(1270) Impact of Pharmacist Intervention on Medication Errors in ICU Transitions of Care

Introduction: ICU to floor transitions result in medication-related errors in almost 50% of patients. Interventions associated with a decreased risk of medication errors include a pharmacist on ICU rounds and the discontinuation and reordering of medications at transfer. Data on the impact of pharmacists in transitions of care is limited to admission and at discharge. The purpose of this study was to compare outcomes in patients with pharmacist intervention to those without review.

Methods: This single-center, pre- and post-pharmacist intervention study was conducted at Temple University Hospital-Main Campus (TUH-MC). The pre-intervention group consisted of patients (n=100) transferred without pharmacist prospective review, between January 1 and June 29, 2023. The post-intervention group consisted of patients (n=100) prospectively reviewed by a pharmacist within 24 hours of transfer from the ICU to the floor, between August 15, 2023 and April 10, 2024. The primary endpoint was the number of medication interventions upon transfer. Secondary endpoints included the number and type of medication classes inappropriately continued at transfer, ICU and 30-day hospital readmission, and inappropriate discharge medications. Endpoints were compared between groups.

Results: Baseline characteristics were similar between both groups except for age, weight, and ICU length of stay. There were a higher number of interventions made in the post-intervention group (163 vs. 82; P=0.795), however there was no difference in ICU readmission and 30-day hospital readmission rates between the pre- and post-intervention groups (ICU readmission 17 vs. 25; P=0.224 and 30-day hospital readmission 36 vs 21; P=0.0584). There was a significant difference in study period cost-avoidance with $21,514 over 72 days in the pre-intervention group and $46,537 over 40 days in the post-intervention group (P=0.000288). The average time spent on prospective reviews was 39 minutes per patient.

Conclusions: Although there was not a statistically significant difference in readmission outcomes, pharmacist interventions provided a potential cost avoidance of $465 per patient. The results of this study provide the framework to outline quality improvement opportunities to identify specific gaps in ICU care transitions that pharmacists could help address.