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Advancing Pharmacy Practice through an Innovative Ambulatory Care Transitions Program at an Academic Medical Center

1
Department of Medicine, University of North Carolina (UNC) School of Medicine, Chapel Hill, NC 27599, USA
2
UNC Eshelman School of PharmacyChapel Hill, NC 27599, USA
3
Department of Pharmacy, UNC Health, Chapel Hill, NC 27514, USA
4
UNC Health Alliance, UNC Health, Morrisville, NC 27560, USA
5
Department of Family Medicine, UNC School of Medicine, Chapel Hill, NC 27599, USA
*
Author to whom correspondence should be addressed.
Pharmacy 2020, 8(1), 40; https://doi.org/10.3390/pharmacy8010040
Received: 1 February 2020 / Revised: 29 February 2020 / Accepted: 3 March 2020 / Published: 12 March 2020
(This article belongs to the Special Issue Medication Management in Care Transitions)
Hospital readmissions are common and often preventable, leading to unnecessary burden on patients, families, and the health care system. The purpose of this descriptive communication is to share the impact of an interdisciplinary, outpatient clinic-based care transition intervention on clinical, organizational, and financial outcomes. Compared to usual care, the care transition intervention decreased the median time to Internal Medicine Clinic (IMC) or any clinic follow-up visit by 5 and 4 days, respectively. By including a pharmacist in the hospital follow-up visit, the program significantly reduced all-cause 30-day hospital readmission rates (9% versus 26% in usual care) and the composite endpoint of 30-day health care utilization, which is defined as readmission and emergency department (ED) rates (19% versus 44% usual care). Over the course of one year, this program can prevent 102 30-day hospital readmissions with an estimated cost reduction of $1,113,000 per year. The pharmacist at the IMC collaborated with the Family Medicine Clinic (FMC) pharmacist to standardize practices. In the FMC, the hospital readmission rate was 6.5% for patients seen by a clinic-based pharmacist within 30 days of discharge compared to 20% for those not seen by a pharmacist. This transitions intervention demonstrated a consistent and recognizable contribution from pharmacists providing direct patient care and practicing in the ambulatory care primary care settings that has been replicated across clinics at our academic medical center. View Full-Text
Keywords: care transitions; pharmacist; medication reconciliation; hospital follow-up; ambulatory care; primary care care transitions; pharmacist; medication reconciliation; hospital follow-up; ambulatory care; primary care
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Cavanaugh, J.; Pinelli, N.; Eckel, S.; Gwynne, M.; Daniels, R.; Hawes, E.M. Advancing Pharmacy Practice through an Innovative Ambulatory Care Transitions Program at an Academic Medical Center. Pharmacy 2020, 8, 40.

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