People with complex medication routines who are admitted to the hospital are at a higher risk for readmission due to several factors, including gaps in the continuity of care. Care transitions can be difficult and as patients transition from the hospital setting to home, they are particularly vulnerable to medical error, especially to adverse drug events (ADEs).
Three Rivers Community Coalition in northeast Mississippi saw this as an opportunity for improvement in their rural community. Working with atom Alliance quality improvement advisors and the local hospital, the Coalition implemented pharmacy-directed transitional care in 2013. As a result, the rate of hospital readmissions for patients receiving this intervention has dropped from 26 percent to about 10 percent in five years.