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Updated: Oct 14, 2025

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Meds to Beds: A Quality Improvement Approach to Optimizing the Discharge Medication Process for Pediatric Patients

Lauren Foster, Shivali Choxi, Rebecca E Rosenberg

    Joint Commission Journal on Quality and Patient Safety
    |November 6, 2021
    PubMed

    Insights

    Implementing an on-site pharmacy and medication to bedside (MTB) program significantly increased discharge antibiotic prescriptions to the pharmacy and bedside delivery for pediatric patients. This initiative improved medication access and adherence post-discharge.

    Area of Science:

    • * Health Services Research
    • * Pediatric Pharmacy Practice
    • * Medication Management

    Background:

    • * On-site pharmacies and medication to bedside (MTB) programs can enhance patient prescription access and education prior to discharge.
    • * These programs aim to improve medication adherence and prevent adverse events in pediatric acute care settings.

    Purpose of the Study:

    • * To improve pediatric acute care discharge processes.
    • * To increase the proportion of oral antibiotics prescribed to the on-site pharmacy from 15% to 70%.
    • * To increase the proportion of discharge oral antibiotics delivered to the patient's bedside from 0% to 50%.

    Main Methods:

    • * The Model for Improvement framework guided iterative interventions.
    • * Interventions included enhancing on-site pharmacy capabilities, establishing an MTB program, and implementing secure electronic health record (EHR) messaging.
    • * Process measures tracked on-site pharmacy prescription rates and bedside delivery; outcomes assessed family satisfaction and safety reports; discharge before noon (DBN) served as a balancing measure.

    Main Results:

    • * On-site pharmacy prescriptions increased from 15% to 86% post-intervention.
    • * Bedside medication delivery rose from 0% to 58%.
    • * No significant changes were observed in family satisfaction or medication-related safety reports; DBN varied.

    Conclusions:

    • * Clinician and pharmacy staff collaboration successfully increased on-site pharmacy utilization and bedside antibiotic delivery for pediatric discharges.
    • * Key successful interventions involved enhanced pharmacy services, an optimized MTB program, and EHR-based communication.
    • * The study highlights the effectiveness of integrated pharmacy services in improving medication delivery processes.
    Abstract

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