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Patient satisfaction improves under PDAS model
Implementation of a pharmacy service that provides dosing, monitoring, education, and ensured safe transition from the inpatient to the outpatient setting is associated with improved patient satisfaction with overall care and with care related to anticoagulation management, according to a study published in the Annals of Pharmacotherapy.
PDAS gets props
A Henry Ford Hospital study found that a pharmacist-directed inpatient anticoagulation service (PDAS) might provide an unexpected opportunity. In a survey of 689 patients who received inpatient anticoagulant therapy, when PDAS was involved, patient satisfaction increased significantly compared to patients' reviews of their care under a previous pharmacy model.
Patients were included if they responded to a mail-in survey and had received inpatient anticoagulation from February 2001 to April 2007, before PDAS was implemented, and from December 2008 to December 2010, after implementation.
Survey items included patient satisfaction, amount of information, clarity of information, quality of the answers, and communication with a pharmacist ("Did a pharmacist speak with you during your stay?").
Response options for amount of information, clarity of information, answer quality, and satisfaction used a symmetric 5-point Likert-type scale, with options 1 to 5 indicating most positive to least positive, respectively. Options 1 and 2 were considered positive and options 3 to 5 were considered negative.
Primary analysis compared patient satisfaction (defined as rate of positive responses) between pre-PDAS and post-PDAS respondents. χ2 Test was used for all comparisons.
“Surveys were divided into those completed prior to implementation of a PDAS and those completed after implementation of the service,” James Kalus, PharmD, senior clinical pharmacy manager at Henry Ford Hospital and senior author of the study, told Formulary. “Positive response rate on the 5 items in the survey were compared between patients completing the survey before and after service implementation.”
Key findings include:
• Overall satisfaction with medical care rose 10.6%.
• Satisfaction with the amount of information communicated about patients’ drug therapy rose 37.2%.
• Satisfaction with the clarity of information communicated to patients about their drug therapy rose 35.2%.
• Satisfaction with the quality of answers provided by the pharmacist to their questions rose 29.5%.
“The study not only demonstrated higher satisfaction with care related to anticoagulant management with implementation of the new service; it also showed higher overall satisfaction with the healthcare experience,” Dr Kalus said.
Since implementing the PDAS model 4 years ago, Henry Ford has reduced the risk of bleeding and thrombosis and other complications by 5% and achieved more than 70% success with patients transitioning from the hospital to an outpatient clinic.
This is believed to be the first study to show patient satisfaction with a pharmacy program.
“This study is important because it demonstrates improvement in patient satisfaction through employment of a model that has previously been shown to improve safety, efficacy, and care transitions with anticoagulant medications,” Dr Kalus said. “As many hospitals are struggling to improve patient perceptions of their healthcare experience, this study suggests that targeted services provided by pharmacists may provide added benefits of improving patient satisfaction data.
He added, “Systematically deployed clinical pharmacy services, in which a structured pharmacist-patient relationship is formed, may result in improvements in patients’ perception of the care provided during an inpatient encounter.”