Introduction
Public hospitals are facing increasing challenge in service demand; to relieve heavy workload of doctors and nurses and to enhance medication safety, Tseung Kwan O Hospital piloted Ward Pharmacist Service on a medical ward on 5th March 2018. Ward pharmacists would station on ward and manage drug-related issues throughout patient journey.
Objectives
To reduce workload of frontline doctors and nurses, enhance pharmaceutical care and medication safety and improve overall service quality and efficiency of discharge process.
Methodology
Ward pharmacists would station on an acute medical ward Monday to Friday from 9:00am to 1:00pm. Upon patients’ admission, pharmacists would perform medication reconciliation and compile patients’ “Best Possible Medication History” by reviewing medical records and performing patient interview. Pharmacists would communicate with doctors and nurses if unintentional discrepancies were identified. During inpatient stay, pharmacists would review patient progress, verify IPMOE orders on ward and provide on-site clinical pharmacy support to doctors and nurses when needed. At discharge, pharmacists would assist doctors by preparing discharge prescriptions in advance in CMS for doctors’ endorsement so as to free up their time for other clinical activities. For prescriptions prepared directly by doctors, pharmacists would perform discharge medication reconciliation. Pharmacists would also provide bedside discharge counselling to patients.
Results & Outcome
Till 31st December 2018, ward pharmacists served 201 half-days and reviewed 894 cases. Unintentional discrepancies and compliance problems were identified in 143 cases (16.0%) during admission medication reconciliation. Pharmacists prepared 173 discharge prescriptions (38.9%) out of 445 discharge cases handled during service hours. From the remaining 272 prescriptions prepared by doctors, pharmacists identified unintentional discrepancies and other drug-related problems in 96 cases (35.3%). Overall, pharmacists made 979 treatment recommendations and 928 (94.8%) of them were accepted by doctors. Among all the cases reviewed (n=894), pharmacists made recommendations for 366 (40.9%) of them. The service was well accepted by ward staff. Over 90% of them agreed that pharmacists can reduce unintentional discrepancies and save doctors’ and nurses’ time in discharge process. They also agreed that Ward Pharmacist Service should be extended to other wards. Ward pharmacists could enhance patient care by providing on-site clinical pharmacy support, reducing workload of doctors and nurses and improving medication safety by reducing unintentional discrepancies.
Co-location with:
