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A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
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Continuous Care Provided Through Comprehensive Medication Management in an Acute Care Practice Model
T David Marr1,2, Nicole R Pinelli3, Jamie A Jarmul4
11 University of North Carolina Medical Center, Chapel Hill, NC, USA.
The Annals of Pharmacotherapy
|October 29, 2017
Summary
Comprehensive medication management (CMM) improved patient care and financial outcomes. This pharmacy practice model significantly reduced emergency department visits and increased prescription capture, demonstrating its value in acute care settings.
Area of Science:
- Pharmacy Practice and Health Outcomes Research
- Clinical Pharmacy Services
- Health Services Research
Background:
- Pharmacy practice models are essential for pharmacists' accountability in medication-related outcomes.
- Comprehensive medication management (CMM) presents a significant opportunity to enhance patient care.
- Implementing robust pharmacy services is crucial for improving healthcare delivery.
Purpose of the Study:
- To evaluate the impact of a Comprehensive medication management (CMM) practice model in an acute care setting.
- To assess the organizational, patient, and financial outcomes associated with CMM implementation.
- To understand pharmacist perceptions of the CMM model through qualitative analysis.
Main Methods:
- Implementation of CMM on three adult service lines targeting at-risk patients.
- Inclusion of core CMM elements: medication reconciliation, differentiated clinical pharmacy services, MTM, discharge services, and documentation.
- Mixed-methods approach using historical controls and pharmacist interviews analyzed via thematic coding.
Main Results:
- CMM implementation led to a significant 86.5% reduction in emergency department visits (P=0.02).
- Observed a 24.9% reduction in 30-day hospital utilization and an 8.8% reduction in 30-day readmissions (nonsignificant).
- Increased discharge prescription capture by 11.3%, generating $5780 in additional revenue.
Conclusions:
- Successful implementation of a Comprehensive medication management (CMM) model in acute care.
- The CMM model positively impacted organizational, patient, and financial outcomes.
- Pharmacist feedback highlighted CMM's structure, value, and resource needs.
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