Readmissions fall after pharmacist home visits

An innovative hospital/community pharmacy partnership aims to signficantly reduce readmissions of heart failure patients and boost medication adherence.

Anne Casey, Virginia Mason Heart InstitutueAlready, the pharmacist home visit program with the Kelley-Ross Pharmacy Group in Seattle, Wash., and Virginia Mason, which operates a 336-bed acute-care hospital and regional medical centers throughout the Puget Sound area, has reduced readmissions and solved medication issues.

Utilizing a $25,000 grant from the Cardinal Health Foundation and a $7,500 grant from the St. Jude Foundation, Virginia Mason launched the “Heart to Heart” pilot program in August.

“We have seen such promising results so far, that Cardinal Health asked if we would like to expand the program. We will include our skilled nursing facility in the future,” said Anne Casey, director of the Virginia Mason Heart Institute.

Kelley-Ross Pharmacy Group pharmacists call and visit patients with moderate to severe heart failure once a month for three months after hospital discharge. On average, pharmacists spend 60-90 minutes with each patient in their home.

“If we can reduce patient confusion about medications and make it easier for them to adhere to regimens, respond to side effects and acknowledge other hazards in the home, the potential impact to improved outcomes and reduced costs is incredibly significant,” said Josh Akers, PharmD, manager of the Clinical Pharmacy Institute and residency director for the Kelley-Ross Pharmacy Group.

One key to success of the program is pharmacists’ access to patients’ electronic medical records (EMRs). “Normally the pharmacist doesn’t have access to EMRs, but we allowed the pharmacists from Kelley-Ross to have access to them. They can see what happened during the hospital stay and what medications they are on. Then, the cardiologist – and everyone across the care continuum – sees the pharmacists’ notes,” Casey said.

The early results of the program demonstrate the value of medication therapy management programs like this one. Of the 19 heart failure patients participating in the pilot project, only one has been readmitted to the hospital (for a non-heart failure issue) since the program began in August. “That’s an encouraging early result because the national average for readmission of heart failure patients within 30 days of being discharged from the hospital is about 24 percent,” Casey said.

In addition, pharmacists have identified 86 medication-related issues that required intervention during the home visits.