Accident and emergency

Had a couple of interesting examples this week of where communication channels and discharge procedures from hospitals can go wrong and leave patients uninformed and confused. I know that the evidence-base suggests that there is always room for improvement in discharge procedures, not least of all actively involving the patient’s community pharmacist. And the local hospital here does, since we are regularly faxed discharge summaries of our patients. However, these are a couple of patients who slipped through the loop this week:
- One parkinson’s disease patient who had been changed from one levodopa combination to another by the hospital. We received their new prescription from the GP with the directions of ‘MDU’ and so enquired if the patient knew how to take their new medicine. They didn’t and neither did the GP practice when we checked it with them. So we left it with the GP practice to ring the hospital and get back to us and the patient.
- A patient who had gone into hospital for ‘some checks’ and come out with a HF prescription for an ACE inhibitor starter pack, spironolactone, digoxin and a beta blocker; no counselling and a follow-up appointment in 2 weeks time. So I particularly made sure that he knew how to take the first doses of the ACE inhibitor and what the ‘warning’ side effects were with digoxin.
And of course these ‘significant’ interventions were recorded in the patients’ PMRs as part of the new pharmacy contract.