Sorting out pills is key to fast hospital throughput

Posted: 16 September 2010 by Colin Gray

How many people every day find themselves stuck on hospital wards for hours because the pills they require before going home aren’t ready? It must be thousands. Typically, the patient wants to go home. A relative or friend may be frustrated, waiting to collect them, missing time at work and clocking up charges in the hospital car park. And, of course, clinicians need the bed for others.

So everyone is losing out – and it’s costing the NHS time, money, patient throughput and quality of service. It can leave patients, otherwise happy about their treatment, with a gripe at the very end of it all. Ready to leave in the morning, they may still be stuck there by late afternoon, having missed meals and having suffered unnecessary stress.

So what’s the hold up? Usually it’s because the pharmacy runs through prescriptions on a first come, first served basis. Until they get down to that patient, he or she must wait their turn. The well patients are, in any case, unlikely to take priority over sicker, more urgent cases.

That’s understandable, but it’s a waste to have well patients blocking beds. Here’s a solution: make the manager who facilitates patient discharge also responsible for the pharmacy. It was recently tried at an acute hospital in the north of England and the results are interesting – the pharmacy understood the issues better and adjusted priorities so patients waited shorter times for discharge and beds were freed up. Time and money were saved, quality enhanced. It shows how a small tweak to a managerial structure can benefit everyone. We should learn from this and consider other ways of improving communication between hospital pharmacies and discharge coordinators.