Breakeven analysis of a proposed pharmacy discharge prescription medication reconciliation program

Medication errors are a problem in the United States healthcare system. Many patients are harmed unnecessarily, costing billions of dollars annually. The Institute of Medicine has recommended several strategies for healthcare institutions to potentially decrease medication errors. Medication reconciliation was one such recommendation with the aim of helping to eliminate medication errors. Medication reconciliation is a process whereby a patient's drug regimen is reviewed by a healthcare professional for appropriateness and screened for potential problems that can cause harm. The list is also compared to new orders written for the patient to ensure the list is accurate and up to date. The Joint Commission requires the medication reconciliation process be conducted at all points of patient care transition, including admission, transfer, and discharge in the hospital setting. The process of conducting discharge medication reconciliation may require additional staffing. Additional positions necessitate resources that may not always be readily available. Such staffing could generate potential revenue if a patient's discharge prescriptions were filled at the outpatient pharmacy during the discharge medication reconciliation process. This study evaluated the potential revenue from maximizing the number of discharge patients who fill their discharge prescriptions at the outpatient pharmacy. A breakeven analysis was conducted to determine the point at which the costs of new pharmacist and pharmacy technician positions could reasonably be offset from the estimated revenues of filling discharge prescriptions. The results of this study found that at least one new full-time pharmacist and pharmacy technician position could be created for Monday through Friday from 0800 to 1630 to provide additional hospital units with discharge pharmacy services. In addition, a 50% pharmacist and pharmacy technician position could be created to offer these services in the evening for Monday through Friday from 1631 to 2100, and a 40% pharmacist and pharmacy technician position could be created for Saturday through Sunday from 0800 to 1530 to provide discharge pharmacy services. Therefore, if maximization of the number of filled discharge prescriptions can be achieved, part of the cost of additional staff required for medication reconciliation may be offset in a positive manner.