J Healthc Qual. 2022;44(3):152-160. doi: 10.1097/JHQ.0000000000000313.
Transitions of care can be difficult to manage and if not performed properly, can lead to increased readmissions and poor outcomes. Transitions are more complex when patients are discharged to skilled nursing facilities.
We assessed the impact of pharmacist-led initiatives, including medication reconciliation, on readmission rates between an academic medical center and a local skilled nursing facility (SNF).
We conducted a two-phase quality improvement project focusing on pharmacist-led medication reconciliation at different points in the transition process. All-cause 30-day readmission rates, medication reconciliation completion rates, and total pharmacist interventions were compared between the 2 groups.
The combined intervention and baseline cohorts resulted in a 29.8% relative reduction (14.5% vs. 20.6%) in readmission rates. Medication reconciliation was completed on 93.8% of SNF admitted patients in the first phase and 97.7% of patients in the second phase. Pharmacist interventions per reconciliation were 2.39 in the first phase compared with 1.82 in the second phase.
Pharmacist-led medication reconciliation can contribute to reduction of hospital readmissions from SNFs and is an essential part of the SNF transition process.
医疗护理交接可能难以管理，如果处理不当，可能会导致再入院率增加和预后不良。当患者出院到熟练护理机构时，交接会更加复杂。
我们评估了药师主导的举措（包括药物重整）对学术医疗中心和当地熟练护理机构（SNF）之间再入院率的影响。
我们开展了一项两阶段质量改进项目，重点关注过渡过程中不同阶段的药师主导的药物重整。比较了两组之间的全因 30 天再入院率、药物重整完成率和药师总干预次数。
联合干预组和基线组的再入院率相对降低了 29.8%（14.5% 比 20.6%）。第一阶段有 93.8%的 SNF 入院患者完成了药物重整，第二阶段有 97.7%的患者完成了药物重整。第一阶段每次药物重整的药师干预次数为 2.39 次，第二阶段为 1.82 次。
药师主导的药物重整可以有助于降低 SNF 的医院再入院率，是 SNF 过渡过程中的重要组成部分。
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