Background: Timely and efficient communication between pharmacists and physician providers in the hospital setting is integral to patient care. Inpatient care involves discussions regarding medication dosing, timing, contraindications, side-effect surveillance, and medication reconciliation during admission and discharge, often requiring pharmacy consultation. The current system of communication in our institution relies on electronic pages to be sent between the provider and the pharmacist, often resulting in disruption of work flow and delays in patient care and discharge. The majority of our residents surveyed reported dissatisfaction with the current method of communication with pharmacists.
Purpose: The aim of this project was to enhance physician and pharmacist communication by geographically co-locating pharmacists in our general medicine team rooms. To achieve this aim, general medicine team rooms were equipped with a work station for pharmacists. Pharmacists were co-located in the team rooms and were available during rounds and the work day to answer all questions. Medication reconciliation for admission and discharges were often done with direct supervision by pharmacists, when able. Outcomes monitored included physician and pharmacist satisfaction, pre and post intervention paging frequency, and time to discharge medication reconciliation.
Description: At baseline, 10% of total pages sent to residents were from pharmacists. Our intervention was associated with a 77% reduction in paging between residents and pharmacists. Post-intervention survey data showed that 100% of respondents agreed or strongly agreed that co-location resulted in improved efficiency, communication, and the discharge process overall. Further, our intervention was associated with a 19% reduction in time it took for pharmacists to complete discharge medication discussions with the patient after physician reconciliation.
Conclusions: Communication between physician providers and pharmacists was difficult with our electronic paging technique resulting in provider dissatisfaction and delays in patient care. Geographic co-location between pharmacists and physicians was associated with improved provider satisfaction, improved sense of communication and efficiency, decreased time to discharge medical reconciliation, and reduced paging burden. Future directions may include determining the efficacy of co-location of the complete, multidisciplinary team.