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Published on: August 1, 2019
Effect of a Pharmacist-Led Discharge Counseling Service at a Children's Hospital
Sara W Hovey1,2, Milica Misic1, Jessica L Jacobson1
1Department of Pharmacy (SWH, MM, JLJ, KWC), Rush University Medical Center, Rush Children's Hospital, Chicago, IL.
Insights
Pharmacist-led discharge counseling for pediatric patients significantly improved caregiver satisfaction. This service also showed no 90-day medication-related readmissions, enhancing pediatric patient care.
Area of Science:
- Pediatric Healthcare
- Clinical Pharmacy Services
- Patient Education
Background:
- Discharge counseling is crucial for pediatric patient safety and caregiver understanding.
- Optimizing medication management post-discharge can prevent adverse events.
- Pharmacist involvement in discharge processes is increasingly recognized for its value.
Purpose of the Study:
- To assess the impact of a pharmacist-led discharge counseling service on caregiver satisfaction in a pediatric hospital.
- To evaluate the effect of this service on 90-day medication-related readmissions.
- To determine changes in patient satisfaction related to discharge medications.
Main Methods:
- A prospective observational cohort study comparing pre- and post-implementation phases.
- Caregivers surveyed via telephone within two weeks of patient discharge.
- Primary outcome: caregiver satisfaction scores; Secondary outcomes: 90-day readmissions and HCAHPS survey responses.
Main Results:
- Caregiver satisfaction scores significantly improved post-implementation (p = 0.038).
- No medication-related readmissions occurred within 90 days in either group.
- Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Question 25 scores did not differ significantly between groups (p = 0.761).
Conclusions:
- Implementing a pharmacist-led discharge counseling service enhances caregiver satisfaction in pediatric settings.
- The service shows promise in improving understanding and potentially reducing readmissions.
- Further research may explore broader impacts on pediatric medication adherence and outcomes.
Objective:
To evaluate the effect of a pharmacist-led discharge counseling service at a pediatric hospital.
Methods:
This was a prospective observational cohort study. Patients in the pre-implementation phase were identified by the pharmacist at the time of admission medication reconciliation, whereas patients in the pos-timplementation phase were identified at the time of pharmacist discharge medication counselling. Caregivers were contacted within 2 weeks of the patients' discharge date to complete a 7-question telephone survey. The primary objective was to measure the effect of the pharmacist-led service on caregiver satisfaction, using a pre- and post- implementation telephone survey. The secondary objectives were to evaluate the effect of the service on 90-day medication-related readmissions and determine the change in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey response (Question 25) regarding discharge medications following implementation of the new service.
Results:
A total of 32 caregivers were included in both the pre- and post-implementation groups. The most common reason for inclusion was high-risk medications (84%) in the pre-implementation group and device teaching (62.5%) in the post-implementation group. The primary outcome, the average composite score on the telephone survey, was 30.94 ± 3.50 (average ± SD) in the pre-implementation group and 32.5 ± 2.26 in the post-implementation group (p = 0.038). There were no medication-related readmissions within 90 days in either group. The score on HCAHPS Question 25 was not different between groups (p = 0.761).
Conclusions:
Implementation of a pharmacist-led discharge counseling service in pediatric patients improved caregiver satisfaction and understanding as shown by a postdischarge telephone survey.
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