GUIDANCE ON DISCHARGE AND

TRANSFER PLANNING

By
Vijay Nikam

MOVING PATIENTS AND MEDICINES VERY SAFELY

 Contents
 Introduction
 Aim of guidance
 Patients Journey
 Pharmacy Strategies
 Community pharmacy
 Research Evidences
 Adv. of re-engineered services
 Elements of successful services
 Potential interventions
 Action plan
 Why in India
 INTRODUCTION
 Taking any medicines is an
inherently risky business
 There are chance of adverse event
 Use of good practices to minimize
the risk to patients
 Engaging pharmacist and others with
experience of medicines is essential
 AIM OF GUIDANCE
 To maximize good practices of medicines
management
 To minimize the risk associated with
medicines during transfer or discharge
 To raise the awareness of patient’s experiences
with medicines and discharge
 To develop strategies
 To make recommendations to reduce the risks
of incidents with medicines for patients
 PATIENTS JOURNY

 HOME TO HOSPITAL
 HOSPITAL TO CARE HOME
 WARD TO WARD
 HOSPITAL TO HOSPITAL
 DIAGNOSIS/ TREATMNT AND
TESTING THERAPY

PATIENT
PATIENT DISCHARGE

PATIENT
PROCESSING
 PHARMACY STRATEGIES

 Encouraging greater use of Patient’s

own drugs
 Self administration scheme for patient
 Strengthened communication between
hospitals ,pharmacist ,GPs about
patient’s medicines
 better medicines management
 Greater involvement of pharmacist in
clinical care
 POLICY CONTEXTS

 PHARMACY STRATEGIES
 FRAMEWORK OF COMMUNITY PHARMACY
 NEW GENERAL MEDICAL SERVICES
 DISCHARGE WORKBOOK
 TOOL KIT
PHARMACY STRATEGIES
 COMMUNITY PHARMACY
 Extended role of pharmacist
 Essential services
 Advanced services
 Enhanced services
 RESEARCH EVIDENCES

 COMMUNICATION
 CONSEQUENCES OF POOR
COMMUNICATIONS
 IMPLICATIONS FOR PATIENTS
ELEMENTS OF SUCCESSFUL
SERVICES
 REVIEWING MEDICATION
 OBTAINING PRESCRIPTIONS
 OBTAINING MEDICATIONS
 VERBAL COUNCELLING
 DISCHARGE PRESCRIPTIONS
 ELECTRONIC PRESCRIPTIONS
 CLEAR PRACTICE PROTOCOLS
 POTENTIAL
INTERVENTIONS

 ADMISSION DRUG HISTORIES-

taken by pharmacist
 Self administration schemes for
patient
 Electronic prescriptions
HISTORY
FORM
INSTRUCTIONS TO PATIENT
 ACTION PLAN

 RE-VIEW OF COMMUNICATION
 RE-VIEW OF DRUG HISTORY
 SELF ADMINISTRATION
MANAGEMENT
 ROLE PHARMACIST, DOCTORS &
NURSES
 WHY IN INDIA?

 POOR STATUS OF PHARMACY

 SELECTION OF GENERIC DRUGS
 LACK OF CLINICAL EDUCATION &
TRAINING OF PHARMACIST
 LIMITED RESOURCES