From Hospital to Home: A Resident-Driven Quality Improvement Project to Overcome Discharge Prescription Barriers.

Abstract:

BACKGROUND AND OBJECTIVES:Inability to obtain timely medications is a patient safety concern that can lead to delayed or incomplete treatment of illness. While there are many patient and system factors contributing to postdischarge medication nonadherence, availability and insurance-related barriers are preventable. PURPOSE:To implement a systematic process ensuring review of discharge prescriptions to ensure availability and resolve insurance barriers before patient discharge. METHODS:A prospective single-arm quality improvement intervention study to identify and address insurance-related prescription barriers using nonclinical staff. Intervention was pilot tested with sequential spread across general medicine resident teams. The primary outcome was successful obtainment of postdischarge prescriptions confirmed by phone calls to patients or their pharmacies. RESULTS:From April to August 2015, 59 of 161 patients included in the improvement process (36.6%) had one or more insurance or availability-related barriers with their prescriptions, totaling 89 issues. Forty-three of the 59 patients (72.9%) responded to postdischarge phone calls, 39 of whom (39/43, 90.7%) successfully filled their prescriptions on the first pharmacy visit. CONCLUSIONS:In our study, we preemptively identified that over a third of patients discharged would have encountered barriers filling their prescriptions. This interdisciplinary quality improvement project using nonclinical team members removed barriers for over 90% of our patients to ensure continuation of medical therapy without disruption and a safer postdischarge plan.

journal_name

Qual Manag Health Care

authors

Patel PA,Dillon JR,Mazique DC,Lee JI

doi

10.1097/QMH.0000000000000264

subject

Has Abstract

pub_date

2020-10-01 00:00:00

pages

226-231

issue

4

eissn

1063-8628

issn

1550-5154

pii

00019514-202010000-00007

journal_volume

29

pub_type

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