Pharmacy Department, Glasgow Royal Infirmary, Castle St, Glasgow, G4 0SF, Scotland.
Golden Jubilee National Hospital, Agamemnon St, Clydebank, G81 4DY, Scotland.
Int J Clin Pharm. 2023 Dec;45(6):1309-1316. doi: 10.1007/s11096-023-01635-4. Epub 2023 Sep 28.
Patient delays at the point of their discharge account for more than half a million additional bed days every year in Scotland, United Kingdom. Bottlenecks in discharge medication dispensing contribute to such delays.
To test whether the discharge process could be made more time-efficient by utilising community pharmacy supply of medicines on the day of discharge, rather than hospital pharmacy supply.
Glasgow Royal Infirmary, Scotland.
Local community pharmacy staff received training and communication about each patient discharge. Pharmacies could access an immediate discharge letter (IDL) on a shared electronic record. The existing pandemic law allowed medication dispensing from this IDL, without a prescription.
The programme was implemented from June to November 2020, across three Plan-Do-Study-Act (PDSA) cycles. Comparisons were made between the new community pharmacy model and standard hospital model.
Across three PDSA cycles, in total 335 patients had community pharmacy supply compared to 376 patients eligible for hospital pharmacy supply. The median time taken from creation of the IDL to final completion was significantly lower in the new community pharmacy model compared to the hospital pharmacy model; 154 min (interquartile range (IQR) 82-272 min) vs 296 min (IQR 197-1281 min) p value < 0.000 CONCLUSION: A community pharmacy supply model compared to a standard hospital pharmacy model resulted in a median time saving of 142 min per patient. Such a time saving has the potential to deliver a transformational change in patient flow and free up hospital pharmacy staff to deliver other clinical interventions.
在英国苏格兰，患者在出院时的延迟导致每年额外增加超过五十万张床位。出院时配药的瓶颈导致了这种延迟。
通过利用社区药房在出院当天供应药物，而不是医院药房供应，测试是否可以使出院过程更加高效。
格拉斯哥皇家医院，苏格兰。
当地社区药房的工作人员接受了关于每个患者出院的培训和沟通。药房可以在一个共享的电子记录上访问即时出院信（IDL）。现有的大流行法允许从该 IDL 配药，而无需处方。
该计划于 2020 年 6 月至 11 月实施，共进行了三个计划-执行-研究-行动（PDSA）循环。将新的社区药房模式与标准医院模式进行了比较。
在三个 PDSA 循环中，共有 335 名患者接受了社区药房供应，而 376 名患者有资格接受医院药房供应。从 IDL 创建到最终完成的中位数时间在新的社区药房模型中明显低于医院药房模型; 154 分钟（四分位距（IQR）82-272 分钟）与 296 分钟（IQR 197-1281 分钟）p 值<0.000 结论：与标准医院药房模式相比，社区药房供应模式使每位患者的中位数时间节省了 142 分钟。这种节省时间有可能彻底改变患者的流动状况，并释放医院药房工作人员的时间，以提供其他临床干预。
