A Quality Improvement Initiative To Improve Postdischarge Antimicrobial Adherence

Area of Science:

• Pediatric Hospital Medicine
• Infectious Diseases
• Health Services Research

Background:

• Bedside discharge medication delivery enhances caregiver understanding but its effect on medication adherence is less understood.
• Improving antimicrobial adherence is crucial for patient outcomes and reducing resistance.
• The
• Meds to Beds
• (M2B) program was developed to address these gaps.

Purpose of the Study:

• To improve antimicrobial adherence by increasing on-time first home doses for pediatric patients.
• To evaluate the impact of the M2B program on medication adherence and identify barriers to adherence.
• To increase on-time first home antimicrobial doses from 33% to 80% within one year.

Main Methods:

• Implementation of the M2B program using plan-do-study-act cycles on pediatric hospital medicine units.
• Conducting scripted telephone surveys with caregivers of patients prescribed antimicrobials at discharge.
• Measuring on-time first home antimicrobial dose administration and caregiver-reported barriers to adherence.

Main Results:

• Median on-time first home antimicrobial doses increased significantly from 33% to 67% (P < .001).
• Forty percent of M2B prescriptions were adjusted pre-discharge due to financial or insurance issues.
• M2B participants reported significantly less difficulty obtaining medications (1% vs 17%, P < .001).

Conclusions:

• The M2B program effectively increased timely administration of first home antimicrobial doses.
• The program facilitated the identification and resolution of prescription-related problems before patient discharge.
• Caregivers reported fewer barriers to medication adherence with the M2B program.