the primary investigator (PI) completed daily counseling in the intervention unit and counseling once during admission on the control unit. Medication reconciliation was also completed by the PI on the intervention unit, and satisfaction was assessed through a survey provided to caregivers before and after the study. An FTE analysis was completed to determine the FTE and cost burden to implement this practice model. Results: A total of 128 patients were included in the study over 27 days. Overall medication communication scores increased by 11.4% and decreased by 0.9% in the intervention and the control unit, respectively. Communication about side effects increased by 43% (p = 0.007) and 13.3% (p = 0.013) in the intervention and control units, respectively. A number of medication reconciliation satisfaction endpoints trended towards significance including decreased number of medication misadventures (p = 0.107), increased efficiency of patient admission (p = 0.157) and decreased interference with patient discharge (p = 0.157), and decreased total time to complete the discharge process (p=0.058). The FTE cost analysis indicated that on average, an additional 16 minutes of counseling is required per 3 day admission. Therefore, an additional four to seven FTEs will be required to incorporate this model into our institution. Conclusion: Daily counseling by a pharmacist resulted in a statistically significant increase in communication about side effect HCAHPS survey scores and an overall increase in medication communication compared counseling once during admission.
Highlights
Pharmacists provide pharmaceutical care with other healthcare workers to improve medical outcomes for patients
Our data indicated that daily counseling by a pharmacist can improve medication communication related HCAHPS scores, and improve patient care
Our results were limited by low numbers of completed HCAHPS and Medication reconciliation (MR) satisfaction surveys, our trends towards significance indicates the positive impact this practice model could have on patient care if implemented into practice
Summary
Pharmacists provide pharmaceutical care with other healthcare workers to improve medical outcomes for patients. The Center for Medicare and Medicaid (CMS) established reimbursement criteria based on a number of endpoints, including pharmaceutical care and medication communication. Medication communication criteria are measured through a Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Survey. Survey scores are based on the percentage of patients that answer “always” to the survey questions CMS utilizes the HCAHPS survey to standardize measuring patients’ perspectives on hospital care. This is a method that allows collection and public reporting of patients’ perspectives of care information that will allow comparisons to be made across all hospitals [3]
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