Improving patient health outcomes and hospital efficiency through innovative workforce redesign in pharmacy

Mrs Desiree Terrill1

1Department Health Human Services, Melbourne, Australia, 2Alfred Health, Melbourne, Australia

Abstract:

Aim:
To undertake a multi-centre health economic evaluation translating a partnered pharmacist medication charting (PPMC) model in patients admitted to public hospital General Medical Units.

Method:
This unblinded, prospective cohort study compared patients admitted to General Medical Units before and after the intervention in seven public hospitals in Victoria from June 2016 to June 2017. The intervention involved medication charting by pharmacists using a partnered pharmacist model compared to traditional medication charting. The primary outcome measure was length of inpatient hospital stay. Secondary outcome measures were medication errors detected within 24 hours of patient admission, identified by an independent pharmacist assessor.

Results:
A total of 8,648 patients were included in the study. Patients who received the PPMC intervention had reduced median length of hospital stay from 4.7 days to 4.2 days (p<0.001). The PPMC was associated with a reduction in proportion of patients with at least one medication error from 66% to 3.6%. The average saving per PPMC intervention admission was $834 ($7,254 for PPMC compared with $8,088 for standard care, with a cost benefit ratio of 1:17. Savings were driven by reduced complications and increased safety rather than productivity. All hospitals sustained PPMC operation since funding ceased in June 2017. Cost modelling of state-wide roll-out of the PPMC model operating during business hours suggests potential savings of $232 million per annum can be achieved.

Significance of the findings:
Expansion of the partnered pharmacist charting model across multiple organisations is effective and feasible, and is recommended for health services.

Biography:

Desiree Terrill is a Senior Policy Advisor in the Workforce Funding Performance and Review Unit at the Victorian Department of Health and Human Services. Desiree has a background in health promotion, evaluation, research and health economics. Her focus is on the development of evidence-based policy approaches, frameworks and initiatives to enhance efficient advanced practice pathways in the health and human services sector.

As part of the department’s workforce innovation and reform agenda, Desiree led the Partnered Pharmacy Medication Charting Program which aims to assist hospitals to strategically position themselves to build allied health work force capacity into the future in a sustainable way.