The RACGP and Advanced Pharmacy Australia have released a resource to help navigate the patient journey from hospital to general practice, and vice versa.
The RACGP, in collaboration with the Advanced Pharmacy Australia, formerly the Society of Hospital Pharmacists of Australia, has released guidance to help navigate the “riskiest stages of the patient journey”.
The resource, aimed at patients, doctors and pharmacists, outlines how to support patient transitions through the health system.
It comprises of three parts: a practice update outlining the role of hospital pharmacists, general practice pharmacists and GPs, a ticklist for health professionals and a ticklist for consumers.
Speaking to The Medical Republic, chair of the RACGP’s hospital medicine special interest group Dr Sue Hookey said, as a GP liaison from Royal Melbourne, she was really excited about the clarity that this document provided on the scope of practice of the health professionals involved.
This week, Dr Hookey had a patient present with cognitive decline who was unable to accurately answer questions about their health history and medications.
“This was a transition of care from an outside specialist to another hospital,” she said.
“[They] didn’t involve the GP, and so we didn’t have a proper medication list [or an] up-to-date summary from primary care.
“My Health Record was not up to date.
“I think these documents remind everybody of the responsibilities and also share [that] with the consumer.”
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Dr Hookey said that home medicine reviews can be very helpful for ensuring that medication lists are up to date and that the ticklists could improve continuity of case and could help reduce readmissions.
But it would be important to disseminate the resource, she said. She planned on sharing these with her GP liaisons colleagues, as well as the hospital’s consumer reference group.
AdPha president Tom Simpson said communication and collaboration was key to avoiding adverse outcomes and hailed the interdisciplinary collaboration in making the resource.
“Research shows medication-related adverse events occur in approximately 20% of patients following discharge, two-thirds of which are considered preventable,” he said.
“Safely transitioning from primary to acute care, and back to primary care following a significant health event, relies on clear, accurate and timely communication between healthcare providers in both sectors, and with the patient and/or their carer.
“Often, it is the lack of clear, accurate and timely communication, and clearly defined, agreed responsibilities at transitions of care, that lead to medication-related errors and adverse events.
“As pharmacy and medical teams work together to guide patients through care transitions, it’s fantastic they now have a resource kit to promote continuity of care, optimise medication management, and reduce the risk of medication-related issues.”
RACGP president Dr Michael Wright said improving the hospital-GP transition a priority for the college.
“Appropriate clinical handover reduces the risk of readmission to hospital after discharge,” he said.
“These resources will strengthen collaboration between specialist GPs, general practice-based pharmacists, and hospital pharmacists to ensure best practice team care and better patient outcomes.”
