• Andria F Brantley, Deanna M Rossi, Shalonda Barnes-Warren, Jon Carlo Francisco, Ira Schatten, and Vishwas Dave.
• Osceola Regional Medical Center, Kissimmee, FL. andriabrantley@gmail.com.
• Am J Health Syst Pharm. 2018 Mar 1; 75 (5 Supplement 1): S1-S5.

PurposeThe development and implementation of a hospitalwide, pharmacist-led transitions-of-care (TOC) program are described.MethodsThis 21-week quality improvement initiative was conducted from October 1, 2015, to February 26, 2016, at Memorial Hospital Pembroke. A TOC team was comprised of pharmacists, a pharmacy resident, pharmacy students, a physician, case managers, and nurses. All patients over the age of 18 admitted to the inpatient telemetry unit were included in this initiative. The primary endpoint was a sustained improvement in Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores for "Communication About Medications" and "Care Transitions: Understood the Purpose of Taking Medications." Secondary outcomes included 90% of admission and 80% of discharge medication reconciliations reviewed by a pharmacist.ResultsA total of 661 patients were included. The HCAHPS scores for "Communication About Medications" and "Care Transitions: Understood the Purpose of Taking Medications" had a sustained improvement during the study period. A pharmacist completed 94% and 75% of admission and discharge medication reviews, respectively, and a total of 1,579 interventions were made. Discharge education was completed at a rate of 73%.ConclusionAfter a quality improvement initiative developed by pharmacists was implemented, HCAHPS scores showed improvement and more patients received medication reconciliation.Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

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