Enhancing Patient Education And Care Transitions
By Neil DiBernardo, PharmD is Director, Clinical Consulting for Omnicell
Pharmacy expertise central to successful strategy
High performing hospitals and health systems recognize the value of a top-of-license approach to allocating clinical resources. This strategy ensures patients are paired with the right expertise at the right time — ultimately resulting in optimal outcomes.
Most physicians would hesitate to ask a nurse to manage physical therapy or a mental health consult, for instance, because other clinicians are better equipped for these jobs. Yet many hospitals rely on nurses and other staff to fill two critical patient care gaps best addressed by pharmacy expertise — medication education and care transitions.
It is a well-documented fact medication non-compliance and non-adherence account for significant healthcare complications and lead to greater potential for readmissions. This is why organizations should prioritize effective and consistent medication education. Unfortunately, this task often falls to nursing staff, which are already overburdened with a multitude of duties at the time of a patient’s discharge. All too often, attempts at medication education are too hasty or patients become overwhelmed by information overload.
Pharmacists are much better equipped to manage medication education and transitions of care. It’s a natural extension of their expertise in medication therapies and their understanding of the challenges and disconnects that can occur post-discharge.
Accordingly, the best top-of-license strategies are characterized by infrastructures and workflows that free up pharmacists’ time for greater clinical interaction with patients. Pharmacy automation is central to enabling pharmacists to spend more face-to-face time with patients, conducting post-discharge follow-up and improving care transitions.
Overcoming Barriers Through Automation
The current structure of most clinical programs poses a barrier to fully leveraging pharmacists’ knowledge. Although pharmacists recognize the need for greater patient interaction, competing priorities often impact their ability to commit the resources needed for medication education.
For instance, the primary focus of most hospital pharmacy operations is the Five Rights of Medication Administration — ensuring the right patient receives the right drug, dose, route, and time. As a result, the foundational duties of any pharmacy are managing medication dispensing logistics and consulting with other clinicians to strengthen patient safety. Even when pharmacists are able to get out to the patient floor, a good portion of their time is spent behind the scenes making sure that patient therapies are appropriate.
Hospitals need to purposefully design programs that place pharmacists in front of patients beginning at the time of admission and extending to post-discharge. The first step — and one already embraced by many hospitals — is to automate the process of dispensing medications through central pharmacy technology and robotics. Bar-code driven technology, for example, heightens patient safety and minimizes time spent distributing and double-checking medications.
Hospital pharmacies are increasingly embracing the promise of IV compounding robotics solutions to streamline operations as well. Not only do these solutions minimize the time associated with batch compounding processes, but they also improve accuracy and the sterility of products produced.
Technological advancement is even starting to eliminate the time-consuming, manual processes associated with inventory management. Health systems can now gain full visibility into all existing medications across the organization to support faster and better decision-making.
When hospitals take a multi-faceted, layered approach to pharmacy automation, pharmacists and technicians have more time to support higher-level clinical activity. For instance, some hospitals task technicians with completing patient medication histories while pharmacists embark on higher-level patient education and care transitions.
Best Practices For Getting Started
While the goal of automation is to replicate current tasks, pharmacists and pharmacy directors should examine technology investments from a broader perspective — consider the big picture in terms of how technology will need to grow with the hospital or health system.
When introducing automation, it is important pharmacies remain open-minded about workflow changes. Automation can be fairly sophisticated and may not fit into current workflow patterns. For instance, an analysis may yield the need for staffing changes or completing tasks at different times of the day. Those pharmacies that look at how to acquire the most value through workflow and process design stand to achieve a higher return on investment. In fact the realized “ROI” is greatly dependent upon “IOR” (Improved Operational Readiness) of the organization.
Pharmacy leaders should also contemplate how new technology impacts existing, disparate solutions. Smart decisions reflect a thoughtful approach to choosing the right technology to complement other systems, supporting integration and effective communication between solutions. With analytics becoming critical to all aspects of healthcare, technology that uses data to advance better decision-making throughout the medication management process will position hospitals and health systems for heightened performance.
Today’s pharmacists are the best resources hospitals have to act as patient-facing medication experts. Many hospitals leverage their expertise to help physicians and nurses make better choices, but too often the patient is not prioritized. Going forward, health systems that resolve to round out pharmacists’ time for better patient education and interaction will reap the benefits of improved patient safety and outcomes.