Medication administration by inpatient pharmacists: Innovative interdisciplinary care teams.

Abstract

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Pharmacists traditionally provide clinical pharmacy services in acute care settings. Two hospitals within our system integrated medication administration pharmacists into inpatient interdisciplinary care teams. Goals of this interdisciplinary care model were to improve productivity, quality, safety, patient satisfaction, and team member engagement while decreasing waste in the medication-use process and reliance on external nursing agency support. The new pharmacy role of medication administration pharmacist (MAP pharmacist) was integrated into the inpatient interdisciplinary care team. This new pharmacy role was not responsible for order verification in the electronic medical record. MAP pharmacists administered 99% of medications for assigned patients, averaging 100 to 120 medication administrations per day. Pharmacists educated patients about medications, including their purpose and most common adverse effects, using the teach-back method. Patient satisfaction scores increased 37% for patients' ability to understand adverse effects of medications and 44% for understanding the purpose of their new medications. Annual nursing staff turnover decreased from 30% to 7%, with a $2 million decrease in external nurse agency spend from 2022 to 2023. Pharmacist team member satisfaction scores, as measured on a Press Ganey scale ranging from 1 (poor) to 5 (very good), remained high, at a mean of 4.00 for engagement, with "progress," "quality work, and "knows what is expected" cited as strengths (mean scores of 4.23-4.46). The mean Press-Ganey score for pharmacy well-being increased from 3.80 in 2022 to 3.99 in 2023. Pharmacy opportunities identified via survey include enhanced communication and continued professional development. Post implementation, all surveyed nurses requested medication administration pharmacists on the inpatient interdisciplinary care team moving forward. The interdisciplinary care team with pharmacists enhanced medication safety and quality indicators, improved nursing satisfaction with workflow, and had a positive impact on patient satisfaction. Increased nursing capacity allowed for expanded assignments and nurse-to-patient ratios, as well as decreased reliance on external nurse agency support. Due to the overwhelming success of the initiative, MAP pharmacists' role as part of the interdisciplinary care team is being expanded to additional hospital service lines throughout the healthcare system.