Discharge medication counseling: a functional model

A system for providing medication counseling to all patients discharged from a large teaching facility is described. After the patient's discharge regimen is reviewed by the pharmacist, the prescriptions' are filled, and the pharmacist counsels the patient at the bedside. In addition to verbal information, the patient is provided with a medication time sheet illustrating the times at which individual medications should be taken and an information sheet for each drug. Documentation is accomplished by a special entry in the progress notes as required in the hospital's audit criteria.