Department of Pharmacy Services, Houston Methodist Hospital, Houston, TX, and Department of Pharmacy Services, Houston Methodist Continuing Care Hospital - Texas Medical Center, Houston, TX, USA.
Department of Pharmacy Services, Houston Methodist Hospital, Houston, TX, USA.
Am J Health Syst Pharm. 2023 Sep 22;80(19):1364-1370. doi: 10.1093/ajhp/zxad131.
To describe the implementation of a contracted pharmacy service model for a co-located long-term acute care hospital (LTAC).
Historically, most LTACs have been free-standing healthcare facilities, but there is an increased trend towards the co-located LTAC ("hospital within a hospital") model. Co-located LTACs represent a solution for the management of patient throughput within a health system, with optimized bed capacity at the host hospital, increased revenue under a prospective payment system, and reduced readmission rates. A co-located LTAC will likely share resources with the host hospital, including ancillary departments such as pharmacy services, through a contractual model. Operationalization of pharmacy services in a co-located LTAC presents unique challenges in the integration of pharmacy services. Pharmacy leaders at Houston Methodist collaborated with executive leadership and other healthcare disciplines to expand services from a free-standing LTAC to a co-located LTAC at the academic medical center location. The contracted pharmacy service operationalization processes in the co-located LTAC comprised licensure and regulations, accreditation, information technology enhancements, a staffing model, operations/distribution services, clinical services, and a defined quality reporting structure. Admissions from the host hospital to the LTAC consisted of patients requiring long-term antibiotic administrations, pre- and post-organ transplant care, complex wound care, oncologic-related treatment, and neurological rehabilitation for strengthening and continued care.
The framework described here offers guidance to health-system pharmacy departments to support establishment of a co-located LTAC. The case study outlines challenges, considerations, and processes for implementation of a successful contracted pharmacy service model.
描述为一家毗邻的长期急性护理医院 (LTAC) 实施承包药房服务模式的情况。
历史上，大多数 LTAC 都是独立的医疗机构，但现在越来越倾向于采用毗邻的 LTAC（“医院内的医院”）模式。毗邻的 LTAC 为管理医疗系统内的患者吞吐量提供了一种解决方案，可优化宿主医院的床位容量，在预期支付系统下增加收入，并降低再入院率。毗邻的 LTAC 可能会通过合同模式与宿主医院共享资源，包括药房服务等辅助部门。毗邻的 LTAC 中的药房服务运营在药房服务整合方面带来了独特的挑战。休斯顿卫理公会的药房领导与行政领导和其他医疗保健学科合作，将服务从独立的 LTAC 扩展到学术医疗中心的毗邻 LTAC。毗邻的 LTAC 中承包药房服务的运营流程包括许可和法规、认证、信息技术增强、人员配备模式、运营/分销服务、临床服务和定义明确的质量报告结构。从宿主医院到 LTAC 的入院患者包括需要长期抗生素治疗、器官移植前后护理、复杂伤口护理、肿瘤相关治疗和神经康复治疗以加强和持续护理的患者。
这里描述的框架为卫生系统药房部门提供了支持毗邻的 LTAC 建立的指导。该案例研究概述了实施成功的承包药房服务模式的挑战、考虑因素和流程。
