The Impact of a Standardized Discharge Process on 30-Day Readmissions for Patients on Outpatient Parenteral Antibiotic Treatment.

Introduction: Outpatient parenteral antibiotic treatment (OPAT) is associated with shorter length of hospital stay and reduced cost. Yet, patients discharged home on OPAT are at risk of hospital readmissions due to adverse events and complications. Although the impact of a multidisciplinary approach to readmission has been assessed by previous studies, addition of an innovative technology has not been evaluated for OPAT. This study examines the impact of a multidisciplinary approach including automated voice calls on 30-day readmissions of OPAT patients. Methods: A post-discharge transitional care process (PDTCP) targeting OPAT patients was implemented in fall 2016. This process included an automated telephone patient engagement service and coordination among pharmacy, nursing, medicine, and social work personnel. The patients on OPAT received automated telephone calls at 2, 9, 16, 28, and 40 days post-discharge to ensure medication availability and adherence and to circumvent issues that would otherwise result in an emergency room visit or readmission to the hospital. Results: A total 429 voice calls were made to 148 patients from November 8, 2016 to February 28, 2019. Overall, 61% (n = 90/148) of the patients were successfully reached by the automated voice system. The patients who were reached by the automated voice system were less likely to be readmitted than those not reached (18.9% vs 41.4%; relative risk (RR) 0.46, 95% CI 0.27-0.77, P = .003). Conclusion: Our study demonstrated that a multidisciplinary approach involving the use of automated telephone calls was associated with decreased hospital readmissions.

A pilot assessment on perceived stress among working pharmacist moms.

OBJECTIVE: To assess perceptions of stress among working pharmacist moms. METHODS: Members of the then 1000-member Facebook Pharmacist Moms group were invited to complete an 18-question online survey. The survey included questions related to stress and demographics. RESULTS: Ninety-three pharmacist moms responded to the survey. The majority (82%) of respondents graduated more than 5 years ago. Most (81%) had at least 2 children; 44% had at least 1 child younger than 5 years. The largest proportion (58%) of respondents practiced in a community pharmacy, whereas nonretail respondents included those working in a hospital (25%) or in academia (12%). Retail pharmacist moms felt more nervous or stressed about work than nonretail pharmacist mothers (70% vs. 49%; P < 0.01) and were more likely to feel difficulties were piling up so high they could not overcome them (48% vs. 15%; P < 0.01). Moms who worked in retail also felt more upset because of something that happened at work compared with nonretail pharmacist moms (63% vs 28%; P < 0.01). CONCLUSION: Women have become a major force in pharmacy and will continue to play a considerable role in the future of the profession. Pharmacist moms working in retail report higher stress levels compared with their nonretail counterparts. These results indicate a need to educate future female pharmacists on coping skills and life management techniques that foster healthy work-life balances. Employers should be aware of the underlying stressors that pharmacist moms are coping with in the workplace. These findings suggest the need for a more comprehensive survey to determine whether the stress perceived by pharmacist moms is warranted.

Impact of Group Asthma Education on Asthma Control and Emergency Room Visits in an Underserved New York Community.

Objective: Asthma education programs have been shown to be effective in decreasing health care utilization and improving disease control and management. However, there are few studies evaluating the outcomes of group asthma education. The aim of this study was to assess the impact of an outpatient adult group asthma education program in an inner-city-based hospital caring for an underserved population. Methods: We conducted a pre- and poststudy of all patients with asthma who participated in two structured group asthma education sessions led by a respiratory therapist, clinical pharmacist, and pulmonologist. The study period (January 2016 to April 2018) included the year before group education and the year after education. The primary outcomes were the number of patients requiring emergency room visits and hospital admission. The secondary outcomes included asthma control as assessed by Asthma Control Test scores, use of systemic corticosteroids, and change in test scores postintervention. Results: Eighty-eight patients received group education during the study period; 82 attended 2/2 sessions, and 6 attended 1/2 sessions. The study population was largely Hispanic (73%) or African American (25%) and had a mean age of 58 years. Most had moderate (57%) or severe (25%) persistent asthma. Significantly, fewer patients required emergency room visits in the postintervention period than in the preintervention period (20 visits vs. 42 visits, p=0.0002). Group education was also associated with increased asthma control (p=0.0043), decreased use of systemic corticosteroids (p=0.0005), and higher postintervention test scores (p=0.0001). Conclusions: Group asthma education provided by a multidisciplinary team in an inner-city hospital clinic caring for underserved and minority populations is feasible and may decrease utilization of health care resources when patients are educated and empowered to participate in their asthma management.

Combining pharmacy expertise with asthma educator certification: assessing the impact on inner-city asthma patients.

Objective: Asthma is one of the major causes of hospital readmissions in the South Bronx. The goal of this study was to assess the impact of asthma education provided by registered pharmacists with asthma educator certification (AE-C), on medication adherence and hospitalizations/Emergency Department (ED) visits. Methods: This was a retrospective chart review of patients seen in the pulmonary clinic from October 2014 to August 2015 for asthma education by AE-C pharmacists. Medical records were reviewed over an 18-month period - 9 months before and after the initial asthma education session. Data obtained included adherence to asthma controller inhalers based on pharmacy refill claims, asthma control using asthma control test (ACT) scores and asthma-related hospitalizations or ED visits within 30 days of asthma education. Pre-education data served as the pre-intervention group data and post-education data served as the post-intervention group data, allowing each patient to serve as their own control. Results: We found a statistically significant improvement in average medication adherence, i.e. asthma controller inhaler fills at pharmacy (46.3% vs 67.9%, p-value <0.001) and asthma control (15.71% vs 56.38%, p-value <0.001) between the pre-intervention and the post-intervention groups. Additionally, a lower hospitalization/ED utilization rate (31.2% vs 6.38%, p-value <0.001) was observed in the post-intervention group within 30 days of education. Conclusions: Asthma education provided by AE-C pharmacists had a positive impact on asthma care in our inner-city community. Improving medication adherence and asthma control as well as decreasing hospital utilization could potentially decrease health care costs in addition to improving quality of life.

On being a successful clinician educator: Lessons learned to share with new practitioners.

This article discusses lessons learned by a pharmacy clinician-educator during the early stage of her career in academia. In particular, the importance of establishing good mentoring relationships is highlighted as is the need for flexibility, board certification, publications, and loyalty to one's institution. The purpose of this article is to provide new clinician-educators with specific action steps - i.e. principles for success, to combine with self-motivation in order to promote longevity in academia and a sense of personal fulfillment and accomplishment.

Preparing Students to Enter the Race for Postgraduate Training.

PURPOSE: Exposure of pharmacy students to postgraduate training prior to clinical practice is currently endorsed by national professional organizations. To meet this goal, colleges and schools of pharmacy are developing residency preparation programs. In this descriptive report, we review published studies of curricular activities and structured programs from academic institutions across the United States aimed at preparing students for residency training and promoting postgraduate education. Additionally, we discuss our experience developing a residency preparation program at Touro College of Pharmacy (TCOP). SUMMARY: A literature search yielded 15 residency preparation programs. While the format, content, and length of programs varied, there were common components such as curriculum vitae critique, mock interviews, and focused sessions on the residency application process. At TCOP, a 5-themed residency preparation workshop series was implemented during the third and fourth academic year. The workshops were modeled after existing programs and included several of the core components. One feature unique to the TCOP program was the addition of multiple mock interviews. CONCLUSION: The growing focus on residency training has led to increased competition among applicants. To better prepare students for this rigorous application and interview process, development of structured residency preparation programs, similar to TCOP's, should be encouraged.