Transitions of Care Practice Models: Innovations Across Different Health Settings

Authors

Laressa Bethishou, Chapman UniversityFollow
Noah Fang, Stanford Health Care

Document Type

Article

Publication Date

7-15-2024

Abstract

"Being discharged from a hospital may be a joyous occasion for a patient with a long length of stay, but this process may also be riddled with medication issues. With a deluge of new medications, unclear instructions, and new costs that may be unaffordable, many patients face challenges that are all too common. Additionally, the medication list may be fraught with discrepancies of missing or inaccurate home medications, duplicate therapies of new medications prescribed, or drug-drug interactions of old and new medications.

Pharmacists and pharmacy personnel who support patients during transitions of care (TOC) are very familiar with the consequences of ineffective medication management and handoff procedures. Medication errors are the most common type of medical mistake, resulting in nearly 7,000 deaths per year.¹ The percentage of patients with medication errors varies but can be as high as 67%, and even higher when considering nonprescribed medications.² One study found that 30% of patients had at least one medication error during TOC, with 40% of errors deemed moderate in severity and 36% of errors deemed serious or very serious.³ Older adults — as well as those with polypharmacy, chronic diseases, and multiple comorbidities — are at higher risk for medication errors.^4-7

With this crisis, the Institute for Safe Medication Best Practices (ISMP) recently expanded its targeted medication safety best practices to include TOC interventions (www.ismp.org/resources/three-new-best-practices-2024-2025-targeted-medication-safety-best-practices-hospitals). Recognizing that medication discrepancies and inaccurate or incomplete information contribute to errors during health transitions, ISMP recommends that health institutions implement strategies to prevent medication errors at transitions in the continuum of care. Pharmacists are best poised to help bridge this gap.

Pharmacy interventions during TOC can reduce avoidable readmissions, decrease medication errors, improve health outcomes, and increase patient satisfaction.^8,9 Certain elements, such as multimodal models and interdisciplinary collaboration, have demonstrated value, but no optimal practice model exists.⁸ Understanding the needs of a healthcare setting and the populations served can inform the practice model most appropriate to provide optimal care. The practice models below describe innovations that best meet the unique needs of each healthcare institution."

Comments

This article was originally published in Journal of Contemporary Pharmacy Practice, volume 71, issue 2, in 2024. https://doi.org/10.37901/2573-2765-71.2.13

Recommended Citation

Laressa Bethishou, Noah Fang; Transitions of Care Practice Models: Innovations Across Different Health Settings. Journal of Contemporary Pharmacy Practice 2024;71 (2):13–16. https://doi.org/10.37901/2573-2765-71.2.13

Copyright

California Pharmacists Association (CPhA)

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 License.