Dedicated pharmacists improve patient safety

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Having a dedicated in-hospital pharmacist who can take the time to listen and educate has made a huge difference for William Knihnicki, a recent patient on 7th Medicine at St. Paul’s Hospital in Saskatoon.

“When I came to the hospital, I truly believed I was taking too many drugs. I had no appetite and a lot of pain,” he said. “Having time to really talk to the pharmacist was helpful. She solved my appetite issue and (since then) they’ve even been able to take me off another drug, which is nice. I now understand what the drugs do and why I need to take them.”

The tipping is here: Re-imagining healthcare

Experiences such as Knihnicki’s, where in-hospital pharmacists have the time to listen, dig deep into a medical history, answer patient questions, and work closely with their home pharmacy and physician, are becoming more common with the introduction of Connected Care Units (CCUs). CCUs are a system of care where care team members are better connected to one another and are responsible to each other to ensure that patients receive the safest, highest quality care possible. The care of each patient is overseen by a hospital-based physician who manages treatment and tests prescribed by specialists, and by a unit-based registered nurse (RN). The RN collaborates with the physician, specialists and other medical staff, including pharmacists, to assist with patient treatment. An Accountable Care Unit (ACU) follows the same model, but has some enhanced protocols that help ensure consistent care for more intensive medical conditions.

The ACU model, now part of a larger Connected Care Strategy, was first implemented in Regina at Pasqua Hospital in 2016. Since that time, a number of ACUs have been established in Regina and Saskatoon. Lloydminster Hospital’s Third Flood Medical Unit launched the Connected Care model in January, while Battlefords Union Hospital in North Battleford designated the Acute Care Medical/Intensive Care Unit as a Connected Care Unit in February.

One of the most significant changes within Connected Care hospital units is to have care team members (attending physician, primary nurse, pharmacist, social worker, Client Patient Access Services, physical and occupational therapy, dietician, etc.) dedicated to and located on the unit. This allows for more meaningful and regular interactions with patients like William and with other health care providers while improving patient medication safety.

Jeff Herbert was the first pharmacist in Saskatoon to participate in the ACU model of care, and the first Saskatchewan pharmacist to be Structured Interdisciplinary Bedside Rounds (SIBR®) certified. “Prior to the ACU, a pharmacist was responsible for providing care to 80-100 patients every day. All we could do was solve problems generated from the dispensary and complete as many admission medication reconciliations as possible. Working on the ACU is a dream as I finally get to practice the way I was educated in my undergraduate training and pharmacy residency. Being able to see and talk with all my patients on a daily basis empowers them to understand what’s actually going on with their medications during their hospitalization.”

“The pharmacists on this unit now have more time to truly investigate patients’ care needs because the number of patients they are responsible for is significantly lower,” said Barb Evans, pharmacy manager for St. Paul’s and Royal University hospitals. “We have time to do our work like we have always wanted to.”

Another major patient safety improvement for pharmacists on 7th Medicine involves discharge medication planning. “We now have time to focus on discharge planning and communication,” explained Evans. “We can make sure the patient, their pharmacy and their family physician are all aware of what drugs need to continue post-discharge and what drugs have been stopped. This improves safety and can reduce readmissions.”

Knihnicki credits his good experience to dedicated staff on the unit. “I feel so much better. Thank you.”

The Connected Care Strategy is a provincial initiative designed to improve emergency wait times and patient flow, and strengthen team-based care in hospitals and in the community.

This article was submitted by the Saskatchewan Health Authority.