Durkin Kayla, Montgomery Tricia, Lamberjack Kristen, Hafer Cindy C, Naprawa James, Yarosz Shannon
Department of Pharmacy, Nationwide Children's Hospital, Columbus, Ohio; Quality Improvement Services Department, Nationwide Children's Hospital, Columbus, Ohio; Operations Department, TransChart, LLC, Dublin, Ohio; and Emergency Department, UCSF Benioff Children's Hospital, Oakland, Calif.
Pediatr Qual Saf. 2017 Jul;2(4):e033. doi: 10.1097/pq9.0000000000000033. Epub 2017 Jun 16.
Prescription fill rates for children being discharged from the emergency department (ED) after asthma exacerbations are low, placing the child at risk for additional ED visits or admissions for asthma. This article describes the implementation of an ED asthma prescription delivery service designed to improve pharmacy prescription capture and decrease ED revisit rates.
A core group developed a service to provide asthma prescriptions and education to patients in their ED room before discharge. The project assessed the percent of ED asthma patients who filled ED asthma prescriptions at the hospital outpatient pharmacy, 7-, 14-, and 30-day ED revisit rates, and patient satisfaction.
Patients/families who chose to participate in the service received asthma prescriptions and education at the ED bedside. Within 1-3 days, ED outreach nurses obtained patient satisfaction survey responses via telephone.
There was a statistically significant increase in the number of patients who filled ED asthma prescriptions at the hospital outpatient pharmacy (22.2% versus 33.8%; < 0.0001). The decrease in 7-, 14-, or 30-day ED revisit rates for patients who received the medication delivery service compared with standard of care was not statistically significant. Patients were satisfied to very satisfied with the service.
Postimplementation of a medication delivery program within the ED, there was an increase in the percentage of patients who filled ED asthma medication prescriptions at the hospital outpatient pharmacy. There was no difference in ED revisit rates for patients who enrolled in the prescription delivery service versus standard of care.
哮喘急性加重后从急诊科（ED）出院的儿童的处方配药率较低，这使儿童面临因哮喘再次前往急诊科就诊或住院的风险。本文描述了一项急诊科哮喘处方递送服务的实施情况，该服务旨在提高药房处方获取率并降低急诊科复诊率。
一个核心小组开发了一项服务，以便在出院前为急诊科的患者提供哮喘处方和教育。该项目评估了在医院门诊药房配取急诊科哮喘处方的急诊科哮喘患者的百分比、7天、14天和30天的急诊科复诊率以及患者满意度。
选择参与该服务的患者/家属在急诊科床边接受哮喘处方和教育。在1至3天内，急诊科外展护士通过电话获取患者满意度调查回复。
在医院门诊药房配取急诊科哮喘处方的患者数量有统计学上的显著增加（从22.2%增至33.8%；<0.0001）。与标准护理相比，接受药物递送服务的患者的7天、14天或30天急诊科复诊率的降低没有统计学意义。患者对该服务感到满意至非常满意。
在急诊科实施药物递送项目后，在医院门诊药房配取急诊科哮喘药物处方的患者百分比有所增加。参与处方递送服务的患者与接受标准护理的患者的急诊科复诊率没有差异。
