A better pharmacological diagnosis
A patient comes into the emergency department because he has pneumonia. The emergency doctor treats and assesses him, but doesn’t know that patient’s family physician has recently increased the doses of his high blood pressure medications from the dose that is listed in his PharmaNet profile.
As a result, the patient is transferred to the unit where the admitting doctor prescribes the lower listed dose of the blood pressure medications. The patient subsequently becomes hypertensive.
To prevent situations like this, the team at Richmond Hospital has launched its ED Pharmacy Technician program; an innovative and first-ever process designed to comprehensively interview ED patients about what medications they are taking and how they take them.
Integral to providing improved patient care
Creation of an accurate medication list is a fundamental component of medication reconciliation and is integral to VCH Richmond’s commitment to continuous improvement leading to better patient outcomes.
“It’s about providing safer care,” says Mark Wu, the medication safety pharmacist at Richmond Hospital and coordinator of the project. “We need to ask you questions like how you take your medications to help ensure that they are accurately assessed and ordered as appropriate to prevent unintended changes and omissions.”
Pharmacy techs now part of the ED team
Staff conducting these interviews are regulated pharmacy technicians. One of those pharmacy technicians is Gurvinder Helena Kaushal who has been with the program for about a month. She believes the work being done has been very effective.
“With most of the patients, there is a discrepancy between what was originally prescribed and how they are actually taking the medication,” says Gurvinder who does about 15 to 20 interviews each shift. “So when we go through the interview, we note those changes so the doctor is able to have a clearer picture of what the patient is taking and determine if those medications contributed to the admission.”
Because these interviews can take up to 30 minutes to complete, they consume a significant portion of the day. This ED Pharmacy Tech program aims to help ED medical staff and clinicians collect this essential medication information; something that can be difficult to squeeze into normal workflows given high ED patient volumes.
More patients benefit from interviews
A recently completed audit found that 86 per cent of ED patients are now receiving comprehensive medication interviews. Before the ED Pharmacy Tech program, interviews were completed about 50 per cent of the time.
“Once the interview is completed, the physician can order the medications much more safely knowing exactly how the patient has been taking them,” Gurvinder says. “If the doctor doesn’t know how the medications are being taken, they can make an educated guess but they don’t know for certain.”
Gurvinder says she loves her job for two reasons.
“The best part is knowing I am making a difference in somebody’s health care,” she says. “It is nice to know you are making an impact on their visit, on their stay and helping the patient get treated properly and accurately. Also, the patients are very appreciative when being interviewed as they feel someone is coming to discuss their health one-on-one and helping them on their road to recovery.”