Lana Witt, PharmD, wants to improve patients' transitions from hospitals to their homes or skilled nursing facilities.
If hospitals don't proactively plan for a patient's departure, length of stays can rise — and clog up limited bed availability — and if the transition is poor, the risk of readmission rises, according to Dr. Witt, the pharmacy director of Palo Alto, Calif.-based Stanford Health.
At Stanford, there are 800 patients in the hospital and 100 discharged to home or skilled nursing sites each day, she said. Dr. Witt has been working with a team of about 10 people since December 2022 to accomplish a smooth transition with "the most good."
"What we're most involved with is access to medication. Where can patients get their medications once they leave the hospital?" Dr. Witt said. "Retail pharmacies are undergoing massive changes. They've got workforce issues, they've got reimbursement issues. The workload is just increasing. Retail pharmac[ies], where most patients get their meds, are having a hard time filling the prescriptions we send patients home on. At the same time, prior authorization is taking a lot of time to get payers to agree patients need this medication."
Despite these constraints, hospital pharmacy directors can still focus on improving education during the discharge process, Dr. Witt said. Some of these controls include setting up reminders for the patients and ensuring they understand each drug's benefit, the importance of filling the prescription and correct adherence with dosing.
Dr. Witt said constructing transition plans to guarantee all patients are able to get and take their treatments — also known as "pharmacoequity" — delivers on the belief that "everyone deserves the best medications."