A Dedicated Outpatient Pharmacy Improves Access to Discharge Medications in a Pediatric Emergency Department: A Quality Improvement Study - 20/05/24
, Michelle Caruso Barrett, PharmD c, Nicholas Michel, PharmD, MS c, Kamali Bouvay, MD a, d, Hamilton Schwartz, MD a, d, Adam Alexander Vukovic, MD, MEd a, dAbstract |
Study objective |
Following discharge from a pediatric emergency department (ED) or urgent care, many families do not pick up their prescribed medications. The aim of this quality improvement study was to increase the percentage of patients discharged home with medications in-hand from 6% to 30% within 6 months.
Methods |
Due to the planned construction of a new ED, urgent care, and dedicated pharmacy, a multidisciplinary team was formed to increase access to discharge medications. We performed a pilot study in the urgent care to improve the discharge prescription process and expanded its scope to the ED. We evaluated the effect of our interventions on the percentage of patients discharged with medications in-hand through statistical process control charts. Process measures included the percentage of prescriptions electronically prescribed and directed to an on-site pharmacy.
Results |
Between June 21, 2021 and March 27, 2022, 7,678 patients were discharged with at least 1 medication in-hand. The percentage of patients discharged with medications in-hand increased from 6.2% to 60.6%. The percentage of prescriptions e-prescribed and directed to an on-site pharmacy increased to 94.6% and 65.6% respectively.
Conclusions |
In this study, the availability of a 24-hour on-site pharmacy appears to be the most impactful intervention increasing access to discharge medications for families. Other interventions, such as a pilot study in the urgent care and implementing default electronic prescribing, may have potentiated the effect of the new pharmacy.
Le texte complet de cet article est disponible en PDF.Plan
| Supervising editor: Kathy N. Shaw, MD, MSCE. Specific detailed information about possible conflict of interest for individual editors is available at editors. |
|
| Author contributions: JHC, MCB, NM, KB, HS, and AAV conceived and designed the study. NM and JHC managed data collection. JHC performed statistical analyses, and all authors interpreted the results. JHC and MCB drafted the initial manuscript, and all authors contributed substantially to its revision. JHC takes responsibility for the paper as a whole. |
|
| Data sharing statement: All deidentified data files, data dictionary, and analytic code for this investigation are available on request from the date of article publication by contacting Jason Choi, MD, at Jason.Choi@bcm.edu. |
|
| Authorship: All authors attest to meeting the four ICMJE.org authorship criteria: (1) Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND (2) Drafting the work or revising it critically for important intellectual content; AND (3) Final approval of the version to be published; AND (4) Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. |
|
| Fundingandsupport: By Annals’ policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org). The authors have stated that no such relationships exist. |
|
| Please see page 553 for the Editor’s Capsule Summary of this article. |
|
| Readers: click on the link to go directly to a survey in which you can provide MJKTPRN to Annals on this particular article. |
|
| A podcast for this article is available at www.annemergmed.com. |
Vol 83 - N° 6
P. 552-561 - juin 2024 Retour au numéro
Article précédent
- Topical Diclofenac Versus Oral Ibuprofen Versus Diclofenac + Ibuprofen for Emergency Department Patients With Acute Low Back Pain: A Randomized Study
- Nauman Khankhel, Benjamin W. Friedman, Jesse Baer, Lucy Lopez, Carmen Feliciano, Sharon Lee, Eddie Irizarry
- Evaluation of Insurance Type as a Proxy for Socioeconomic Status in the Pediatric Emergency Department: A Pilot Study
- Michael C. Monuteaux, Michelle Du, Mark I. Neuman
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?