Transition of Care Pharmacy Project (ToCPP)
Transition of Care
Transitions of care are the various points where a patient moves to or returns from a physical location or makes contact with a health professional for the purpose of receiving care.[1] An example of a transition of care is when a patient is discharged from a hospital facility to return to the services delivered by their primary healthcare providers.
Transitions between hospital and primary healthcare settings are associated with an increased risk to patient safety.[2] Changes to medication during a hospital admission are common and it is estimated that over 90% of patients have at least one medication-related problem upon discharge.[3] Such problems include:
- Inaccurate or incomplete transfer of medicines information
- Missing therapy
- Inappropriate medicines
- Inappropriate dose
- Adverse effects
Medication-related problems may lead to patient harm or readmission to hospital. Improving communication and patient handover across healthcare settings may prevent many of these problems.
Transition of Care Pharmacy Project
The Transition of Care Pharmacy Project (ToCPP) was piloted between March 2021 until December 2023 in selected patient services at three hospital facilities:
- Royal Brisbane and Women’s Hospital
- Princess Alexandra Hospital
- Townsville University Hospital
Project interventions included:
- Increased communication of medicine-related information to the patient’s nominated general practitioner and community pharmacy.
- Post-discharge telehealth/telephone review of patients by the hospital pharmacist.
Two pilot models of care were developed in consultation with a project oversight committee consisting of pharmacy, medical, and nursing representatives from hospital and primary health care settings. This included a model of care for patients discharging to home and a model of care for patients discharging to residential aged care facilities (RACFs).
The project has now been finalised and the project final report and service evaluation completed.
An economic evaluation is also being undertaken to determine the economic impact of the service and will be made available once finalised.
[1] World Health Organisation. Medication Safety in Transitions of Care Geneva: World Health Organization; 2019 (WHO/UHC/SDS/2019.9). Licence: CC BY-NC-SA 3.0 IGO; 2019 [cited 2021 Jul 07]. Available from: https://www.who.int/patientsafety/medication-safety/TransitionOfCare.pdf?ua=1.
[2] Roughead EE, Semple SJ, Rosenfeld E. The extent of medication errors and adverse drug reactions throughout the patient journey in acute care in Australia. Int J Evid Based Healthc. 2016;14(3):113-22.
[3] Pharmaceutical Society of Australia. Medicine Safety: Take Care. Canberra: PSA; 2019 [cited 2021 Jun 09]. Available from: https://www.psa.org.au/wp-content/uploads/2019/01/PSA-Medicine-Safety-Report.pdf