Reducing Discharge Delay Through Resident-Pharmacist Colocation: A Pilot Study

BACKGROUND AND OBJECTIVES: Discharge delay of hospitalized patients is costly, inefficient, and can impede care of pending admissions. Through pharmacist colocation and daily discharge medication reconciliation meetings, we aimed to improve discharge efficiency and decrease the number of electronic pages. METHODS: We conducted a quality improvement initiative on the family medicine inpatient teaching service at a large academic medical center using two interventions: colocation and daily discharge medication reconciliation meetings of pharmacist and family medicine residents. We assessed: (1) discharge delay, defined as the time between discharge order and pharmacist's completion of discharge medication reconciliation and patient education; (2) the number of electronic messages between the pharmacist and family medicine team, assessed 1 month before and 1 month after implementation of the interventions. We also assessed team members' postinitiative views on collaboration, discharge safety, and timeliness, and knowledge acquisition using three 5-point Likert statements. RESULTS: Ninety-five preintervention and 54 postintervention patients met eligibility criteria. Discharge delay prior to intervention was 72.7 +/- 58.4 minutes and 47.6 +/- 37.4 minutes postintervention. The number of electronic messages between pharmacist and family medicine team pager decreased from 118 to 14 during the months studied. Team members felt collaboration, safe and timely discharges, and acquisition of new knowledge improved. CONCLUSIONS: Colocation of workspaces and daily medication reconciliation meetings were associated with decreased discharge delay and decreased pages between team members. Further study is needed to assess its reproducibility, impact on resident education and patient satisfaction, cost-effectiveness, and ability to scale to other services.