Written by and published in Elements magazine, September 15, 2016
When patients are discharged from the hospital, they must transition to caring for themselves in a home setting, which can be difficult. It’s well known that independent community pharmacies can help these patients with their prescription needs, but if your pharmacy only focuses on prescriptions, you could be missing out on an opportunity in the front end.
“Pharmacists are in an ideal position to become a liaison for these patients, as they’re one of the most trusted health care professionals,” said Dave Wendland, vice president, strategic relations and member of the owners group at Hamacher Research Group, a leading partner in category management, business strategy and marketing services focused on consumer health care at retail.
“Most patients being discharged for acute conditions or chronic care situations are likely to require prescription medication, so aligning pharmacists with the role of managing both the regimen of Rx along with the complement of non-prescription products puts them in an empowered position,” he said.
Hospital readmissions
Readmitting patients to the hospital after a procedure costs the U.S. health care system more than $40 billion annually, according to a study by the Agency for Healthcare Research and Quality (AHRQ).
And of that $40 billion, more than $4 billion is due to Medicare patients suffering from congestive heart failure, septicemia and pneumonia, and being readmitted to the hospital within the first 30 days of discharge.
The magnitude of readmissions is scary and costly, and pharmacists have an opportunity to help as the health care system continues to work toward reducing the number of hospital readmissions.
“Pharmacists are in a unique position because they can be the educational resource or guidepost to the patient and the family caregiver, providing insight, knowledge, access and comfort to help ease the process,” Wendland said.
It’s often not feasible for nurses, attending physicians or a hospital liaison to fully assist with a patient’s transition. Nurses and physicians are caring for a multitude of patients, and are unable to maintain relationships with patients after they leave the hospital in ways that pharmacists can, Wendland said.
Retail opportunities
What independent community pharmacists haven’t yet recognized is how being that liaison for transitional patients provides a significant retail opportunity. “The pharmacy has the products and services that the patient is going to need,” Wendland said. “It can be very profitable for community pharmacies in particular, because of their ability to get close to the patient and have that long-lasting relationship.”
Pharmacies can provide non-prescription products that complement those prescriptions patients need and increase their bottom line at the same time.
Retail products for transitional patients should cover the activities of daily living (ADLs) that patients in the recovery period or those living with a chronic condition need. These activities include mobility, feeding, toileting and bathing.
“If pharmacists emphasize those areas of products and build a portfolio to care for patients being discharged, they can provide a holistic end-to-end solution for patients,” Wendland said. “This could give independent pharmacies another leg up on the competition.”
Promoting transitional products and services
But how do pharmacists make patients and caregivers aware of everything they offer during these transitional periods?
Wendland recommends taking a look at your store merchandising. This may require pharmacies to break away from the traditional approach to merchandising, and instead organize front-end products by transitional need states or with a color coordinated system based on need state.
Another option is creating an inventory checklist based on condition. “If someone is being discharged, make a list of the items that individual should be aware of that you stock in your store. Create it in a bookmark size and include it in a discharge packet that you give to the patient,” Wendland said.
You can also post these inventory checklists on your pharmacy’s website for added convenience. When patients, or caregivers, are searching for information on self-care after discharge, they can easily see how your pharmacy can help meet their needs.
Educating transitional patients
Besides stocking the products patients require, pharmacists also need to provide patients and their caregivers with proper education and counseling to ensure a smooth transition.
“If someone is really interested in managing their condition effectively, that’s not an individual responsibility, it’s a team sport,” Wendland said.
By conducting educational sessions, pharmacists can let family members know how their lifestyle may need to change in order to support their loved ones, and what the pharmacy can offer to assist with the transition.
It’s also important to examine a patient’s reason for discharge, identify his needs and make sure all pharmacy staff are prepared to act as resources.
Wendland suggests pharmacists provide educational workshops or home visits as an additional benefit. “Think about what it would look like if a pharmacist went to an individual’s home, sat with them upon release from the hospital and said, ‘Here are some things you may encounter as you recover, here’s how we can service you, and here’s a 24-hour access number so if there’s anything you need in your transition, I’m available,’” he said.
He also suggests inviting patients and caregivers into the pharmacy and conducting a tour. You can introduce them to everything the pharmacy has to offer and explain the products available in more detail. In addition to the tour, it’s important for pharmacists to let patients know about products outside of the pharmacy that they have access to. For example, while you may not have space for products, such as lift chairs, bed rails or grab bars in your store, let patients know that those items are available.
Taking these extra steps is beneficial for patients because it gives them a clear picture of the products and services available to help them adjust.
Future outlook
The retail opportunity for pharmacies created by transitions of care is an untouched market. And, according to Wendland, independent community pharmacies need to recognize this small window of opportunity before someone else owns the space.
“Someone is going to recognize the tidal wave of opportunity,” he said.
While there are currently pharmacists working with hospital systems regarding educating discharged patients, no one is providing an end-to-end solution for patients struggling with transitions of care, he said.
Wendland suggests starting small by meeting with discharge nurses, reorganizing the pharmacy and making inventory checklists for patients’ conditions.
“Don’t just think about how often you hear that question or find yourself in that place,” he said. “Innovate right now. Create a solution and start promoting it as a point of difference.”
Top 5 Reasons for Hospital Readmission
- Congestive heart failure
- Septicemia
- Pneumonia
- Bronchitis
- Cardiac arrhythmia
Source: Agency for Healthcare Research and Quality (AHRQ)
Retail Product Categories to Stock
Dave Wendland, vice president, strategic relations and member of the owners group at Hamacher Research Group, points to four retail categories to address patients’ transitional needs: prevention, monitoring, recovery and management. Each category calls for certain products the pharmacy should carry based on patients’ transitional needs.
Prevention: Avoid illness and maintain health
Product categories: Vitamins, minerals, supplements, fitness support and wearables, skin care and protection, smoking cessation and general health products
Monitoring: Have a family history or pre-diagnosis
Product categories: Diagnostic equipment, wearables for monitoring, weight management products and services and general health care products
Recovery: Need for post-acute care
Product categories: Hydration products, probiotics, supplements, wound care products and mobility products
Management: Living with a chronic condition
Product categories: Any products necessary to manage and monitor the condition and contribute to the patient’s well-being