Reducing medication errors on emergency department discharge: Evaluation of a collaborative pharmacist-medical officer discharge prescription planning model in a tertiary hospital emergency short stay unit.

ABSTRACT

OBJECTIVE: To implement and evaluate the impact of a collaborative pharmacist-medical officer model of planning discharge prescriptions, Partnered Pharmacist Discharge Prescription Planning (PPDPP) on the safe use of medicines on discharge in an ED short stay unit (SSU). METHODS: A prospective pre- and post-intervention study measured the proportion of medication errors on discharge prescriptions from the SSU using the Five Rights (5Rs) method. Pharmacists assessed discharge prescriptions generated by the medical officers (MO) during the pre-intervention phase (standard practice). During the PPDPP phase, pharmacists planned electronic prescriptions in consultation with MO and completed prescriptions were independently assessed by another pharmacist. RESULTS: There were 163 and 147 prescriptions collected during the pre- and post-intervention phases, respectively. There was a significant difference in the proportion of discharge prescriptions that met all 5Rs between the standard practice (47.2%) and PPDPP phase (91.8%) (P < 0.001). There was no statistical difference seen in the mean time taken from discharge decision to prescriptions given to patients or patients leaving the SSU between the two phases. There was a non-statically significant trend towards a decrease in time taken for patients to obtain prescriptions by 11% (P = 0.16) and for actual departure time by 6% (P = 0.46). Additionally, the proportion of opioids prescribed as one of the high-risk medication classes reduced from 23.8% to 16.2% (P = 0.023) with the PPDPP model. CONCLUSION: The PPDPP model improved medications safety on discharge from the ED SSU. The PPDPP did not impact patient flow parameters as measured in this study.