Cameron B
Izaak Walton Killam Children's Hospital, Halifax, NS.
Can J Hosp Pharm. 1994 Jun;47(3):101-9.
Maintaining high quality patient care following hospital discharge is essential for complete recovery and continued well-being. Historically, pharmacist participation in discharge planning has been minimal and has been frequently limited to last minute patient counselling. Hospital pharmacists can contribute to the continuity of patient care by summarizing changes made to a patient's therapy, their rationale, and future considerations in a discharge report to the family physician and/or community pharmacist. In this study, pharmacy discharge summaries were prepared for inclusion in the discharge report to the family physician. Summaries were also forwarded to the community pharmacist, where appropriate. Two types of pharmacy summaries completed were "Rationale for Inpatient Changes" (RIC) and "Recommendations for Future Changes" (RFC) summaries. Evaluation forms accompanying the summaries elicited very favourable responses. An independent review group of two physicians and two pharmacists rated the potential for reduction of patient mortality/morbidity as either marked, modest, minor or negligible; most of the summaries were evaluated as having a "modest" impact. Workload associated with preparation of pharmacy summaries would require additional pharmacy staff. Direct and indirect cost savings, including decreased drug costs and avoidance of drug complications and hospital readmissions, are associated with this service.
出院后维持高质量的患者护理对于完全康复和持续的健康状况至关重要。从历史上看，药剂师参与出院计划的程度很低，并且经常仅限于在最后时刻对患者进行咨询。医院药剂师可以通过在给家庭医生和/或社区药剂师的出院报告中总结患者治疗方案的变更、变更的理由以及未来的注意事项，来促进患者护理的连续性。在本研究中，编写了药房出院总结以纳入给家庭医生的出院报告中。在适当情况下，总结也会转发给社区药剂师。完成的两种类型的药房总结是“住院期间变更理由”（RIC）总结和“未来变更建议”（RFC）总结。总结附带的评估表得到了非常积极的反馈。一个由两名医生和两名药剂师组成的独立评审小组将降低患者死亡率/发病率的潜力评为显著、适度、轻微或可忽略不计；大多数总结被评估为具有“适度”影响。编写药房总结的工作量需要额外的药房工作人员。这项服务带来了直接和间接的成本节约，包括降低药品成本以及避免药物并发症和再次入院。
