Innovative Meds-to-Beds program ensures hospital patients are successful with prescriptions after discharge
Public health systems often serve as a ‘safety net’ for their patients, and Harris Health System in Houston, Texas, is no different.
Harris Health System recently launched a new offering with its Meds-to-Beds program, a bedside delivery service in which patients can leave the hospital with their prescriptions in hand to take care of their health when they go home. Harris Health System pharmacists deliver prescriptions to the bedside for each patient enrolled in the program, allowing a more in-depth counseling session than a patient might receive at a store or drive-thru. This level of comprehensive care is provided to improve medication comprehension and adherence and eliminate or decrease hospital readmissions.
“Pharmacists sit down with the patient, take each medication out of the bag, show them the pills, read the instructions, and discuss the most common side effects they may experience with the medications,” says Sara Dwivedi, Pharmacy Operations Manager, Harris Health Ben Taub Hospital. “We use a teach-back method, so we’ll say, ‘I know that was a lot of information, and I want to make sure you understand how to take this medication properly. Can you teach me how you’re going to use this?’”
Initially, the program went through a pilot in September 2020 at a few units at Harris Health Lyndon B. Johnson Hospital. Preparing for a successful launch required the involvement of many teams, including pharmacists, physician representatives, nursing representatives, patient-satisfaction representatives and IT personnel, to help manage Epic’s different builds and workflows to support the program. The program expanded hospital-wide by November 2020, then was implemented at Ben Taub Hospital in January 2021, supported by another Harris Health System pharmacy 10 minutes away.
“When we launched, this was also during a peak with the COVID pandemic,” says Dwivedi. “We thought this was also a way to make sure patients got what they needed, so they didn’t have to go to the pharmacy. It’s been a successful program; we have over 90% of discharged patients enrolled.”
Dwivedi explains sometimes you may have a patient who is only being discharged with one medication, but other times you may have a patient with 15. “It’s a lot of information at once, but we work with them to make sure they understand everything,” she says. “We include a phone number on the bottle that they can call if they have questions, and we encourage them to reach out to us if they come up with a question once they are home.”
Dwivedi recalls a patient who started crying at the end of the pharmacist’s counseling session. “The patient said, ‘Everyone here has been just so great and so patient with me. I feel so blessed. Thank you.’ The patient had a lot of questions, and it ended up being a 25-minute counseling session, but he was so happy someone took the time to speak to him and made sure he understood.”
“Making sure that all of our staff conducts their counseling sessions this way is really how I think we’ve been very successful with the program,” she adds. “It’s a team effort; you can’t accomplish something like this when it’s just one group.”
Success with the Meds-to-Beds program means measuring metrics for positive outcomes and identifying room for improvement. Harris Health measures:
- Number of patients enrolled
- Number of patients discharged with meds
- Number of enrolled patients with prescription education
- Number of prescriptions dispensed
- Prescription turn-around time
- HCAHPS ‘Care Transitions’ survey scores
- HCAHPS ‘Communication about Meds’ survey scores
Harris Health System has achieved its goal of prescription processing in the pharmacy in under an hour for the last six months. The organization also met a majority of their HCAHPS patient-satisfaction goals, with an internal goal of greater than 80%—which is equal or greater to the NRC Health 70th percentile benchmarks, based on the average of the entire Harris Health System for specific questions.
“NRC Health gave us that critical metric to monitor and share,” says Sally Sims, Director of Pharmacy at Ben Taub Hospital. “If you don’t have that, you don’t really know how you’re doing. So it’s really important to be data-driven and to have that feedback.”
“We are the safety net for the patients of Harris County,” says David Riddle, Harris Health’s Administrative Director of Patient Experience. “When they come to our hospital, they’re ours for acute care, specialty care and primary care. So, it’s our responsibility to ensure the highest level of quality across the continuum of care.”
“Before this, a patient might be discharged with a prescription, but it’s up to them to go out and fill their medications,” Riddle adds. “That’s huge if we can send them out with a clear understanding of what their medicine is for and a supply to start taking. It helps support their recovery and keeps them from returning to our emergency centers or being readmitted to the hospital, so it’s a win-win all around.”
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