Authors (including presenting author) :
Yuen SE(1), Kam KW(1), Mak CK(2), Mak LKK(1)(2)(3)
Affiliation :
(1)Department of Pharmacy, Haven of Hope Hospital, (2)Department of Pharmacy, Tseung Kwan O Hospital (3)Department of Pharmacy, United Christian Hospital
Introduction :
Haven of Hope Hospital (HHH) is an extended care hospital providing subacute medical care and rehabilitation. Patients transferred from acute hospitals in Kowloon East Cluster (KEC), namely United Christian Hospital (UCH) and Tseung Kwan O Hospital (TKOH) accounted for majority of the cases admitted to HHH. Due to the variety of medication availability subject to formularies between hospitals, the discharged hospital pharmacy would carry out discharge prescription screening of HHH non-formulary items for patients transferring to HHH, any HHH non-formulary drugs identified would be dispensed for 5 days in order to ensure sufficient supply of medications for transferred patients. In other words, patients need to wait for the completion of prescription screening and dispensing of non-formulary items before they can be transferred, which may hinder patient transfer process.
Objectives :
To enhance patient transfer efficiency and avoid delay in patient transfer.
Methodology :
A project revamping the workflow of discharge prescription handling process was implemented in January 2019 and July 2020 for patients transferring to HHH from TKOH and UCH respectively, in which the non-formulary item screening process would be carried out by HHH pharmacy instead of the discharged hospital pharmacy. Any HHH non-formulary items identified would be dispensed for 5 days by HHH pharmacy upon arrival.
Result & Outcome :
A before-and-after study over a period of 16 weeks was conducted to evaluate the impact of the revamping project. The percentage of patients arrived at HHH at or before 4pm increased from 81.4% to 93.2% and from 81.4% to 94.3% for patients transferred from UCH and TKOH respectively. The number of cases prescribed with HHH non-formulary items ranged from 11.4% to 19.8% during the study period. Patients no longer need to wait for the completion of prescription screening and dispensing of non-formulary items before they can be transferred. The discharge prescription handling process is not considered as a rate-determining step of patient transfer anymore. This allows doctors, nurses, pharmacists and other allied health professionals to provide care at an earlier manner.
Revamping of the discharge prescription handling process enhanced the efficiency of patient transfer to HHH from UCH and TKOH; allowed patients to receive care promptly and potentially helped to relieve the problem of access block.
