Preventing Medication-Related Problems in Care Transitions to Skilled Nursing Facilities

N/ACompletedNCT05241951

University of Washington1,052 enrolled

Overview

The Pharmacy Integrated Transitions (PIT) program, utilizes a crossover randomized control design to evaluate the impact of a clinical pharmacist in decreasing medication related problems during a patient's transition from hospital to skilled nursing facility (SNF).

Standard hospital discharge processes (e.g. as recommended by the Joint Commission Center for Transforming Healthcare), include hospital staff completing a paper-based discharge summary and medication reconciliation form. To reduce the likelihood of medication-related problems during care transitions, the Pharmacy Integrated Transitions (PIT) program aims to improve the standard transition process by adding a coordinating transitional pharmacist to provide a structured synchronous "warm-handoff" between clinical teams at the hospital and the Skilled Nursing Facility, in addition to reconciling, adjusting, and monitoring medications during and after discharge from the hospital.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Enrollment

1,052

Conditions

Care Transition

Interventions

Structured hand-offOTHER

Use of standardized checklist to provide synchronous or asynchronous handoff that conveys medication recommendations to the SNF clinical teams

Medication reconciliation during transitional periodOTHER

Comprehensive medication reconciliation conducted during transitional period between hospital and SNF, focused on SNF-specific requirements for medication delivery (e.g., stop dates, titration instructions)

Transitional medication monitoringOTHER

Review of medication orders during first 7 days of SNF admittance to address barriers to translation of medication orders and appropriate medication delivery

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * 18 years of age and older * patients receiving inpatient care at University of Washington Mountlake, University of Washington Northwest, Harborview, and Valley Medical Center hospitals to one of 14 collaborating SNF's on a day when the PIT program pharmacist is conducting the intervention Exclusion Criteria: * Under 18 years of age * patients with a discharge on hospice care * patients discharged on days that the pharmacist is not conducting the intervention

Locations (1)

University of Washington Health System

Seattle, Washington, United States

Outcomes

Primary Outcomes

Medication Related Problems

Number of medication related problems experienced by patients within 30 days post hospital discharge.

Time frame: 30 days post hospital discharge

Secondary Outcomes

Death

Number of deaths experienced by patients within each cohort

Time frame: 30 Days post hospital discharge

Readmissions

Number of readmissions within 30 days of index hospital discharge

Time frame: 30 Days

Data from ClinicalTrials.gov

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