The Pharmaceutical Journal
Vol 273 No 7315 p307
4 September 2004

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Pharmacists can accelerate hospital discharge

Hospital pharmacy staff can contribute to the timely discharge of patients from hospital by making sure that discharge medicines are ready on time. This is clear from guidance issued by the Department of Health last week.

At least 80 per cent hospital discharges are simple discharges: patients are discharged to their own home, with simple ongoing health care needs which can be met without complex planning. Streamlining this process — to bring discharges forward by just a few hours — can have a dramatic impact on the availability of hospital beds and significantly reduce admission delays.

The guidance — described by the DoH as a toolkit — includes a number of case studies that show how simple changes can make a difference.

One, describing procedural changes made at Chesterfield and North Derbyshire Royal Hospital, shows the benefits of changing ward rounds so that patients who are likely to be discharged are seen first. Prescriptions for discharge medicines were written during these rounds. A further change was the opening of a discharge lounge where patients could wait, rather than continue to occupy a bed. Discharge prescriptions were checked and dispensed in the lounge by pharmacy technicians.

The toolkit implies that simple changes such as these can prevent the experience of one patient, set out as an example of what should not happen. The patient said: “When I was due for discharge, the ambulance arrived but medicines were not ready. Then, by the time the medicines were ready there were no ambulances.”

Effective medicines management is also seen as a component of the solution to delayed discharge.

One of nine factsheets appended to the guidance summarises the hospital medicines management collaborative (HMMC) programme to optimise medicines management systems in hospitals in England.

A key factor in the HMMC programme is the development of partnerships between primary and secondary care, including joint admission and discharge planning.