Abstract
The Discharge Medicines Review (DMR) referral system, Refer-to-Pharmacy (RTP), PharmOutcomes and Help for Harry are UK transfer of care systems that aim to reduce the risks associated with hospital discharge. These systems use technology to facilitate the transmission of discharge information to community pharmacy, allowing community pharmacists to provide an adherence-support service. Despite the evidence that these systems benefit patient safety, there is a paucity of literature on their use. This study aimed to describe, compare and contrast these systems to highlight areas that could inform good practice recommendations. A rapid literature review was completed, and from the twenty-six sources of literature that were synthesised, three themes were identified for further exploration in semi-structured interviews with key informants: implementation, system attributes and stakeholder engagement. The key informants were purposively sampled for their role in the development and/or strategic implementation of each transfer of care system (n = 4). Audio recordings were transcribed ad verbatim and analysed both deductively and inductively. One interview was undertaken for each of the DMR, RTP and PharmOutcomes systems. Although all systems shared the same aim, differences were identified such as automated feedback for referrals, marketing strategies and practitioner accountability. Good practice recommendations suggested in this study could be applied to the future development of such systems.
Highlights
Patient transfer from hospital to the community is a process that is associated with many risks including medication errors, care discontinuity and subsequent hospital readmission [1]
We aimed to describe, compare and contrast the current United Kingdom (UK) technologysupported transfer of care systems to inform good practice recommendations
This study focused on UK technology-supported transfer of care systems, and as such, the transferability of this study is limited to the UK
Summary
Patient transfer from hospital to the community is a process that is associated with many risks including medication errors, care discontinuity and subsequent hospital readmission [1]. There have been numerous attempts to reduce the risks associated with transfer of care, typically focusing on specific aspects of the discharge process including electronic transmission of discharge information from hospital to community, post-discharge medicines reconciliation, and post-discharge support [4] These attempts have been combined to different extents, creating more co-ordinated approaches called transfer of care systems. This professional group can effectively identify and rectify post-discharge medication-related issues which could have resulted in patient harm, as evidenced by a recent systematic review [5] International examples of these systems include the hospital-initiated Home Medication Review in Australia and the IBOM-1 protocol in the Netherlands, both involving post-discharge medicines adherence-support provided by community pharmacists [6,7]. Some of these systems use technology to facilitate the transmission of discharge information from hospital to community pharmacy
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