Reduces Rehospitalization Rate and Costs, Improves Satisfaction and Acceptance

BACKGROUND

Holy Cross Health in Germantown, MD provides care to more than 200,000 patients annually through inpatient, outpatient and community-based services. A member of Trinity Health of Livonia, MI, Holy Cross Health is a leading regional hospital facility serving one of the state’s most densely populated areas. Holy Cross Health strives to innovate, and sought new ways to reduce the number of patients returning to hospitalization after discharge.

CHALLENGE

Holy Cross Health leaders first tasked APC with a pilot program, pairing APC pharmacists with a single hospital discharge team. The Holy Cross team included doctors, nurses, discharge planners and various therapy practitioners. In total, the team included more than twenty people tasked with providing discharge services to patients.

SOLUTION

Upon initiation of the program, hospital staff began admitting patients, integrating APC team members into the intake and discharge process. APC practitioners made contact with each patient and arranged face-to-face visits. During these in-person consultations, APC clinicians performed comprehensive reconciliations to prepare the most accurate medication recommendations for physicians. Once medications were prescribed, APC managed the fulfillment of prescriptions, and provided medications in presorted, single-dose compliance packaging. APC’s one-on-one reconciliations brought a new perspective that filled a void in the previous discharge workflow. The pharmacists’ expertise provided new insight into prescribed treatment regimens, often identifying areas where alternate medication therapies could improve effectiveness of treatment and increase the likelihood of adherence.

Case Study Summary:

  • Initial pilot program at Holy Cross Health
  • APC paired with a single discharge team
  • APC pharmacists meet one-on-one with patients
  • Provide recommendations to physicians
  • Provide medications in single-dose compliance packaging
  • Increase savings by average of $150 per patient, per month
  • Decrease number of medications by 1.4 per patient, per month
  • Improve acceptance rate
  • Improve satisfaction of patients, providers and staff
  • Pilot program becomes full-scale, system-wide project

RESULTS

At just two weeks into the pilot program, 142 patient days, the change in reconciliation resulted in an average savings of $140 per patient per month.

On average, the number of medications was reduced by 1 per patient, and the average recommendation acceptance rate rose to 72%. Of self-reported satisfaction, patients reported 75%, primary care physicians 85% and Holy Cross staff 100%. The infusion of the pharmacist’s perspective into the intake and discharge process resulted in immediate cost savings for patients, reduction in the number of medications needed, and higher rates of satisfaction for all involved. As a result, APC’s pilot program was terminated early, and Holy Cross Health initiated APC’s service system-wide.

At five weeks, 670 patient days, the average savings were $150 per patient per month, with the number of medications decreased by an average of 1.4 per patient. The average recommendation acceptance rate had risen to 75%, and the number of patients rehospitalized in this time = 0.

At Holy Cross Health, APC’s entrance into the intake and discharge process filled a critical void. The pharmacist’s expertise revealed areas where changes to medication could significantly improve outcomes. APC’s personal approach, combined with the precision of compliance packaging, made it easy for patients to understand and comply with prescribed treatments. This resulted in reduced cost, reduced rehospitalization and improved satisfaction overall.