Physician-Pharmacist Team Improves Hospital Care

A practice model in which pharmacists worked alongside physicians in a community teaching hospital led to reduced readmissions, emergency department visits, and hospital costs.

Hospitals and patients both benefit when pharmacists work alongside physicians in the community hospital setting, according to the results of a study presented on June 4, 2013, at the American Society of Health-System Pharmacists summer meeting in Minneapolis. The study, which was conducted from February 4, 2013, to March 1, 2013, at Mission Hospital, a 735-bed community teaching hospital in Asheville, North Carolina, introduced a new practice model in which pharmacists and physicians worked as part of a team to deliver care. The research team was led by Adrienne Giddens, PharmD, MS, a pharmacy administrative resident at Mission Hospital.

Participating physicians continued to follow their regular routine for 2 weeks at the beginning of the study while researchers recorded data on prescribing errors, drug costs per discharge, and the use of pharmacy consults. Physicians also completed a survey on their satisfaction with the established practice model. A pharmacist then joined the physicians for 2 weeks, providing patients with drug information and discharge counseling, making medication interventions including medication reconciliation, filling prescriptions for discharged patients before they left the hospital, and submitting discharge summaries to the primary care provider.

The researchers evaluated 15- and 30-day readmission rates and emergency department visits for patients treated in both portions of the study. Participating physicians also completed a post-study survey to assess their satisfaction with the pharmacist team model.

The results indicated that approximately 33% of patients who received physician-only care were readmitted to the hospital at any point, compared with approximately 17% of patients who received physician-pharmacist team care. Almost 11% of patients who received physician-only care were readmitted within 15 days after discharge, compared with just 2% of those who received physician-pharmacist team care. Almost 9% of patients who received physician-only care visited the emergency department within 30 days after discharge, compared with approximately 4% of those treated by the physician-pharmacist team.

The results also indicated that physician-pharmacist team care was associated with decreased drug spending and care costs. The researchers estimated that physician-pharmacist team care saved $62.60 per discharge, adding up to a total of $2629 in savings over the 2-week period, which would translate to more than $2.5 million in annual savings if applied to all of the hospital’s patients.

The pre- and post-study surveys also found that participating physicians expressed increased satisfaction with the new practice model, giving it a 95% satisfaction rating compared with a 73% satisfaction rating for the physician-only model used at the start of the study. Physicians listed education given to patients at discharge, medication reconciliation, and expert drug knowledge as the most valuable assets pharmacists contributed to the program.

The physician-pharmacist team model appeared to increase clinical interventions, decrease readmissions, and increase drug savings per discharge while improving physician satisfaction with the practice model. However, because most of hospital physicians’ work is unrelated to medications, the researchers note that the model of care used in the study may not make the best use of pharmacists’ time. They suggest that a “pharmacy rounds” model be studied to see whether it can improve outcomes and reduce costs while saving staff time.

Editor's Note: This article has been updated and corrected since it was originally published.