Newswise — Making sure patients and their primary caregivers are ready for the return home is critical in the recovery process. So Gottlieb Memorial Hospital, part of Loyola University Health System, is adding an extra measure of patient safety and care by offering increased communication with inpatient pharmacists.

Patients and family members can speak directly with an inpatient pharmacist at any time during the hospital stay and also even after the patient returns home. “The hospital experience, and especially the discharge process, can be overwhelming for patients and their caregivers with a lot of information to process in a short time,” said Mary Clausen, R.Ph, assistant Director, Pharmacy at Gottlieb. “We discovered that there were many questions about medications in particular that needed to be discussed.”

Every day, Gottlieb inpatient pharmacists are actively reviewing patient’s medication profiles, closely following lab values and reviewing patient medical histories to make recommendations on drug therapy.

“Our pharmacists are an integral part of the healthcare team at Gottlieb. Because of this, we feel we are in the unique position to provide detailed education to our patients on their medications,” Clausen said.

The pharmacy has begun implementing the programs in a two-phase program. The first phase involved clinical pharmacists “rounding” to educate hospitalized patients on new medications. More than 330 patients have been educated since the program started mid-August.“Our initial focus has been on the high-risk medications, such as cardiac and diabetic meds, as well as Coumadin. We also educate new moms on how to measure medication for their infants,” said Clausen. “Our patients have been very positive and appreciative of the time the pharmacists spend with them.”

The second part of the program involves the implementation of an “Ask the Pharmacist” consultation phone line. The purpose of the phone line is to give patients and caregivers the opportunity to speak with a hospital pharmacist during their hospital stay or after discharge. The patient or caregiver will leave a message on the line, and after reviewing the patient’s records, a pharmacist will either visit the patient’s room or call the patient/caregiver at home. A translator can be provided if needed.

“We discovered many patients were confused after discharge not only about when and how to take their medications, but also about the need to continue taking those medications,” said Clausen. “Because many patients will already know us from their hospital stay, we hope they will contact us with their questions.”

A Consumer Reports poll reports that of 2,038 people, 16 percent don’t fill prescriptions, 13 percent have taken a drug that expired, 12 percent skipped a dose without checking in with the doctor or pharmacist, 8 percent cut pills in half and 4 percent shared medicines with others. Making mistakes with medications can land discharged patients right back in the hospital. Around 20 percent of hospitalized Medicare patients – or about one in five – are re-admitted to the hospital within 30 days of discharge, according to a study published in the New England Journal of Medicine. “Medication non-compliance can play a major role in hospital readmission,” said Clausen. “We feel continued access to a hospital pharmacist reinforces our hospital mission of patient-centered care and safety.”