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Improve Patient Safety And Cut Costs With Clinical Pharmacists

Posted Sep 08 2010 6:13pm

What if you could improve patient safety, cut costs, broaden your medical knowledge and find 20% more time in your workday?  On October 1, 2010, that is just what we can expect when clinical pharmacists move from the back room to the bedside in ten general medical units at the Hospital of the University of Pennsylvania.

As we all know, medications play an intensely complex and ever-growing role in patient care. In tertiary care hospitals, it is not uncommon for patients to take 12 to 16 medications a day.  When patients return home, one-third to one-half of them don’t take medications as prescribed, and up to one-quarter never fill prescriptions at all.  Furthermore, we all know that medication problems at discharge — such as prescription omissions and instructions that are incomplete, inaccurate, and difficult for patients to understand — are common. It’s no wonder medication issues are a major cause of readmissions.

In pilot studies, the presence of a residency-trained pharmacist as an active part of our medical team addressed all of these concerns.  Our clinical pharmacist attended daily bedside rounds, optimized inpatient medication regimens, served as a drug information resource, performed discharge medication reconciliation, and provided discharge medication education, including, in some cases, custom-made medication lists in an easier to read calendar/pictorial format for patients with limited health literacy.

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