Journal Article

A qualitative dual-site analysis of the pharmacist discharge care

Shane, Rita, Salandanan, Audrienne, Llamas-Sandoval, Ruby, Schnipper, Jeffrey L., Armbruster, Christine, Guan, James, Phung, Emily, Ko, Eun Ji Michelle, Moriarty, Dylan, Matta, Lina, Amer, Kallie, Henreid, Andrew, Wu, Shirley, Wisniewski, Jesse, Nguyen, An T., Pevnick, Joshua M., Keller, Michelle S., Rosen, Sonja L., Conti, Nicole, Rosen, Olga, Fanikos, John, Leang, Donna W., Muske, Anne Marie, Kennelty, Korey A., Murry, Logan T.

2022

Overview

Older adults face several challenges when transitioning from acute hospitals to community-based care. The PHARMacist Discharge Care (PHARM-DC) intervention is a pharmacist-led Transitions of Care (TOC) program intended to reduce 30-day hospital readmissions and emergency department visits at two large hospitals. This study used the Consolidated Framework for Implementation Research (CFIR) framework to evaluate pharmacist perceptions of the PHARM-DC intervention. In total, ten semi-structured interviews and one focus group were completed across both hospitals. At Site A, six interviews were conducted with intervention pharmacists and pharmacists in administrative roles. Also at Site A, one focus group comprised of five intervention pharmacists was conducted. At Site B, interviews were conducted with four intervention pharmacists and pharmacists in administrative roles. Three overarching themes were identified: PHARM-DC and Institutional Context, Importance of PHARM-DC Adaptability, and Recommendations for PHARM-DC Improvement and Sustainability. Increasing pharmacist support for technical tasks and navigating pharmacist-patient language barriers were important to intervention implementation and delivery. Identifying cost-savings and quantifying outcomes as a result of the intervention were particularly important when considering how to sustain and expand the PHARM-DC intervention. The PHARM-DC intervention can successfully be implemented at two institutions with considerable variations in TOC initiatives, resources, and staffing. Future implementation of PHARM-DC interventions should consider the themes identified, including an examination of institution-specific contextual factors such as the roles that pharmacy technicians may play in TOC interventions, the importance of intervention adaptability to account for patient needs and institutional resources, and pharmacist recommendations for intervention improvement and sustainability.

• Publisher: BioMed Central Ltd