2025 Southeastern Residency Conference

Title: Evaluation of Hospital Readmission Rates on Patients Who Completed Medication Reconciliation With A Transitions Of Care Clinical Pharmacy Specialist (CPS) Versus Those Who Did Not


Authors: Margaret Stubblefield, Helen T. Bryant, Candace Nichols, Kristina Hazard


Background: Transitions of care from inpatient facilities to outpatient providers can lead to adverse health outcomes and medication errors. Clinical pharmacy specialists are utilized at Kaiser Permanente during transitions of care to prevent these adverse outcomes through a medication reconciliation service. 


Methods: This is a retrospective, observational, IRB-exempt cohort study including Kaiser Permanente of Georgia patients discharged from a hospital to their personal residence. Patients will be excluded from the study if they have already had an office, video, or telephone visit with a medical doctor or were discharged from acute care centers, clinical decisions units, or skilled nursing facilities. The primary outcome of the study is to measure the readmission rates at 30 days after hospital discharge for patients who have a medication reconciliation completed by a transitions of care CPS compared to patients who did not receive a CPS-led medication reconciliation. The secondary outcome is to determine the percentage of patients who do not have a medication reconciliation completed by a transitions of care CPS. Primary outcome data will be analyzed using a Chi-square test of association.


Results: In Progress


Conclusion: In Progress