Following discharge from a pediatric emergency department (ED) or urgent care, many families do not pick up their prescribed medications. The aim of this quality improvement study was to increase the percentage of patients discharged home with medications in-hand from 6% to 30% within 6 months. Due to the planned construction of a new ED, urgent care, and dedicated pharmacy, a multidisciplinary team was formed to increase access to discharge medications. We performed a pilot study in the urgent care to improve the discharge prescription process and expanded its scope to the ED. We evaluated the effect of our interventions on the percentage of patients discharged with medications in-hand through statistical process control charts. Process measures included the percentage of prescriptions electronically prescribed and directed to an on-site pharmacy. Between June 21, 2021 and March 27, 2022, 7,678 patients were discharged with at least 1 medication in-hand. The percentage of patients discharged with medications in-hand increased from 6.2% to 60.6%. The percentage of prescriptions e-prescribed and directed to an on-site pharmacy increased to 94.6% and 65.6% respectively. In this study, the availability of a 24-hour on-site pharmacy appears to be the most impactful intervention increasing access to discharge medications for families. Other interventions, such as a pilot study in the urgent care and implementing default electronic prescribing, may have potentiated the effect of the new pharmacy.

中文翻译：

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专门的门诊药房改善儿科急诊科出院药物的获取：质量改进研究


从儿科急诊科 (ED) 或紧急护理出院后，许多家庭没有领取处方药物。这项质量改进研究的目的是在 6 个月内将出院回家时手里有药物的患者比例从 6% 提高到 30%。由于计划建设新的急诊室、紧急护理和专用药房，因此成立了一个多学科团队，以增加获得出院药物的机会。我们在紧急护理领域进行了一项试点研究，以改进出院处方流程，并将其范围扩大到急诊室。我们通过统计过程控制图评估了干预措施对出院时手中有药物的患者百分比的影响。流程指标包括以电子方式开处方并直接发送到现场药房的处方的百分比。 2021年6月21日至2022年3月27日期间，7,678名患者出院时手中至少有1种药物。出院时手头有药物的患者比例从 6.2% 增加到 60.6%。电子处方和现场药房处方比例分别增加至 94.6% 和 65.6%。在这项研究中，24 小时现场药房的可用性似乎是最有影响力的干预措施，增加了家庭获得出院药物的机会。其他干预措施，例如紧急护理试点研究和实施默认电子处方，可能会增强新药房的效果。