At El Camino Hospital, pharmacists and pharmacy technicians play a key role in medication reconciliation and education.
Our HCAHPS scores around medication were relatively low. We heard from patients that they weren’t sure how to take their medication, what the side effects were, and what red flags they should look out for. We had a case of a patient getting his medication confused. When he happened to show the medication to one of our team members during a home visit, it was the wrong pill at the wrong dose and could have stopped the patient’s heart.
El Camino is a non-profit hospital in Mountain View, CA. It has 399 beds and serves a primarily affluent and educated population, many of who are non-English speaking or have English as a second language. Their transitions program began in 2012 and is influenced by the Care Transitions Program.
What We Tried
We work with unit pharmacists and have a transitions pharmacist on our team. Our pharmacist works very closely with the physicians to review the patient’s medications from and to home, and confirm that the prescription and dosing are correct. The unit pharmacists provide education to any patient who starts a high-risk medication like warfarin or insulin in the hospital. It was important that they understood why they were taking the medication, how to take it, what the side effects were, and what the follow-up should be.
Involving pharmacists in the transitions process has improved our HCAHPS scores around medication and also reduced our readmissions due to medication problems.
Originally our transitions pharmacist was doing the education on the floor, but we later realized that the unit pharmacists could do this, freeing up our pharmacist to work closely with the physicians and oversee pharmacy technicians in the medication reconciliation process.