The pharmacy and home health agency collaborate to plan the discharge of a patient on home inotrope therapy. They verify the patient and caregiver's readiness, educate all parties, and establish communication protocols. The pharmacy supplies medication and verifies understanding while the home health agency provides nursing visits. Both monitor the patient and ensure compliance with the treatment plan through ongoing communication and verification of parameters.

1. Pharmacy Home Health Agency
Responsibilities Inotrope Patient Discharge Planning: Day 1 Responsibilities
Receive referral from hospital for Collaborative Home health agency (HHA) receives referral
from hospital for home health services
drugs & supplies Responsibilities
Patient meets reimbursement
criteria and pharmacy has Patient meets reimbursement
required documents of proof criteria for home health.
Yes No Yes
Patient meets Contact D/C
pharmacy Patient meets Contact D/C
planner
admission • Verify central line is/will be placed HH admission planner
criteria • Verify point of service delivery location and all criteria.
demographic information
Yes • Determine who HHA will be billing for nursing
No
service – the insurance company or pharmacy? Yes
Contact D/C • Provide HHA process for paperwork & billing
Contact HHA & pharmacy (if applicable).
planner Contact D/C
assure • Determine & confirm who is hooking patient planner
knowledgeable in up to home infusion pump prior to D/C.
providing home • Determine & confirm planned date/time of D/C
inotrope therapy. from hospital
• Clarify all communications to assure smooth
transition
Yes
Collaborate with pharmacy to
provide nurses with educational
Confirm that nurse caring for patient materials related to home inotrope
is knowledgeable in home inotrope therapy.
therapy.

2. Pharmacy Home Health Agency
Responsibilities Inotrope Patient Discharge Planning : Day 2 Responsibilities
Collaborative Responsibilities
Communication & Verification
Pharmacy to:
• Perform pre-discharge assessment to
assure no additional risk for doing • Discuss any questions related to inotrope therapy.
therapy at home • Verify knowledge and answer any questions.
• Contact caregiver and discuss home
health care plan and expectations
• Perform pre-admission assessment of
home environment for items (phone,
electricity, 911 service)
• Call local EMS to inform them of • Verify with D/C Planner who is hooking patient up at
inotrope patient in their area hospital and what time med and supplies will arrive
• Obtain patient specific critical there
parameters and provide to home • Verify caregiver will be available for initial teach /hookup
health agency along with appropriate in hospital
standing orders. • Verify what initial teaching will be done
• Communicate this information
to HHA
Review with Home Health Agency:
• Who contact person is for pharmacy and HHA.
• How communication will take place.
• Review critical parameters, expected interventions
and physician orders.
• Preferred communication with physician with issues re
inotrope therapy specifically
• Discuss shared expectations of pharmacy and HHA
• Verify if HHA is billing insurance or pharmacy & process

3. Pharmacy Home Health Agency
Responsibilities Inotrope Patient Discharge Planning : Day 3 Responsibilities
Pharmacy to confirm with D/C planner -current orders & labs:
• Patient is stable on dose of inotropes (24 hour minimum)
• Fluid and electrolytes are stable Communication & verification
• Caregiver will be available for initial teach at hospital
• Communicate to HHA
Yes No
Yes No
Contact cardiologist & Await further direction
Plan delivery of drug & Continue to discharge
D/C planner from pharmacy
supply & hook-up
Obtain from Pharmacy:
Patient & Caregiver:
• Verification of final orders/critical parameters
• Perform all activities necessary prior to d/c on inotrope therapy
• Update on patient/caregiver initial teaching and any
• Instruct on storage/handing of medication & supplies
concerns
• Provide patient & caregiver with written information & review
• Verify specific hook-up time and next scheduled bag
emergency plan, HHA contact numbers, etc.
change
• Verify understanding of first home visit date/time
• Verify next day HHA admission visit
• Verify understanding of next scheduled bag change date/time
• Call patient and check on status once home
• Verify that remainder of shipment arrived at home and • Call patient and check on status once home
is stored properly. • Verify that remainder of shipment arrived at home
• Verify home health agency number and planned visit and is stored properly.
time • Verify nurse’s name & planned visit time
• Review emergency plan • Review emergency plan

4. Home Health Agency
Pharmacy
Inotrope Patient Ongoing Care and Collaboration Responsibilities
Responsibilities
• Do not decrease visit frequency until
patient/caregiver independent and
• Minimum weekly phone call to knowledgeable regarding critical parameters
patient for refill assessment and reporting
• Lab results monitoring & analysis • Minimum weekly visit
• Identify and communicate
• Communicate abnormal lab results • Make visits periodically at time of bag change
areas of concern
or findings to physician to observe patient/caregiver compliance with
• Monitor and verify compliance
• Inventory monitoring sterile technique and infection control
with medical regimen.
• Preparation and delivery of • Review and monitor compliance with
• Communicate any order
medication and supplies medication regimen.
changes (pharmacy or home
• Review and reinforce • Confirm with patient and/or caregiver that
health related).
patient/caregiver knowledge of they understand critical parameters,
critical parameters reporting, and emergency plan.
• Draw blood specimens & communicate
regular location of delivery (to assure
pharmacy receives knows where to obtain
results).
• Monitor ongoing compliance with proper
storage of medications.
• Increase visit frequency when patient
symptoms increase or if a change in dosage
occurs.