The role of the pharmacist in the discharge process has previously been minimal. However, new studies of hospital readmission rates aimed to improve healthcare has resulted in increasing the roles of various workers in the healthcare profession in order to improve readmission rates.
Pharmacists are now playing an integral part in the discharge process largely due to the change in medications that often results from hospitalization and the recovery process. By being a part of this process, pharmacists are becoming great contributors to the reduction of hospital readmission rates.
The first and foremost responsibility that pharmacists fulfill in the discharge process is reconciliation of medication. Often, patients are already taking prescription medication prior to hospitalization. Upon discharge, these patients are often prescribed a variety of other medications. Pharmacists take the time to reconcile medications, a highly time consuming process, in order to ensure that all medications are compatible with each other and for the patient. This prevents the omission of needed medication, duplication of medication, or incorrect dosing. Additionally, this process provides clarity to patients on what medications they are taking and how to take them.
Pharmacists also meet with patients in the hospital. This in-hospital patient counseling allows the pharmacist to build a relationship with the patient and to understand the patient’s background. Information as simple as how often a patient misses her medication can give insight to a pharmacist regarding dosing and appropriate medication choices. These meetings also allow the pharmacists to meet and work with caregivers to help them to understand how to best help the patient with medication after discharge.
Meeting with patients just prior to discharge is another important role of pharmacists. At this time, pharmacists share with patients all necessary information regarding the medication and its dosage. Though time consuming, many pharmacists will create a schedule for patients outlining the time and dosage for each medication. This is also an excellent opportunity for pharmacists to use the Teach-Back method in order to ensure patients and caregivers understand the medications and dosing instructions.
Post-discharge follow up is another important responsibility of a pharmacist. After discharge, pharmacists will follow up with patients with phone calls to discuss adherence to medication and any possible issues or side effects. This follow up helps to ensure patients have the opportunity to ask any questions not previously asked or addressed and allows for the patient to ask for changes in medication or dosage if the current prescription is not effective or is causing negative side effects.
The increased communication between pharmacists and patients is helpful not only in reducing readmission but also in helping to provide the highest quality of care to all patients.