Background: The Integrated Medicines oPtimisAtion on Care Transfer (IMPACT) project aimed to enhance assessment of post-discharge needs for patients on the acute older people admission wards at Leeds Teaching Hospitals NHS Trust. Post-discharge needs e.g. clinical follow up or medicines support were communicated to healthcare professionals in primary care and patients/ carers were educated about their medicines.
Innovation: We aimed to determine if IMPACT prevented patients from being re-admitted to hospital with medicine-related problems. IMPACT patients who were re-admitted within 30 days of discharge and had their cases reviewed by a Consultant Physician for Older People and a Consultant Pharmacist. The cases of 3 additional patients were reviewed after feedback from practice pharmacists in primary care.
Evaluation: All elderly admissions were screened, 351 were high risk, 180 were given a medicines care plan.
33 readmissions were reviewed, 11 patients were admitted due to a medicines-related problem. Of the 30 patients who were re-admitted within 30 days, 6 were re-admitted with medicines-related problems. The types of medicines identified as a cause of admission or re-admission are shown below.
The causes of the other re-admissions were multi-factorial and included chest infection, mechanical fall, heart failure, urinary tract infection and reduced mobility/ increased confusion.
The overall 30 day re-admission rate for the older people admission wards was 20% over the course of the 6 month project. The re-admission rate for IMPACT patients was 17%.
Conclusions: The review of re-admissions as part of the IMPACT project found a 3 percentage point reduction in overall 30-day re-admission rate, although due to the multi-factorial nature of admissions in this population, it was not possible to attribute this reduction to the project intervention