“For our patients, knowledge is power,” says Dr. Marilyn Stebbins, whose pharmaceutical innovations help keep newly released patients from landing back in the hospital.
Moving back home after a stay in the hospital is a precarious time, especially for an elderly patient or someone living alone. With so many people underinsured and underserved by transportation, medical care, and other social services, it’s no surprise that nearly 20 percent of Medicare patients discharged from the hospital are readmitted within 30 days.
On the front lines of this perilous territory is Marilyn Stebbins, PharmD ’88, who joined the UCSF Department of Clinical Pharmacy faculty in 1998 and in 2013 was named vice chair for clinical innovation. Applying her expertise in Medicare Part D (the federal drug benefit program), cost containment, and education, Stebbins creates and implements team-based interventions to help keep patients healthy so they don’t land back in the hospital.
Anything we can do to engage them in their own care gives them tools to take charge of their well-being.
“For our patients, knowledge is power,” Stebbins says. “Anything we can do to engage them in their own care gives them tools to take charge of their well-being.” She’s also guarding the well-being of the health care system: Estimates show that preventing just 10 percent of those hospital readmissions could save Medicare as much as $1 billion.
Her signature project is the pharmacy component of the Care Transitions Outreach Program (CTOP), which provides automated discharge phone calls to patients at home. Pharmacists then follow up by telephone to provide counsel and solve any medication-related problems the patients are experiencing. The key to success, Stebbins says, is establishing direct contact and trust with each individual – from admission through the hospital stay and into those first days at home. She trains her team of pharmacy residents and students to perform the outreach, and they, in turn, get to hone their patient-interaction skills.
Data from the CTOP made it clear that one of patients’ biggest challenges was accessing their medications. In response, the UCSF School of Pharmacy’s departments of Pharmaceutical Chemistry and Clinical Pharmacy partnered with Walgreens at UCSF to establish the Meds to Beds program, which delivers discharge prescriptions to patients before they leave the hospital. Whether it’s insulin, antibiotics, or blood thinners after a cardiac procedure, Walgreens and UCSF student pharmacists dispense the meds at bedside and counsel patients on how to take them. When needed, they also transfer prescriptions to other pharmacies, which is especially helpful for the 80 percent of UCSF patients discharged to locales outside the Bay Area.
Results already show a marked improvement in patients’ ability to fill their prescriptions and take the medications they need, Stebbins says, adding that additional research will evaluate whether Meds to Beds makes an impact on hospital readmissions. Her efforts are paying off, not just by potentially preventing re-hospitalizations but also by providing excellent, patient-centered medical care for everyone, one patient at a time.