NCT05241951

Preventing Medication-Related Problems in Care Transitions to Skilled Nursing Facilities

Preventing Medication-Related Problems in Care Transitions to Skilled Nursing Facilities Using a Pharmacy Integrated Transitional Team

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 1,052 (actual)
• Sponsor: University of Washington · Academic / Other
• Sex: All
• Age: 18 Years
• Healthy volunteers: Not accepted

Summary

The Pharmacy Integrated Transitions (PIT) program, utilizes a crossover randomized control design to evaluate the impact of a clinical pharmacist in decreasing medication related problems during a patient's transition from hospital to skilled nursing facility (SNF).

Detailed description

Standard hospital discharge processes (e.g. as recommended by the Joint Commission Center for Transforming Healthcare), include hospital staff completing a paper-based discharge summary and medication reconciliation form. To reduce the likelihood of medication-related problems during care transitions, the Pharmacy Integrated Transitions (PIT) program aims to improve the standard transition process by adding a coordinating transitional pharmacist to provide a structured synchronous "warm-handoff" between clinical teams at the hospital and the Skilled Nursing Facility, in addition to reconciling, adjusting, and monitoring medications during and after discharge from the hospital.

Conditions

• Care Transition

Interventions

Type	Name	Description
OTHER	Structured hand-off	Use of standardized checklist to provide synchronous or asynchronous handoff that conveys medication recommendations to the SNF clinical teams
OTHER	Medication reconciliation during transitional period	Comprehensive medication reconciliation conducted during transitional period between hospital and SNF, focused on SNF-specific requirements for medication delivery (e.g., stop dates, titration instructions)
OTHER	Transitional medication monitoring	Review of medication orders during first 7 days of SNF admittance to address barriers to translation of medication orders and appropriate medication delivery
OTHER	Teleconsultation	Ad hoc consultation to provide additional clarification to SNF clinical teams

Timeline

• Start date: 2022-01-31
• Primary completion: 2024-03-01
• Completion: 2025-10-31
• First posted: 2022-02-16
• Last updated: 2025-11-24

Locations

1 site across 1 country: United States