Hospital Pharmacy - October 2019 - 315

315

Conliffe et al

Figure 1. Overview of "Meds 2 Beds" program workflow. Note. APPE = advanced pharmacy practice experience.
a

The role of APPE student may be filled by a pharmacist or resident during times when a student is not on rotation.

patients surveyed, only 40% filled their discharge medications on the day of discharge. At the latest point of contact (at
least 9 days after discharge), 22% of patients had not filled
their discharge medications.3,4 These studies highlight the
importance and need for a program that removes or alleviates
these barriers to patient access and ensures the delivery of
discharge medications to the patient prior to leaving the hospital. In addition to access issues, other patient-related medication issues include noncompliance and failure to take
medication appropriately. Discharge is often a rushed process, leaving patients confused about their treatment plan and
unsure of how to take their medications. According to the
Hospital Consumer Assessment of Healthcare Providers and
Systems (HCAHPS) scores from October 2013 to September
2014, only 65% of patients felt that they had adequate communication about medications.5 Lack of education can lead to
noncompliance, drug and food interactions, lack of proper
follow-up, and inappropriate dosing of medications. Patient
education at discharge can be addressed with thorough and
appropriate discharge counseling. Pharmacists are the ideal
health care provider to perform discharge counseling.
Pharmacist inclusion in transitions of care has significantly
improved readmission rates and patient satisfaction.6-8 In support of this growing body of evidence, the American College
of Clinical Pharmacy (ACCP) released a publication identifying the best ways to utilize these services.9 In addition to
participating in interdisciplinary rounds and admission medication reconciliation, ACCP advocates for pharmacist discharge counseling and telephone follow-up. The importance
of pharmacist inclusion in transitions of care is made evident
by ACCP's recommendation to incorporate transitions of care
opportunities in advanced pharmacy practice experiences
(APPEs) during the final professional year of PharmD curriculum. While there is clear evidence and support from
national pharmacy organizations for the expansions of pharmacy services into transitions of care, barriers still exist.10,11
As cited in the American Society of Health-System

Pharmacists' Best Practices in transitions of care initiative,
these barriers include lack of time, financial barriers, and poor
interdisciplinary communication.12
This institution responded to the opportunity for extension of pharmacy services by implementing a "Meds 2 Beds"
program that integrates clinical services with dispensing and
medication delivery. The model for this program uses a
unique approach to overcome existing resource barriers with
the utilization of APPE students for discharge counseling and
medication delivery. While other transitions of care rotations
have been described, to the authors' knowledge, this is the
first publication to describe a transitions of care rotation that
utilizes students in this way.13 This study evaluated the program's impact on outcomes relevant to patients, health care
providers, pharmacists, and administrators.

Methods
Study Design
This observational, retrospective cohort study evaluated the
effectiveness of the "Meds 2 Beds" program from May 1,
2014, through December 1, 2015. Patients in the intervention
group were identified through a pharmacist documentation
database. Patients in the control group were identified based
on International Classification of Diseases, Ninth Revision
(ICD-9) code (match to a "Meds 2 Beds" patient) and discharged during the same time frame. Further matching was
done on the basis of insurance status and history of admission in the last 6 months. This study was approved by the
hospital's institutional review board.

Program Overview
An overview of the program is outlined in Figure 1. It is
important to note that an APPE student is not always available to provide services of the program, and there are times



