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Pediatric Patient-Centered Transitions From Hospital to Home: Improving the Discharge Medication Process
Leah A Mallory1, Noah P Diminick2, Jonathan P Bourque3
1Departments of Pediatrics and mallol@mmc.org.
Hospital Pediatrics
|November 9, 2017
Summary
Ensuring patients have discharge medications before leaving the hospital significantly improves understanding and satisfaction. This initiative increased medication access, reducing risks associated with hospital discharge.
Area of Science:
- Pediatric Healthcare Quality Improvement
- Patient Safety in Medication Management
- Health Services Research
Background:
- Discharge medications pose risks if patients face access barriers or instruction misunderstandings.
- Pre-discharge prescription fulfillment can mitigate these risks, enhancing patient safety.
- Improving medication adherence and understanding is crucial for positive patient outcomes.
Purpose of the Study:
- To increase the percentage of pediatric patients leaving the hospital with new discharge medications in hand to 70% within 18 months.
- To evaluate the impact of pre-discharge medication access on caregiver understanding and patient satisfaction.
- To reduce medication-related errors and improve patient experience during hospital transitions.
Main Methods:
- Utilized sequential plan-do-study-act cycles from January 2015 to September 2016.
- Employed statistical process control charts to monitor process and outcome measures.
- Tracked rates of bedside medication delivery with pharmacist teaching and caregiver medication understanding.
Main Results:
- Achieved an increase in patients leaving with medications in hand from 2% to 85%.
- Reached 71% for bedside medication delivery with pharmacist teaching.
- Demonstrated a significant decrease in caregiver report inaccuracy (3.3% to 0.7%) and increased patient satisfaction (50% to 88%).
Conclusions:
- An engaged interprofessional team optimized on-site pharmacy use, exceeding the target for pediatric patients leaving with discharge medications (>80%).
- Increased bedside medication delivery and pharmacist teaching correlated with improved caregiver experience and understanding of discharge medications.
- This quality improvement initiative successfully enhanced medication access and patient education at hospital discharge.
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