Optimizing the Use of Discharge Medication Lists in Nursing Facilities.

OBJECTIVE: To highlight the need to optimize the use of discharge medication lists in nursing facilities.

SETTING: In January 2014, the care transitions (CT) pharmacists at Frederick Memorial Hospital, Frederick, Maryland, began a pilot project in which they identified and followed high-risk patients transitioning from hospital to nursing facility and from nursing facility to home.

PRACTICE DESCRIPTION: This pilot project served as a needs assessment to identify opportunities to improve patients' transition from nursing facility to home with the goal of reducing hospital readmissions.

PRACTICE INNOVATION: One of the enormous opportunities that were immediately recognized was the nursing facility discharge medication list.

MAIN OUTCOME MEASUREMENTS: The CT pharmacists found that patients had difficulty deciphering and understanding the medication lists.

RESULTS: By reviewing the elements of existing medication lists, the CT pharmacists identified 11 components of a nursing facility discharge medication list that would increase patient safety and potentially reduce medication-related hospital readmissions. These elements include the capability of electronically generating a medication list that includes both brand and generic medication names with accurate indications in layperson terms. The ideal discharge medication list would also be patient-specific and remove irrelevant information and take into consideration patients' age, vision, and health literacy.

CONCLUSION: With the upcoming implementation of the nursing facility value-based purchasing program, nursing facilities may soon receive incentives to improve their medication management systems at discharge.