Columbus, OH - July 2016
In 2014, a significant issue was becoming clear to Seth Alpert, MD, an attending urologist at Nationwide Children’s Hospital. The Section of Urology was regularly fielding calls from parents whose children had recently undergone outpatient surgery – or from neighborhood pharmacies where those parents were waiting to have prescriptions filled.
“There was a problem with access to certain pediatric medications, particularly liquid narcotics for postoperative pain after surgery that we were prescribing,” Dr. Alpert says. “Either the local pharmacy didn’t stock them, or they were having a hard time getting them due to intermittent national shortages. In other cases, adult pharmacists who weren’t familiar with pediatric dosing were calling to ask: “Are you sure you want to give the child a narcotic? Are you sure you want this dose?”
Patient families were becoming frustrated. They were understandably anxious to leave the hospital after surgery and bypassed the Outpatient Pharmacy, assuming they could get necessary medications near home. Patients themselves were sometimes in pain.
So Dr. Alpert worked closely with Nationwide Children’s Pharmacy Services to create something entirely new for the hospital: the Medication Discharge Delivery Service. The tagline is: “After Discharge, Make Home Your Only Stop.”
From the patient’s perspective, it’s simple. A nurse explains the program pre-operatively. If parents opt in, a trained pediatric pharmacist or pharmacy student under the supervision of a pharmacist fills the correct medication. The pharmacist or student then not only makes bedside delivery of the medication after surgery, but also provides counseling and other supplies a patient needs, such as oral dosing syringes.
“Our patients and parents love it,” says Kristen Baron, PharmD, Transitions of Care pharmacist at Nationwide Children’s. “There’s no extra stop after they go home, and they do not have to wait in line at the pharmacy to pick up medications after surgery.”
An initial survey of patients and families after the program began found that 97 percent were “very satisfied,” and 100 percent said they would recommend it. A typical month involves deliveries to approximately 15 to 25 outpatient Urology surgery patients, Baron says.
Since the pilot program began with the Section of Urology in 2014, the Medication Discharge Delivery Service has expanded to include certain patients in the Emergency Department, as well as Pulmonary Medicine and General Pediatrics inpatient units. Outpatient Pharmacy Services eventually would like to offer the program to other surgical specialties for their outpatient cases, Barron says.
For now, many of those phone calls to Urology about medications have stopped.
“We get fewer phone calls, but more importantly, we’re ensuring that these children are getting the correct medication,” says Dr. Alpert, who is also a clinical associate professor of Urology at The Ohio State University School of Medicine. “Ultimately, we are providing better patient care.”