Pharmacist support for discharge prescription writing

A pilot project at Brighton and Sussex University Hospitals NHS Trust is investigating the impact of introducing pharmacist support for discharge prescription writing on the discharge process. In this study, the discharge pharmacist writes up medicines for the discharge letter (TTO) which are then clinically screened by a second pharmacist. The clinical narrative is still completed by a doctor.

The aims of this project were to:

>reduce the time between a patient being declared medically ready for discharge (MRFD) and being discharged
>reduce prescribing errors and improve the quality of information regarding medication changes on discharge letters.

Baseline data was collected prior to the implementation of the project on 54 TTOs written over a week in March 2015. Data collected included the following: the timings of the TTO process, when the patient was declared MRFD and when the patient was discharged, the number of errors found on the TTO when screening, the time spent correcting the errors and the quality score of the TTO. This data was also collected for the pilot project. Data on errors and the quality score was collected by the pharmacist screening the TTO (separate to the researcher).

Conclusions

>TTOs written by the discharge pharmacist have fewer errors and better quality of information regarding changes in medication during admission.
>Due to the lower number of errors found on the TTOs written by the discharge pharmacist, the screening pharmacist spends less time rectifying errors.
>The lack of effect of the discharge pharmacist on the time between a patient being declared MRFD and being discharged is thought to be due to the number of other factors involved in discharging a patient.