Hospital Pharmacy - October 2019

Table of Contents for the Digital Edition of Hospital Pharmacy - October 2019

TOC/Verso
Disrespectful Behavior in Health System Pharmacy Practice: Consequences and Next Steps
The Orphan Drug Act: An Appropriate Approval Pathway for Treatments of Rare Diseases?
Significant Published Articles for Pharmacy Nutrition Support Practice in 2018
Impact of Delayed Oral Vancomycin for Severe Clostridium difficile Infection
Evaluation of a Hospital Pharmacist Annual Competency Program
A Retrospective Analysis of Adherence to Risk Evaluation and Mitigation Strategies Requirements for Pulmonary Arterial Hypertension Drugs
Impact of an Advanced Pharmacy Practice Experience Student-Run “Meds 2 Beds” and Discharge Counseling Program on Quality of Care
A Retrospective Surveillance of the Antibiotics Prophylactic Use of Surgical Procedures in Private Hospitals in Indonesia
Stability and Compatibility of Diphenhydramine Hydrochloride in Intravenous Admixtures: A New Look at an Old Drug
The Impact of an Automated Dispensing System for Supplying Narcotics in a Surgical Unit: The Experience of the National Cancer Institute Foundation of Milan
Hospital Pharmacy - October 2019 - Cover1
Hospital Pharmacy - October 2019 - Cover2
Hospital Pharmacy - October 2019 - 277
Hospital Pharmacy - October 2019 - TOC/Verso
Hospital Pharmacy - October 2019 - 279
Hospital Pharmacy - October 2019 - Disrespectful Behavior in Health System Pharmacy Practice: Consequences and Next Steps
Hospital Pharmacy - October 2019 - 281
Hospital Pharmacy - October 2019 - 282
Hospital Pharmacy - October 2019 - The Orphan Drug Act: An Appropriate Approval Pathway for Treatments of Rare Diseases?
Hospital Pharmacy - October 2019 - 284
Hospital Pharmacy - October 2019 - Significant Published Articles for Pharmacy Nutrition Support Practice in 2018
Hospital Pharmacy - October 2019 - 286
Hospital Pharmacy - October 2019 - 287
Hospital Pharmacy - October 2019 - 288
Hospital Pharmacy - October 2019 - 289
Hospital Pharmacy - October 2019 - 290
Hospital Pharmacy - October 2019 - 291
Hospital Pharmacy - October 2019 - 292
Hospital Pharmacy - October 2019 - 293
Hospital Pharmacy - October 2019 - Impact of Delayed Oral Vancomycin for Severe Clostridium difficile Infection
Hospital Pharmacy - October 2019 - 295
Hospital Pharmacy - October 2019 - 296
Hospital Pharmacy - October 2019 - 297
Hospital Pharmacy - October 2019 - 298
Hospital Pharmacy - October 2019 - 299
Hospital Pharmacy - October 2019 - Evaluation of a Hospital Pharmacist Annual Competency Program
Hospital Pharmacy - October 2019 - 301
Hospital Pharmacy - October 2019 - 302
Hospital Pharmacy - October 2019 - 303
Hospital Pharmacy - October 2019 - 304
Hospital Pharmacy - October 2019 - 305
Hospital Pharmacy - October 2019 - 306
Hospital Pharmacy - October 2019 - 307
Hospital Pharmacy - October 2019 - 308
Hospital Pharmacy - October 2019 - A Retrospective Analysis of Adherence to Risk Evaluation and Mitigation Strategies Requirements for Pulmonary Arterial Hypertension Drugs
Hospital Pharmacy - October 2019 - 310
Hospital Pharmacy - October 2019 - 311
Hospital Pharmacy - October 2019 - 312
Hospital Pharmacy - October 2019 - 313
Hospital Pharmacy - October 2019 - Impact of an Advanced Pharmacy Practice Experience Student-Run “Meds 2 Beds” and Discharge Counseling Program on Quality of Care
Hospital Pharmacy - October 2019 - 315
Hospital Pharmacy - October 2019 - 316
Hospital Pharmacy - October 2019 - 317
Hospital Pharmacy - October 2019 - 318
Hospital Pharmacy - October 2019 - 319
Hospital Pharmacy - October 2019 - 320
Hospital Pharmacy - October 2019 - 321
Hospital Pharmacy - October 2019 - 322
Hospital Pharmacy - October 2019 - A Retrospective Surveillance of the Antibiotics Prophylactic Use of Surgical Procedures in Private Hospitals in Indonesia
Hospital Pharmacy - October 2019 - 324
Hospital Pharmacy - October 2019 - 325
Hospital Pharmacy - October 2019 - 326
Hospital Pharmacy - October 2019 - 327
Hospital Pharmacy - October 2019 - 328
Hospital Pharmacy - October 2019 - 329
Hospital Pharmacy - October 2019 - Stability and Compatibility of Diphenhydramine Hydrochloride in Intravenous Admixtures: A New Look at an Old Drug
Hospital Pharmacy - October 2019 - 331
Hospital Pharmacy - October 2019 - 332
Hospital Pharmacy - October 2019 - 333
Hospital Pharmacy - October 2019 - 334
Hospital Pharmacy - October 2019 - The Impact of an Automated Dispensing System for Supplying Narcotics in a Surgical Unit: The Experience of the National Cancer Institute Foundation of Milan
Hospital Pharmacy - October 2019 - 336
Hospital Pharmacy - October 2019 - 337
Hospital Pharmacy - October 2019 - 338
Hospital Pharmacy - October 2019 - 339
Hospital Pharmacy - October 2019 - 340
Hospital Pharmacy - October 2019 - 341
Hospital Pharmacy - October 2019 - 342
Hospital Pharmacy - October 2019 - 343
Hospital Pharmacy - October 2019 - 344
Hospital Pharmacy - October 2019 - Cover3
Hospital Pharmacy - October 2019 - Cover4
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