Abstract
Background The Transit Care Hub (TCH) is an inpatient ward traditionally used as a waiting area for patients who require transport to return home. In July 2018, a six-month pilot of a TCH pharmacist was funded to improve the flow of patients through the hospital. Setting Major Australian teaching hospital. Objective(s) To determine the effect that the TCH pharmacist had on patient flow within the hospital and on the time saved for other clinical pharmacists, as well as estimating cost savings. Methods A service delivery framework for the TCH pharmacist was developed and tested. This involved a proactive approach to patient discharge with ward-based staff. Data were collected from July to November 2018, 20 weeks prior to and 20 weeks after the commencement of the pilot. Main outcome measure Measurements included the number of best possible medication histories (BPMHs) completed during admission, improvements in arrival time to TCH from inpatient wards and cost savings. Results During the pilot study period (20 weeks), 791 patients were discharged by the TCH pharmacist, arriving an average of 70 minutes earlier than other patients discharging through TCH. There was a 16% increase in patients discharging through TCH which released ward beds. The TCH pharmacist increased the number of BPMHs on day of admission by 14%. There was an estimated annual saving of AU$252,008 for the hospital. Conclusions The TCH pharmacist service enhanced patient flow by coordinating earlier discharges, increasing the timely completion of BPMHs, and saving ward pharmacist time. Significant cost savings supported a permanently funded position.
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Acknowledgements
A very sincere thank you to Amanda Vaux, Jill Hudspeth, Madhu Permal and Michael Abbey from the Metro South Patient Flow Unit whose support and guidance was essential in the planning, implementation and success of this role. The authors also thank all the Transit Care Hub and pharmacy staff who supported this pilot, without their valuable involvement it wouldn’t have succeeded. The authors additionally thank the university students who helped with data collection, as well as Vivien Banks and Monica Taylor for thier assistance in editing the manuscript.
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This study was funded from existing salaries.
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Snoswell, C., Jensen, E., Wang, N. et al. Transit Care Hub pharmacist: improving patient flow within the hospital. Int J Clin Pharm 42, 1319–1325 (2020). https://doi.org/10.1007/s11096-020-01092-3
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DOI: https://doi.org/10.1007/s11096-020-01092-3