Evaluation of an Innovative Transitional Care Clinic in an Interprofessional Teaching Practice

During transitions of care, great opportunity exists for miscommunication, poor care coordination, adverse events, medication errors and unnecessary healthcare utilization costing billions of dollars annually. An Interprofessional Transitions of Care (IPTC) clinic was developed utilizing a Family Medicine team that included physicians, nurses, a clinical social worker, and a clinical pharmacist. The purpose of this study was to determine if utilization of an IPTC clinic prevented hospital readmission, and to identify factors that predict most benefit from an interprofessional approach to transitions of care. A retrospective chart review of 1,001 patients was completed. A treatment group (TG) of 501 patients were offered IPTC clinic appointments following hospital discharge. A control group (CG) of 500 patients were hospitalized and received traditional follow-up prior to development of the IPTC clinic. Traditional follow-up typically consisted of an automated appointment reminder and a physician office visit. Outcomes assessed included 30-day hospital readmission of TG versus CG, and whether patient characteristics predisposed specific patient groups to attend IPTC appointments or benefit more from IPTC participation. Compared with CG, patients who completed an IPTC appointment were 48% less likely to be readmitted to the hospital within 30 days. Patients with congestive heart failure and cellulitis particularly benefited from IPTC. Telephone contact within two business days of discharge was the greatest predictor of patients attending an IPTC appointment. These results demonstrate that an interprofessional approach to transitions in care effectively addresses this high risk for error and high cost time in the continuum of care

Effectiveness of an Adapted Virtual Medication Reconciliation OSCE Compared with In Person OSCE

Introduction: The objective of this study was to measure virtually-based objective structured clinical exam (OSCE) pass rates of student pharmacists who received remote, synchronous instruction on medication reconciliation compared with OSCE pass rates from the previous class, who received face to face synchronous instruction and OSCEs. The secondary objective was to measure student perceptions of remote instruction and OSCE preparation. Materials and Methods: Second year student pharmacists attended four online preparatory labs to learn and practice the process of performing a medication reconciliation. A virtually-based OSCE was used to assess student competency of identifying the primary or life-threatening medication related problem (MRP). Failing to identify the MRP represented a “kill point” and an automatic failing grade. A brief 10-item survey designed to measure student perceptions was sent to all participants post OSCE. Results: Seventy-seven students completed the OSCE and the overall pass rates were similar between the 2020 and 2019 class years (97% vs 94%, respectively; p = 0.24). Survey responses showed students lacked confidence, preferred face-to-face learning rather than online and most described their remote environments as not conducive to learning. Conclusion: Online instruction and assessment was at least as effective as traditional face-to-face methods. however the virtual-based platform was not preferred by learners