Reducing 30-Day All-Cause Rehospitalizations: A Pharmacist-Led Telehealth Service.

Abstract

BACKGROUND: Use of skilled nursing facilities (SNFs) has grown as an intermediary step for patients unready to discharge to lower acuity care settings. Discharge planning from SNFs has become a critical component of the care continuum and may impact patient outcomes and facility payment status. Currently, the discharge process does not include a pharmacist-led comprehensive medication review.<br/> OBJECTIVES: To determine the impact of a pharmacistdriven discharge consultation service on 30-day allcause rehospitalization. Secondary outcomes included hospital readmission diagnosis, discharge consultation times, number of pharmacist interventions, and patient satisfaction.<br/> METHODS: The institutional review board approved this prospective cohort with a historical control pilot study to evaluate patients discharging from SNFs. Patients who provided informed consent were enrolled to participate in a video consultation service at the time of discharge. The primary outcome measured was 30-day hospital readmission rate postdischarge compared with one year prior.<br/> RESULTS: One hundred ninety-six counseling sessions were performed at three facilities. The average time per discharge was 15.4 ± 3.3 minutes, average number of medications was 15.5 ± 6.2, and average Charlson Comorbidity Index was 5.6 ± 2.2. Patient readmission data were tracked by diagnosis and reported by facility.<br/> CONCLUSION: A positive correlation between reduced readmission rates and participation in consultation service were observed. Second, positive patient satisfaction surveys indicated patients value medication education. The use of a pharmacist-led telehealth service like the one described in this study may lead to a reduction in facility readmission penalties and improve patient access to pharmacist services in remote locations.