Improved patient safety and outcomes with a comprehensive interdisciplinary improvement initiative in kidney transplant recipients

Am J Med Qual. 2013 Mar-Apr;28(2):103-12. doi: 10.1177/1062860612450309. Epub 2012 Jul 22.

Abstract

Although kidney transplant recipients at the authors' institution had a short length of stay (LOS), delayed discharges and early readmissions were common; medication use and safety were at the core of these issues. A multidisciplinary quality improvement initiative was developed that targeted eliminating these issues. The team developed key initiatives including improved medication reconciliation, development of a diabetes management service, and improved discharge medication dispensing, delivery, education, and scrutiny. Follow-up analysis demonstrated reduced medication discrepancies by >2 per patient and obtaining 100% adherence with reconciliation. Pharmacists reviewed discharge medications, reaching 100% by study end, leading to a 40% reduction in medication safety issues. LOS remained short, and delayed discharges were reduced by 14%; 7-day readmission rates decreased by 50%. Acute rejection and infection rates also significantly decreased. In conclusion, a multidisciplinary quality improvement initiative can improve medication safety in kidney transplant patients, which can lead to improved clinical outcomes.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Infective Agents / therapeutic use
  • Continuity of Patient Care / organization & administration*
  • Diabetes Mellitus / therapy
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Interprofessional Relations
  • Kidney Transplantation*
  • Male
  • Medication Reconciliation / organization & administration
  • Middle Aged
  • Patient Care Management / organization & administration*
  • Patient Care Team / organization & administration
  • Patient Education as Topic / organization & administration
  • Patient Safety*
  • Quality Improvement / organization & administration*
  • Racial Groups
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Infective Agents
  • Immunosuppressive Agents