DeKalb Medical Reduces Readmissions, Increases Satisfaction With Bedside Medication Program

Hospitals are increasingly focusing on lowering readmission rates to improve quality and patient safety and reduce costs. One contributor to 30-day readmissions is failure to take medications properly. To target medication noncompliance, Decatur, Ga.-based hospital DeKalb Medical is partnering with Walgreens on a bedside medication delivery program, which has already resulted in increased patient satisfaction, improved medication adherence and lower readmission rates.

Program
DeKalb Medical and Walgreens began bedside medication delivery in July 2011 in the hospital's surgical departments. Walgreens operates a pharmacy on the DeKalb Medical campus. Under the program, the hospital-based pharmacists deliver patients' medication to the bedside and educate them on how to take the medication. The pharmacists then follow-up with the patients 72 hours after discharge to ensure they understand the instructions for their medication and steps to take if there is a problem.

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Satisfaction
DeKalb Medical saw improvements in its Hospital Consumer Assessment of Healthcare Providers and Systems top box scores in roughly 3 months. Scores related to patient communications on medication increased from 50 percent to 63 percent over the 90-day period after the program launched.

"It's a convenience that patients can have their prescription quickly filled and delivered to the room before being discharged," says Solomon Tafari, MD, medical director of DeKalb's hospitalists. In addition, the consultation with the pharmacist eases patients' anxiety, giving them confidence in their post-hospital care, he says. "Such extra services create an experience for our patients which will eventually [be reflected in] patient satisfaction scores and enable us to create loyal customers."

Medication adherence
The program has boosted patients' medication adherence in large part due to increased education of patients before and after discharge. Patients are trained on not only how to take their medications, but also what the possible side effects are and actions to take if a problem occurs. For example, Dr. Tafari says that a patient who is newly diagnosed with diabetes mellitus requiring insulin would be counseled and educated about insulin by a pharmacist and trained on how to self-administer insulin injections as well as test his or her blood sugar prior to discharge. This education and training would significantly augment compliance, resulting in better outcomes.

The 72-hour follow-up call also helps patients adhere to their medication, says Ron Weinert, Walgreens' vice president of health systems services. "Typically, as people are being discharged, they're not completely focused; they don't remember everything they hear when leave. So, there is a lot of value and benefit following-up when the patient is back in the home and thinking about how to move forward," he says. In addition, he says the program works well because pharmacists are specifically trained on educating patients about medication compliance. "Consultation and education are core competencies of our pharmacists. They are becoming an integral part of a patient's care team in the hospital."

Readmission
DeKalb has seen readmission rates decrease because of increased medication compliance, according to Dr. Tafari. He says this trend is important not only because it signals improved patient safety and outcomes, but also because it can help the hospital avoid potential financial penalties from CMS, which may cut hospitals' Medicare payments if their 30-day readmission rates are too high.

Due to the success of the program at DeKalb, the hospital and Walgreens are planning to expand the service to other departments in the hospital. "We look to continue to expand throughout the hospital to go above and beyond particular disease states, to broaden the program to as many patients as we can provide this too," Mr. Weinert says.

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