Year: 2025
Type: conference-paper
Abstract: Introduction Transition between primary to secondary care and vice versa is identified as portraying a singularly unique risk to safe and effective care patient may receive, with a known 30 to 70% chance of medication related error(s) occurring. 1 2 Effective communication between care providers as patients migrate between care setting to allow an accurate, safe, and timely medications reconciliation and clear understanding by care providers for the intended indications, is a hallmark of gold standard patient care.It has long been an NHS mandate that patients being admitted to hospital have an accurate medicines reconciliation conducted in timely manner. Similarly on discharge from secondary care, all patients should be discharged with an accurate discharge summary which should include medications that the patient is to continue. This should be received by primary care clinicians within 24 hours of discharge. Despite this community pharmacy contractors often struggle to be included in these communication cascade and so remain a single point at which safe care may fail. Discharge Medication Service (DMS) is a pharmacy led initiative established in 20213 to improve communication between secondary care and community pharmacy contractors.To support high risk transitions of care from a specialist tertiary paediatric hospital to community, a project commenced in 2023 to establish a discharge medicines service.Aim Following completion of the initial project we proceeded to conduct a qualitative review of pharmacists completing referrals to understand barriers and facilitators to support DMS.Method From April 2024 to July 2024, we interviewed 10 pharmacists across all bands and paediatric specialities. Thematic analysis of interviews was undertaken to identify commonly cited barriers and facilitators to making referrals.Results Common thematic facilitators allowing the introduction of a DMS were: acknowledgement of meeting a trust target for a Commissioning for Quality and Innovation project associated with significant financial benefit; the ability to communicate on-going patient care to partner community pharmacy improving patient safety and care efficiency; enhancing the patient and family experience; improving and building patient and community relationships to support patient care; project leads supporting and driving projects and availabilities of key standard operating procedure.Barriers emerging were: completion of referral but without dedicated time required to allow referring pharmacists opportunity to achieve full benefits of information transfer; uncertainty around outcomes of referral; lack of feedback for rejections to tertiary centre referral, making it difficult to develop optimisation strategies for patients to refer.Conclusion Our evaluation highlights that DMS can be introduced, following development and implementation of an integrated database, supporting care for children and young people transitioning from a tertiary specialist care environment to primary care that can be further developed. The evaluation recognises the value to safe and effective patient care and allows a platform from which the pathways can be improved and refined to further develop safe and effective care transitions as well as improve communications provided to improve the seamless and effective care provision in primary care to children and young people.References NICE guideline [NG5] Published: 04 March 2015 Overview | Medicines optimisation: the safe and effective use of medicines to enable the best possible outcomes | Guidance | NICE (Accessed 1 June 2024)Keeping patients safe - getting the medicines right: Royal Pharmaceutical Society, FINAL REPORT, June 2012 Keeping patients safe transfer of care report.pdf (rpharms.com) (Accessed 1 July 2024)NHS Discharge Medicines Service [internet] NHS England » NHS Discharge Medicines Service (Accessed 1 June 2024)
Source: BMJ Paediatrics Open
Institution: Great Ormond Street Hospital
Language: English
Subfield: Geriatrics and Gerontology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4408799010