Enhancing the quality of medicine handover at hospital discharge: a priority setting workshop

Abstract

Background: When a patient is discharged from hospital it is essential that their general practitioner (GPs) and community pharmacist are informed of changes to their medicines. This necessitates effective communication and information-sharing between hospitals and primary care clinicians. Objective: To identify priority medicine handover issues and solutions to inform the co-design and development of a multifaceted intervention. Method: A modified nominal group technique was used to reach consensus on medicine handover priority areas. The first hour of an interactive 2-hr workshop focused on ranking pre-identified issues drawn from literature. In the second hour, participants identified solutions that they then ranked from highest to lowest priority through an online platform. Descriptive statistics were used to analyse workshop data. Results: In total 32 participants attended the workshop including hospital doctors ( n = 8, 25.0%), GPs and hospital pharmacists ( n = 6 each, 18.8%), consumers and community pharmacists ( n = 4 each, 12.5%), and both hospital and aged care facility nurses ( n = 2 each 6.3%). From the list of 23 issues, the highest ranked issue was high workload and time pressures impacting the discharge process (22/32). From the list of 36 solutions, the participants identified two solutions that were equally ranked highest (12/27 each). They were mandating that patients leave hospital with a discharge summary, including medication reconciliation information and, developing an integrated information technology system where medication summary and notes are accessible for primary, secondary and tertiary health provider. Conclusion: The consensus process highlighted challenges in hospital procedures where potential solutions may be implemented through co-design of a multifaceted intervention to improve medicine handover quality.