RESUMO
OBJECTIVES: The primary objective of this report is to describe the implementation of a pilot pharmacist-run transitions of care clinic. The secondary objective is to present data collected on the impact of this clinic in regard to 30-day, all-cause hospital readmission rates and provider acceptance rates of pharmacist recommendations. SETTING: This transitions of care clinic was implemented in a Department of Veterans Affairs ambulatory care center located in Columbus, Ohio. PRACTICE DESCRIPTION: Pharmacists saw high-acuity patients who met inclusion criteria in the transitions of care clinic to complete medication reconciliation, disease state education, and medication counseling. After the visit, the pharmacist made recommendations to the patient's primary care provider. PRACTICE INNOVATION: This transitions of care clinic is unique in that it is solely pharmacist-run and is located within a primary care setting. EVALUATION: The impact of the pharmacist-run clinic was evaluated against a matched control group via a retrospective chart review. A chi-square test was run to assess the difference in 30-day, all-cause hospital readmission rates between patients seen in the transitions of care clinic and those who were not. RESULTS: There was a statistically insignificant difference in 30-day, all-cause hospital readmission rates between the transitions of care and control groups (13% vs. 26.1%; P = 0.265). For secondary outcomes assessed in the transitions of care group, 32.9% of medication-related recommendations, 47.4% of laboratory blood work recommendations, and 48.6% of care coordination referrals made by pharmacists were accepted by providers. CONCLUSION: Pharmacist involvement in the transitions of care process in the primary care setting through the implementation of a pharmacist-run clinic may decrease the likelihood of hospital readmission.