Making the Call
Published on 30 June 2016
Five minutes on the phone. That’s all it takes for Amy Drew, Pharm.D., BCPS, or Jamie Pitlick, Pharm.D., BCPS, to significantly reduce a patient’s chances of being readmitted to the hospital. Pharmacists, physicians, health care executives, and everyone in between are trying to figure out the best ways to keep patients out of the hospital as they recover. Drew and Pitlick believe they’ve found a way to do so.
The two associate professors of pharmacy practice recently completed a study, presented at the 2015 American College of Clinical Pharmacy (ACCP) Global Conference on Clinical Pharmacy, in which a pharmacist or pharmacy student called patients shortly after discharge to review medications. Pharmacist-led calls have been studied closely, but Drew and Pitlick noticed a gap.
“No one had looked at doing those calls in an outpatient setting,” Drew said.
Both practice at clinics in the Mercy hospital system. Drew is at Mercy Clinic Family Medicine, which is physician-based. Pitlick works at Mercy JFK Clinic, a hospital-based clinic serving patients who are uninsured or covered by Medicare and Medicaid. Their study first looked at whether a pharmacist’s involvement in post discharge counseling services led to a reduction in hospital readmission rates.
While the findings on that question were not statistically significant, Drew recognized a trend toward reducing re-hospitalizations. The two were encouraged to find that pharmacists made a noticeable impact on a group of patients who had a follow-up visit with a physician within two weeks of going home. Among those patients who had an office visit, there was a reduction in readmissions for those patients who had talked to a pharmacist before their physician visit.
“Though not what we initially set out to look for, it’s what we’re most excited about,” Drew said. “Pharmacists are making a big difference on hospital readmissions.”
Drew and Pitlick attempt to contact every discharged patient by phone. They’re able to talk with the majority. In addition to reducing readmission rates, the pair are helping patients avoid serious complications. Drew was able to expedite the authorization of a medication vital to the survivor of a stroke. Pitlick caught a situation where a patient with chronic obstructive pulmonary disease (COPD) didn’t realize he was taking duplicate therapy.
Buy-in from their physician group was no problem, according to Drew and Pitlick.
“Other health care professionals can uncover some big picture issues,” Drew said. “A pharmacist can make decisions based on the medications and expectations of the patient’s health. It’s important to cover all the big counseling points, especially if it is a new prescription.”
Opportunity to Learn
Pharmacy students on rotation with Drew and Pitlick make their own calls after a period of observation and training.
“They practice assessing a patient’s needs over the phone and have the opportunity to improve their listening skills and written communication when documenting the call,” Drew said.
Students follow the script developed at the beginning of the project. During the course of the call, they review the discharge notes, talk about new medications, and confirm that the prescriptions have been received by the patient. The biggest question, according to Drew, is whether the patient started any new medications.
The study, which was first mentioned in the Spring 2013 issue of Script, caught the attention of Pharmacy Times and several other media outlets. Drew and Pitlick’s next steps include submitting for publication and sharing their findings with their physician group. “We’re careful not to make assumptions about applying this to a larger practice setting or patient population, but this is working for us,” Drew said.
This story was originally published in the fall 2016 issue of Script, the College’s alumni magazine. Read the current and past issues online at stlcop.edu/script.