The document describes a case study of Ms. TG, a 66-year-old woman admitted to the hospital with atrial fibrillation who is now being discharged on warfarin and other medications. As a pharmacist, you will be meeting with Ms. TG for a 30-minute comprehensive assessment prior to her discharge. The assessment should include reviewing her medications, understanding how she currently manages her conditions at home, and ensuring she has the knowledge and support needed for safe transitions of care and medication management upon returning home. Partnering effectively with patients like Ms. TG is important for improving outcomes, quality of care and reducing readmission rates.

1. Principles for
Partnering with Patients
December 5, 2012
8:00 – 9:45 am A Patient Perspective at ASHP

2. 1. Read the patient case study an patient view.
2. Attend the session.
3. Add to your knowledge to effectively partner with patients.

3. Life: Case Study:
“Hello? It’s Tammy. I am not sure how Ms. TG, a 66-y.o. female with
long I’ll be here. osteoporosis, type-2 diabetes, and
hyperlipidemia, is admitted to your
Been having palpitations again, I think rural, critical access hospital for
they put me Coumadin again. I guess no cardioversion with recently-diagnosed atrial
Grape fruit this week. fibrillation.
Will you check on Bob? I left a casserole Ms. TG is expected to be in your facility
In the freezer. But I am sure he forgot.” for 3 days and is now receiving long-term
anti-coagulation therapy with warfarin.

4. Case Study Continued
Ms. TG’s medications prior to discharge include:
alendronate 70 mg weekly,
calcium citrate with vitamin D 500 mg/400 I.U. daily,
metformin 500 mg twice daily,
and simvastatin 20 mg daily at bedtime.
Life Continued
“Well, they might have me leave
Today, not sure. The nurse says it
may be tomorrow.
Well, they are giving me some new
Medicines not sure what they are.
The nurse brings them in the little cup.
Please tell little Billy I love him and hope
to make it home for the birthday party.”

5. What’s next?
“I don’t know. They told me to be ready
What if….
to go a while a go. I have my bag of old
Meds but I don’t know about the new
On the morning of Day 3, you receive a care
ones.
coordination order from the inter-professional
health team
I am waiting on the pharmacist, I don’t
You are scheduled to see Ms. T.G. in her
know why. I usually go talk with Don at that
hospital room for a 30-minute comprehensive
Pharmacy at the old Rexall’s building.”
assessment.
Your institution is an Accountable Care
Organization with two-way risk sharing
incentives to improve quality at decreased
costs, and an emphasis on reducing readmission
rates.

6. Are you prepared to do a comprehensive
“I am I prepared to talk to you?
assessment with Ms. TG?
What does a comprehensive assessment
I have never seen my MAR.
include for Ms. TG?
I do not know how to spell the names
of my meds and I am not sure what they
do.
And by the way… my name is Tammy”