Impact of first and second shift tele‐critical care pharmacy services and virtual rounds on interventions at Atrium Health Lincoln

Abstract

AbstractBackgroundIn 2015, Atrium Health (AH) established second shift pharmacy services in the tele‐critical care (TCC) setting to optimize medication therapy and serve as a drug information resource to facilities across the health care system. TCC pharmacy services expanded to the first shift in July 2017. In September 2017, the first shift pharmacist began participating in virtual multidisciplinary rounds 1 day per week, which increased to 3 days per week in October 2019 at AH Lincoln, a community hospital with a 10‐bed intensive care unit (ICU).MethodsThis was a nonrandomized retrospective cohort study of adult ICU patients at AH Lincoln across two different time periods. The primary outcome was the number and type of pharmacy interventions made on rounding day(s) vs nonrounding days and first vs second shifts. Data are reported using descriptive statistics.ResultsDuring time period 1, a total of 1174 patients were admitted to the ICU for a total of 2115 patient days, with an average length of stay (LOS) of 1.8 days (SD ± 1.8 days). During time period 2, a total of 812 patients were admitted to the ICU for a total of 1775 patient days with an average LOS of 2.2 days (SD ± 2.7 days). During time period 1, a total of 753 interventions (297 on first shift and 456 on second shift) were performed as compared to time period 2, which had 1276 interventions (816 on first shift and 460 on second shift). For both time periods, the most common intervention on the first shift was medication management (45%) vs glycemic control (36%) on the second shift.ConclusionsThe addition of TCC pharmacy services to AH Lincoln has resulted in a positive impact on medication management, with the largest impact demonstrated through virtual rounding by the first shift TCC pharmacist.