The cost of healthcare is not getting any less, and Covenant Health has approved a program to address costs, the first within the Covenant Health system, and it that is being implemented in Morristown. The program addresses the issues of patient readmission — those who have been treated, but return within a 30-day period and often present the same symptoms as their initial admission.
Patients who present with symptoms of a chronic illness are at high risk to develop other health problems solely due to a lack of medication compliance.
“We’ve probably talked about a program like this for two and a half to three years,” Jutanna Fulbright, quality care manager at Morristown-Hamblen Healthcare System, said. “We looked at ways to reduce our readmission rates, because reduced readmission rates are better for the patient. You lower your mortality and just improve health across the board.
“One of the biggest issues impacting readmission is compliance with medication. We met with different people and researched before we met with College Park Pharmacy. The pharmacy has experienced pharmacists who have done this in other places.”
According to extensive studies, sometimes patients don’t get their discharge medications, other times they don’t know how to appropriately take medications and when to take them. Others stop taking their medications as soon as they start feeling better.
Studies show 35 percent of patients don’t get their medications filled at discharge. Medications most commonly not filled are anti-hypertensives, statins and diabetic meds. One survey found 75 percent of patients were confused about their medications when they left the hospital. The result is further health issues for patients and possible hospital readmissions within 30 days.
The Meds to Beds program is a partnership between Morristown-Hamblen Healthcare System, College Park Pharmacy and Covenant Homecare. The program will focus on at-risk diagnoses of: myocardial infarction, pneumonia, chronic heart failure, chronic obstructive pulmonary disease and complicated Type II diabetes. The target populations are patients with these diagnoses being discharged home.
“This program will give another layer of instruction to the patient,” Fulbright said. “They will hear the importance of the medication from the nursing staff as we teach them about the medications. As we go through their discharge plans and medications, we re-educate. With this program, the medications are delivered to the patient’s bedside and a pharmacist will be available on an iPad Facetime viewer. The pharmacist can do counseling on every new medication right there before they leave the hospital. Once the patient is home, the pharmacist will do a follow-up phone call and go through the medication plan, asking how they are working, are there any questions, etc.”
Initial presentation of the Meds to Beds program to the patient will be by the case manager at MHHS. The case manager will let the patient know of the Meds to Beds, or transitions of care program, and if the patient elects the program, the patient will sign a form and are providing permission to release information required for filling prescriptions. On the morning of discharge prescriptions will be written by the physician and will be e-prescribed or faxed to the pharmacy. The goal is to fill the prescriptions and deliver them within two hours to the patient’s bedside.
Compliance packaging is an option provided free of charge and families will be offered the option of bringing any other medications from home to be included in the packaging. College Park Pharmacy will call the patient’s room to let them know the expected time of delivery and confirm form of payment.
A pharmacy technician from the pharmacy will deliver medications to the bedside. Via iPad technology, the patient will have a bedside consult with a College Park pharmacist. Medications will be left with the patient in sealed packaging.
“The important thing is having more hands on a patient during a critical time,” College Park Pharmacist Jacob Cox said. “The more interactions you have with a patient right after release from the hospital, which is a critical time, the better it is for them and the entire healthcare system.”
For follow up, College Park Pharmacy will contact patients the day after discharge to answer any medication questions and determine if the meds are being taken as prescribed.
Patients will also receive a follow up call from the Quality Department on discharge day four to ensure follow up instructions are being carried out. If at any time it is felt the patient would benefit from a home visit, Covenant Homecare will visit the patient. The program is not limited toward patients with chronic illnesses.
“We want to make sure we offer the program to every patients that has, for example, chronic obstructive pulmonary disease, congestive heart failure or have been treated for a heart attack, have diabetes (uncontrolled) and pneumonia patients. Those are the patients we will see re-admitted, especially if they don’t continue the medications and take them the right way. We are targeting those diagnosis, but the program is open to anyone that wants to participate,” Fulbright said.
Article courtesy of Citizen Tribune, published Monday, June 18, 2018.
By Glenna Howington, Tribune Staff Writer