2025 Southeastern Residency Conference

Title: Expansion of Pharmacy Services to Improve Patient Care Outcomes and Quality Metrics in a Rural Community Hospital
Authors: Andrew Howell, Stephanie Smith, Kyli Latimer, Johny Nguyen, Grace Kenley
Background: Pharmacists play a key role in the medication outcomes of patients across a variety of health care settings. Equipped with a toolbox of drug knowledge and communication skills, pharmacists are uniquely positioned to be the liaison between patients and medications. Recent studies have supported the idea that regular pharmacist review of patients admitted to the hospital improves patient care outcomes and increases hospital cost savings and quality metrics. The objective of this study is to assess the impact of expansion of pharmacy services on patient care outcomes and hospital quality metrics in a rural, community hospital.
Methods: This is a single center, pre-post implementation study at a 358-bed, community hospital in rural South Carolina. The implementation phase will take place from February 24 – March 21, 2025 and will consist of the placement of pharmacists on the adult medical (non-intensive care unit) floors where most patients have traditionally been managed solely by hospitalists. The duties of the pharmacists placed on the floors will include both distributive and clinical responsibilities, with an emphasis on discharge medication reconciliation and education, renal dose adjustment, anticoagulation monitoring and management, and intravenous to oral (IV to PO) transitioning. Additionally, pharmacists will be responsible for attending multidisciplinary rounds in order to review patients, present recommendations, and assist with medication-related questions and inquiries. Streamlined policies and monitoring aids have been developed to ensure that workflow is consistent and standardized and to help prevent potential confounders. Tools have been developed to assist with documentation of medication interventions and clinical responsibilities. To measure the effect of the intervention on hospital quality measures and patient outcomes, changes in medication areas of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores and 30-day readmission rates will be assessed both before and after the implementation of the intervention. Secondary outcomes will focus on changes in Leapfrog scores, average length of hospital stay, and time to prescription order verification. Any increase in quality metrics from before to after the implementation will be considered statistically significant. 
Results: From February 24 – March 26, 2025, 1046 patients were enrolled in the pilot study. 30-day readmission rates are not yet available since the end of the pilot period. Data from 39 HCAHPS surveys for the month of April are available through April 19, 2025. From March to April, there was an increase in scores for “Communication about Medicines” (March = 68, April = 77), “Discharge Information” (March = 29, April = 92), and “Care Transitions” (March = 38, April = 75). Of note, the domain, “Care Transitions” had its name changed to “Care Coordination” starting in April 2025. For secondary outcomes, Leapfrog and length of stay data for the pilot period is not yet available.
Conclusions: After implementation of the pilot, an increase in HCAHPS scores was observed for all three domains pertaining to medication questions, suggesting that pharmacists may play a role in bettering patients’ perceptions of their care. Pharmacists are well equipped and positioned to assist with transitions of care services.