Enhancement of a pharmacy consultation program on a transitional care unit

The revision and outcomes of a pharmacy consultation program on a transitional care unit (TCU) are described. In 1996, the pharmacy consultation program for the TCU at a 550-bed, tertiary care, community teaching hospital was revised. The changes included increasing the number and depth of medication reviews, mandating pharmacist attendance at interdisciplinary meetings, simplifying the medication review form, and expanding physician education. Data collected during the final two years of the original program (May 1994 to April 1996) and the first two years of the revised program (July 1996 to August 1998) were compared. The number of drug-related problems identified per admission was 0.80 for the revised program (versus 0.32 for the original program), the percentage of patients receiving at least one pharmacy medication review was 99% (versus 70%), the number of pharmacist recommendations made was 726 (versus 140), and the percentage of recommendations accepted was 82% (versus 55%). The program required up to 15 hours of pharmacist time per week. Cost savings were estimated at $15,000 for the first year of the revised program and $23,000 for the second year. Revision of the pharmacy consultation program for a TCU increased the identification of drug-related problems and the number of pharmacist recommendations, helped integrate pharmacists into the interdisciplinary care team, and produced a modest estimated cost savings.