Pharmacist integration into the discharge process: a qualitative and quantitative impact assessment

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Abstract
Objective To determine whether a discharge pharmacist can improve the timeliness of patient discharge. Method Following a pilot phase on an acute admissions ward to assess the suitability of data collection forms (DCFs), patients were assigned to have their discharge medication organised either by a pharmacist (intervention group) or by the existing system (control group). Information relating to a variety of prescription processing times, together with data on clinical interventions and use of patient's own drugs (PODs), was recorded for each group. Setting Sixty-eight patients were recruited from one surgical ward and one medical ward at Bristol Royal Infirmary. Key findings Median discharge prescription processing time (time from discharge decision to patient discharge) was significantly less in the intervention group than in the control group (322 versus 460 minutes, P=0.0056). The median discharge prescription dispensing time was significantly greater with the existing system than when prescriptions were transcribed by the discharge pharmacist (240 versus 177 minutes, P=0.005). A cost-saving of £6 per patient by the reuse of PODs was calculated for the intervention group. No PODs were documented in the control group. Conclusion Our study demonstrates that integration of a pharmacist into the discharge system improves the timeliness of discharge, benefiting hospital bed management. Significant reductions in drug wastage and release of medical time are also apparent with this modified discharge process.

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