title: Implementation of an emergency department-based clinical pharmacist transitions-of-care program.
abstract: OBJECTIVE
  The implementation of an emergency department (ED)-based clinical pharmacist transitions-of-care (TOC) program is described.
  
  
  CONCLUSIONS
  The intervention program consisted of collaboration between ED and ambulatory care pharmacists to provide patient-specific comprehensive medication review and education in the ED setting and to help ensure a coordinated transition to the ambulatory care setting by scheduling an ambulatory pharmacy clinic or home-based visit. Patients who sought care at an adult ED for an exacerbation of asthma, chronic obstructive pulmonary disease (COPD), or congestive heart failure (CHF) were assessed for issues with medication adherence or administration technique, patient-specific concerns regarding medication use, access to medications at discharge, the need for modification of chronic therapy, contraindicated medications, and vaccination status, if applicable. The pharmacist then referred the patient to follow up in an ambulatory care pharmacy clinic or with the home-based medication management (HBMM) program. Of the 18 program participants who were referred to follow-up care, 5 successfully followed up with a pharmacist after ED discharge. The mean time from the ED visit to follow-up for these 5 patients was 16.6 ± 8.6 days. In addition, 5 patients followed up with their primary care provider within 30 days of the initial ED visit; 2 of these patients also followed up with a pharmacist. Within 30 days of the initial ED encounter, 4 patients had ED revisits.
  
  
  CONCLUSIONS
  A TOC pharmacist-led program targeting patients who arrived at the ED with the chief complaint of asthma exacerbation, COPD, or CHF provided interventions from an ED or ambulatory care pharmacist as well as follow-up opportunities at outpatient clinics or an HBMM program.
authors.affiliation: Department of Pharmacy, Johns Hopkins Medical Institutions, Baltimore, MD. e-hohner@onu.edu.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hohner
authors.affiliation: Department of Pharmacy, Johns Hopkins Medical Institutions, Baltimore, MD.
authors.forename: Melinda
authors.initials: M
authors.lastname: Ortmann
authors.affiliation: Department of Pharmacy, Johns Hopkins Medical Institutions, Baltimore, MD.
authors.forename: Umbreen
authors.initials: U
authors.lastname: Murtaza
authors.affiliation: Department of Pharmacy, Johns Hopkins Medical Institutions, Baltimore, MD.
authors.forename: Sheeva
authors.initials: S
authors.lastname: Chopra
authors.affiliation: Department of Pharmacy, Johns Hopkins Medical Institutions, Baltimore, MD.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Ross
authors.affiliation: Department of Pharmacy, Johns Hopkins Medical Institutions, Baltimore, MD.
authors.forename: Meghan
authors.initials: M
authors.lastname: Swarthout
authors.affiliation: Department of Pharmacy, Johns Hopkins Medical Institutions, Baltimore, MD.
authors.forename: Leigh
authors.initials: L
authors.lastname: Efird
authors.affiliation: Department of Pharmacy, Johns Hopkins Medical Institutions, Baltimore, MD.
authors.forename: Emily
authors.initials: E
authors.lastname: Pherson
authors.affiliation: Department of Emergency Medicine, Johns Hopkins Medical Institutions, Baltimore, MD.
authors.forename: Mustapha
authors.initials: M
authors.lastname: Saheed
mesh_terms: D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy; D004636:Emergency Service, Hospital / Q000639:trends*; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D010360:Patient Transfer / Q000379:methods / Q000639:trends*; D004364:Pharmaceutical Preparations / Q000008:administration & dosage; D010595:Pharmacists / Q000639:trends*; D010607:Pharmacy Service, Hospital / Q000379:methods / Q000639:trends*; D016730:Program Development / Q000379:methods; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D004364:Pharmaceutical Preparations