title: The impact of a Continuum of Care Resident Pharmacist on heart failure readmissions and discharge instructions at a community hospital.
abstract: OBJECTIVE
  To examine the impact of a Continuum of Care Resident Pharmacist on (1) heart failure 30-day hospital readmissions and (2) compliance with Joint Commission Heart Failure core measure 1 at a community hospital.
  
  
  METHODS
  The Continuum of Care Network led by a Continuum of Care Resident Pharmacist was established in August 2011. The Continuum of Care Resident Pharmacist followed Continuum of Care Network patients and retrospectively collected data from August 2011 to December 2012. Thirty-day readmission rates for Continuum of Care Network heart failure patients versus non-Continuum of Care Network heart failure patients were compared and analyzed. Joint Commission Heart Failure core measure 1 compliance rates were retrospectively collected from January 2011 and compared to data after establishment of the Continuum of Care Network.
  
  
  RESULTS
  In all, 162 Continuum of Care Network patients and 470 non-Continuum of Care Network patients were discharged with a diagnosis of heart failure from August 2011 to December 2012. Continuum of Care Network heart failure patients had a lower 30-day all-cause readmission rate compared to non-Continuum of Care Network heart failure patients (12% versus 24%, respectively; p = 0.005). In addition, Heart Failure core measure 1 compliance rates improved from the 80th percentile to the 90th percentile after implementation of the Continuum of Care Network (p = 0.004). The top three interventions performed by the Continuum of Care Resident Pharmacist were discharge counseling (74.1%), providing a MedActionPlan(™) (68.5%), and resolving medication reconciliation discrepancies (64.8%).
  
  
  CONCLUSIONS
  The study findings suggest that a Continuum of Care Resident Pharmacist contributed to lowered heart failure readmission rates and improved Heart Failure core measure 1 compliance rates. Future randomized, controlled trials are needed to confirm these findings.
authors.affiliation: Keck Graduate Institute School of Pharmacy, Claremont, CA, USA.
authors.forename: Julie T
authors.initials: JT
authors.lastname: Truong
authors.affiliation: Frederick Memorial Hospital, Frederick, MD, USA.
authors.forename: Andrea C
authors.initials: AC
authors.lastname: Backes
keywords: Hospital readmissions; discharge instructions; heart failure; transitions of care