Mrs Estelle Jensen1, Mrs Nancy Wang1
1Queensland Health, Brisbane, Australia
Background: The Transit Care Hub (TCH) is an interim ward for patients awaiting transport home from hospital. It intermittently opens overnight as a 12-bed ward when the hospital reaches full capacity. When patients discharge from hospital, most wait on the inpatient wards for pharmacists to supply their discharge medication. Delays in discharge medications can lead to hospital bed block and increase Emergency Department Length of Stay (ELOS). A six-month Transit pharmacist trial began in July 2018 with an aim to improve patient flow by discharging patients earlier from inpatient wards.
Method: During the trial, a new procedure was implemented where patients were discharged from inpatient wards to TCH to await their medications. The Transit pharmacist liaised with ward pharmacists and treating teams to safely dispense medications, create medication lists and counsel patients.
Results: 791 patients were discharged by the Transit pharmacist over the 20-week trial period. These patients discharged to TCH an average of 70 minutes earlier than other patients (who awaited discharge medications on an inpatient ward). There was also a 16% increase in the total number of patients discharging through TCH during the trial, reaching the hospitals key performance indicator (KPI).
Over the 20 weeks, this role saved an estimated $100,862. This was calculated through reducing inpatient bed days (70 minutes x 791 patients x $2,312 per bed day), preventing pharmacist overtime when open as an overnight ward (36 nights x $136.50), and preventing three overnight patient stays by reviewing inappropriate bookings for heparin infusion admissions. It is projected this role could save $265,198 annually.
Discussion: The Transit pharmacist has enhanced patient flow by promoting earlier discharges from the inpatient wards. The role has successfully been allocated permanent funding as there were clear demonstrated quality and economic benefits. Other large hospitals could benefit from implementing this service.
Senior Pharmacist, Queensland Health