Text Size

April 2017 Excerpt

In-home visits from pharmacist helped reduce readmission rates
A Seattle-based community pharmacy and hospital recently partnered on an intervention that uses in-home visits and follow-up phone calls from pharmacists to substantially reduce rehospitalizations among heart-failure patients. In Idaho, 17.1% of Medicare's heart failure patients are rehospitalized within 30 days; in Washington, that rate is 21.3%—but among the 50-patient study population, just 8% were readmitted.
Kelley-Ross Pharmacy Group (KRPG) was already performing in-home visits for various complex patient groups. They secured a grant to expand on this work and coordinate with the cardiology department of a local hospital to deliver in-home medication coaching to heart failure patients over a period of three months.
The hospital's nursing staff screened for high-risk patients upon admission, then (during the inpatient stay or shortly after discharge) obtained their consent to participate in the project and alerted KRPG.
Patient screening criteria
  • Took more than five 5 chronic medications
  • Followed by cardiologist in the outpatient setting
  • Discharged from hospital to home with a primary diagnosis of heart failure
  • Resided in surrounding tri-county area
Pharmacists performed monthly in-home visits, each followed in two weeks by a phone call. All pharmacist-patient encounters were documented within the hospital's EHR to streamline coordination of care among providers.
The pharmacists conducted a thorough medication reconciliation, and were able to make evaluations and recommendations based on the lifestyle and situation of each patient and family.
Buoyed by the success of this initial effort, KRPG is working with their hospital partner to broaden the scope of the project to include patients with heart failure who are discharged from the hospital and sent to a skilled nursing facility before going home.
Interested in establishing a similar project in your community? Contact us to discuss implementation ideas and tracking metrics.