Transit Care Hub pharmacist: improving patient flow within the hospital
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RESEARCH ARTICLE
Transit Care Hub pharmacist: improving patient flow within the hospital Centaine Snoswell1,2,3 · Estelle Jensen1 · Nancy Wang1 · Krishna Shah1 · Elizabeth Currey1 · Michael Barras1,2 Received: 7 May 2020 / Revised: 25 June 2020 / Accepted: 29 June 2020 © Springer Nature Switzerland AG 2020
Abstract Background The Transit Care Hub (TCH) is an inpatient ward traditionally used as a waiting area for patients who require transport to return home. In July 2018, a six-month pilot of a TCH pharmacist was funded to improve the flow of patients through the hospital. Setting Major Australian teaching hospital. Objective(s) To determine the effect that the TCH pharmacist had on patient flow within the hospital and on the time saved for other clinical pharmacists, as well as estimating cost savings. Methods A service delivery framework for the TCH pharmacist was developed and tested. This involved a proactive approach to patient discharge with ward-based staff. Data were collected from July to November 2018, 20 weeks prior to and 20 weeks after the commencement of the pilot. Main outcome measure Measurements included the number of best possible medication histories (BPMHs) completed during admission, improvements in arrival time to TCH from inpatient wards and cost savings. Results During the pilot study period (20 weeks), 791 patients were discharged by the TCH pharmacist, arriving an average of 70 minutes earlier than other patients discharging through TCH. There was a 16% increase in patients discharging through TCH which released ward beds. The TCH pharmacist increased the number of BPMHs on day of admission by 14%. There was an estimated annual saving of AU$252,008 for the hospital. Conclusions The TCH pharmacist service enhanced patient flow by coordinating earlier discharges, increasing the timely completion of BPMHs, and saving ward pharmacist time. Significant cost savings supported a permanently funded position. Keywords Medication Safety · Pharmacoeconomics · Pharmacy Administration · Social andAdministrative Sciences · Transitions of Care
Impacts on practice • Adding a pharmacist for the multidisciplinary team car-
ing for patients in the transit care are can improve patient flow through the hospital. • A transit care pharmacist can ensure that best possible medication histories are completed in an expedited manner when compared to routine care, increasing the likeli-
* Estelle Jensen [email protected] 1
Pharmacy Department, Ground Floor, Princess Alexandra Hospital, Woolloongabba, Brisbane, QLD 4102, Australia
2
School of Pharmacy, The University of Queensland, Brisbane, QLD, Australia
3
Centre for Health Services Research, The University of Queensland, Brisbane, QLD, Australia
hood that they can be used to aid medication prescribing at admission and at discharge from the ward. • A pharmacist in transit care can expedite patient discharge from inpatient wards and save time for ward pharmacists during the discharge process.
Introduction With population growth
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