Okay, here’s a breakdown of the key takeaways from the provided text, focusing on the hospital’s initiatives and their impact. I’ll organize it into sections for clarity.
I. The Problem: High Readmission Rates & Resource Gaps
* Unfunded Care & ED Overuse: The primary drivers of financial strain on the hospital are unfunded hospital stays and overuse of the emergency department.
* High Behavioral health Readmissions: Specifically, readmission rates for patients discharged from the acute care behavioral health floor were over 10%.
* Lack of Ambulatory Resources: The root cause of these readmissions is a severe shortage of resources on the ambulatory (outpatient) side for patients needing ongoing mental health care. Patients were stabilized in the hospital but lacked access to follow-up care, leading to relapse and readmission.
* Difficulty with Methadone Access: Patients with substance use disorder on methadone faced notable barriers to continued treatment upon discharge due to limited clinic hours (after hours, weekends, holidays).This led to readmissions or ED visits.
II. Solutions Implemented by the Hospital
* Long-Acting Injectable (LAI) Program:
* Pharmacist Screening: pharmacists screened patients admitted to the behavioral health unit to identify those suitable for LAIs.
* Transition Buffer: lais provided a “buffer” allowing case managers and social workers more time to connect patients with ambulatory care after discharge.
* Cost Offset: The hospital utilized industry-sponsored hospital-free drug programs to cover the cost of LAIs.
* Significant Results: The 30-day readmission rate was reduced by 80%.
* Expansion Plans: The program is expanding to include a second dose of LAI administered on the ambulatory side to further facilitate the transition to outpatient care and address 60- and 90-day readmissions.
* Inpatient Discharge Methadone Dispensing Program:
* Legislative Advocacy: The hospital successfully lobbied the state legislature to allow hospital pharmacies to dispense a 3-day supply of methadone directly to patients at discharge.
* Improved Access: This program addresses the challenge of patients being unable to access methadone clinics outside of regular buisness hours.
III. Role of Pharmacy
* Proactive Screening: Pharmacists are central to identifying appropriate candidates for LAIs.
* Program Implementation: Pharmacy is actively involved in implementing and managing both the LAI and methadone dispensing programs.
* Collaboration: Pharmacy collaborates with case managers, social workers, and ambulatory pharmacy colleagues to ensure a smooth transition of care.
* Cost Management: pharmacy utilizes programs to offset the cost of medications.
* Ensuring Safe Access: Pharmacy plays a critical role in ensuring patients have safe and timely access to necessary therapies (LAIs and methadone).
In essence, the hospital is proactively addressing the systemic issues of limited outpatient resources by leveraging pharmacy expertise to bridge the gap between acute care and ongoing treatment, ultimately reducing readmissions, ED overuse, and the associated costs.
