The Sacramento Medical Center Discharge Prescription Improvement Process



 

Jimmy Munteanu, PharmD; Linda Yee, PharmD;
Dan B Dong, PharmD; Jeff Mierczynski, PharmD;
Qui Nguyen, PharmD

https://doi.org/10.7812/TPP/17-140-19

Introduction: In June of 2016, the Morse Discharge Pharmacy was confronted with a number of complaints from patients and nursing staff regarding delays in discharging patients caused by delays in filling medication orders. Discharge medication orders for 30% to 40% of the patients were not processed within the regional standard of 1 hour.|
Methods: The pharmacy team initiated an improvement project to track the time and the process to fill discharge medications. An updated Discharge Tracker Log Sheet was developed and officially implemented into the daily workflow on July 8, 2016. Prescription processing times for every hospital discharge were tracked and delays were documented. Common trends were identified and addressed with key stakeholders from various departments involved in the discharge process. Workflow challenges were acknowledged at the daily safety and operations briefings and resolved among the appropriate stakeholders. This process was implemented, repeated, and fine-tuned on a daily basis, resulting in significant and positive outcomes within the first month.
Results: Monthly average processing times for discharge medications ranged from 51 to 62 minutes per patient for the months of January 2016 through June 2016. Within the first month of implementing the improvement project, the monthly average processing time decreased to 34 minutes in July. By the third month, the average processing time was 28 minutes and each subsequent monthly average was maintained under 30 minutes. The percentage of discharge orders with processing times greater than 1 hour decreased from 30%-40% to 15% within the first month and was steadily maintained at ≤ 10% by the third Month.
Discussion: Pharmacy processing times were significantly reduced by identifying recurrent issues through the use of a simple tracking tool and promptly addressing them with key stakeholders. Noteworthy achievements and partnerships were established throughout the process with minimal cost impact on the department and high impact for patients.

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