title: Local Pharmacy Partnership to Prevent Pediatric Asthma Reutilization in a Satellite Hospital.
abstract: In our previous work, providing medications in-hand at discharge was a key strategy to reduce asthma reutilization (readmissions and emergency revisits) among children in a large, urban county. We sought to spread this work to our satellite hospital in an adjacent county. A key initial barrier was the lack of an outpatient pharmacy on site, so we sought to determine if a partnership with community pharmacies could improve the percentage of patients with medications in-hand at discharge, thus decreasing reutilization.
  
  
  
  A multidisciplinary team partnered with community pharmacies. Using rapid-cycle improvement methods, the team aimed to reduce asthma reutilization by providing medications in-hand at discharge. Run charts were used to display the proportion of patients with asthma discharged with medications in-hand and to track 90-day reutilization rates.
  
  
  
  During the intervention period, the median percentage of patients with asthma who received medications in-hand increased from 0% to 82%. A key intervention was the expansion of the medication in-hand program to all patients. Additional changes included expanding team to evening stakeholders, narrowing the number of community partners, and building electronic tools to support key processes. The mean percentage of patients with asthma discharged from the satellite who had a readmission or emergency department revisit within 90 days of their index admission decreased from 18% to 11%.
  
  
  
  Impacting population-level asthma outcomes requires partnerships between community resources and health providers. When hospital resources are limited, community pharmacies are a potential partner, and providing access to medications in-hand at hospital discharge can reduce asthma reutilization.
authors.affiliation: Division of Hospital Medicine, Department of Pediatrics, and hadley.sauers-ford@cchmc.org.
authors.forename: Hadley S
authors.initials: HS
authors.lastname: Sauers-Ford
authors.affiliation: Department of Patient Services, Cincinnati Children's Hospital Medicine Center, Cincinnati, Ohio; and.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Moore
authors.affiliation: Division of Hospital Medicine, Department of Pediatrics, and.
authors.forename: Amy B
authors.initials: AB
authors.lastname: Guiot
authors.affiliation: Division of Hospital Medicine, Department of Pediatrics, and.
authors.forename: Blair E
authors.initials: BE
authors.lastname: Simpson
authors.affiliation: Division of Hospital Medicine, Department of Pediatrics, and.
authors.forename: Caitlin R
authors.initials: CR
authors.lastname: Clohessy
authors.affiliation: Yost Pharmacy, Mason, Ohio.
authors.forename: David
authors.initials: D
authors.lastname: Yost
authors.affiliation: Department of Patient Services, Cincinnati Children's Hospital Medicine Center, Cincinnati, Ohio; and.
authors.forename: David C
authors.initials: DC
authors.lastname: Mayhaus
authors.affiliation: Division of Hospital Medicine, Department of Pediatrics, and.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Simmons
authors.affiliation: Division of Hospital Medicine, Department of Pediatrics, and.
authors.forename: Craig H
authors.initials: CH
authors.lastname: Gosdin
mesh_terms: D018927:Anti-Asthmatic Agents / Q000008:administration & dosage; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D003157:Community Pharmacy Services / Q000639:trends*; D003266:Continuity of Patient Care / Q000639:trends*; D005260:Female; D006781:Hospitals, Satellite / Q000639:trends*; D006801:Humans; D007223:Infant; D008297:Male; D010359:Patient Readmission / Q000639:trends*
chemical_list: D018927:Anti-Asthmatic Agents