Abstract P185: Feasibility and Outcome of Pharmacist-Enhanced Stroke Rounds

Background: Treatment of stroke patients is complex. Multidisicplinary rounds have been shown to decrease 30-day readmission rates, improve efficiency in work flow, communication between disciplines and promote patient-centered care. Pharmacy-enhanced intensive care unit rounds reduce adverse drug events (ADE) and provide real-time resource for drug selection, interaction and dosages. Reports on the feasibility of pharmacist-enhanced stroke rounds (PEnSR) and its effect on outcomes are few. Objective: Determine the effect of a pharmacy-enhanced stroke-rounds on patient and healthcare outcomes. Methods: A performance improvement analysis was done in the University of Mississippi Medical Center from September 1, 2019 to November 30, 2019. A pharmacist assigned to the stroke service performed medical reconciliation, monitored drug interaction, provided recommendations on drug choice and dosages for the stroke patients and alerts on medication errors. The primary outcome includes the proportion and severity of medication errors detected utilizing the EPIC iVent tool. The secondary outcomes include characteristics of interventions to prevent an ADE, cost-avoidance based on the errors and cost-analysis for the continued presence of a pharmacist for stroke rounds based on time spent to perform the role. A feedback-survey regarding the pharmacist was done at the end of analysis period. Results: A total of 77 interventions were performed during 2 month with a total cost avoidance of $40,250. Most common errors were minor. The most common intervention by the pharmacist was to initiate orders followed by discontinuing orders. Overall time spent daily for the stroke service was 5-hours. All residents and attendings of the stroke service were aware of the pharmacist’s presence, utilized the service and perceived that the PEnSR was beneficial. Conclusion: PEnSR was feasible and cost-effective and allows for the pharmacist to still contribute to other roles in the hospital. PEnSR also improves patient-centered care for stroke patients by preventing ADE resulting in hospital savings of ~$20,000/month. The UMMC-Stroke team has adapted PEnSR as part of the daily multidisciplinary stroke care.