Bridges at and after discharge
| At discharge | After discharge | |
| Bridges | Hospitals have established methods of communicating about patients' treatment with primary care. | Some trusts provide outpatient clinics where patients can receive intravenous fluids, thus avoiding them to need to be admitted to receive these medicines or speeding up discharges. |
| Preparing discharge summaries and To Take Out (TTO) lists is a multidisciplinary task involving nurses and pharmacists. | GP practices have systems for acting on discharge information once it is received, although processes and times to process this information vary. | |
| Ward pharmacists can expedite well-managed discharge through proactively creating TTO lists. | Some practices have targets in place linked to time to process discharge information (eg, 24 hours from receiving this information). | |
| One trust routinely referred patients to community pharmacy for follow-up support with their medicines. | One practice pharmacist re-engineered the process for action on discharge information. | |
| All hospitals had policies for informing patients about their medicines. | Some practices use practice pharmacists to improve and expedite the processing of discharge information. | |
| Heart failure nursing staff attempted to see patients before their discharge to talk about their medicines to avoid having these conversations rushed at discharge. | Community pharmacy is sometimes able to perform postdischarge Medicines Use Review for patients. | |
| In two trusts, ward-based pharmacists would speak to patients about their medicines before discharge. | Two hospital trusts run pharmacist-led titration clinics to manage patients' medicines, meaning that patients can be seen and followed up quickly. | |
| Patients received written information about their medicines, with one trust providing an easy-to-understand medicines chart occasionally annotated by staff. | Some practices have ambulatory services. | |
| Patients are referred to specialist heart failure teams for follow-up. | Heart failure specialist nurses offer support services including medicines optimisation. | |
| Some GP practices have systems to identify discharged patients with high risk of being readmitted so they can take preventative action. |
GP, general practitioner.