Authors (including presenting author) :
Chan CLC(1), Cheung YF(2), Yue L(2), Leung YS(1), Cheung MY(1), Cheung MH(1)
Affiliation :
(1) Department of Pharmacy, Queen Elizabeth Hospital
(2) Department of Medicine, Queen Elizabeth Hospital
Introduction :
It is common that patients have numerous changes in their medication regimen during hospital stay and involvement of pharmacists in medication management during discharge in wards could optimize patient safety outcome and also increase efficiency of strained discharge process. Queen Elizabeth Hospital has set up a new clinical ward pharmacist service at discharge since July 2021 and this study acts as an interim evaluation of the service.
Objectives :
The primary objective is to compare the patient’s perception on discharge medication information received throughout discharge journey before and after service implementation. The secondary objective is to review the number and types of medication discrepancies found at discharge prescription, evaluate the satisfaction of patients and medical staff about the new service and evaluate the impact of the new service on the time taken to prepare a finalized prescription.
Methodology :
Retrospective data collection was carried out to retrieve pre-service data (control group) and data at 8 weeks after service implementation (study group). Data before and after service implementation were then compared. The primary outcome is the change in average scores of the patient experience survey about medication information received during discharge before and after service implementation. The secondary outcomes include the number and types of medication discrepancies found at discharge prescriptions, patient’s satisfaction about ward pharmacist discharge counselling service, satisfaction of medical staff about the new service and change in average time to prepare finalized prescription before and after service implementation.
Result & Outcome :
A total of 50 patient experience surveys were screened out in both control group and study group. Higher scores were observed and shown statistically significance in all four questions after service implementation in the study group. The largest increase in scores was observed in question about side effect (Q3), the mean increase was from 2.50 ± 3.49 to 7.39 ± 3.96 [mean difference of 4.89 (95% CI 3.30 to 6.48, P<0.001)]. Nearly 30% of the prescriptions that pharmacists screened were identified with at least 1 unintentional discrepancies and 100% acceptance rate was achieved. The most frequent type of unintentional discrepancies was inadequate drug supplied on discharge prescriptions. High satisfaction was expressed by both patients and medical staff about the new service.
