Project RED pharmacists reconcile meds, lower patient hospital return rate

The readmission rate for congestive heart failure patients was reduced by more than 50% after Morris Hospital in Morris, Ill., implemented a pilot medication reconciliation program.

Project RED (Re-Engineered Discharge) is a research group at Boston University Medical Center that develops strategies to improve the hospital discharge process and lower readmission rates. Project RED pharmacists actively reconcile medications upon admission, during the patient's stay, and upon discharge.

The 89-bed Morris Hospital began the small pilot program last October. "We identified the same problems that other hospitals are having. Lots of times, a patient's list of medications to take at home is inaccurate, so we will reconcile that," said Alyssa Urbasek, pharmacy manager at Morris Hospital.

With administrative and physician support, the pharmacy staff developed a core team to oversee the project, including a pharmacist, nurses, patient case managers, physicians, a dietitian, a social worker, and a respiratory therapist.

The Project RED team opted to start the pilot project with congestive heart failure patients on the medical floor, because those patients often have medication complications and need to be readmitted. Pharmacists met with patients upon admission to discuss current medications and followed them throughout their stay, keeping tabs on medication changes and other medication issues. Before the patients were discharged, the pharmacy was was given the list of medications ordered by physicians.

Pharmacists reviewed the list for discrepancies and inaccuracies, and then discussed the list with the patients. "Pharmacists counsel [patients] on drug-drug interactions and drug-food interactions, as well as the timing of their meds," Urbasek said.

As a result of the team's intervention, the 30-day readmission rate for these patients dropped from 30.6% to around 12% from October 2011 through February 2012. "We have gotten great feedback from the nursing staff and physicians on having pharmacists involved," Urbasek said.