Transforming Home Health Care: How a WSU Project is Significantly Cutting Hospitalizations for Patients

An estimated 90% of patients receiving home health care have mismatched medication lists, increasing their chances of being hospitalized.

A recent initiative from Washington State University (WSU) tackled this issue head-on by collaborating with a Spokane home health care agency. This project focused on ensuring that medication lists were accurate, especially for high-risk heart-failure patients. Remarkably, hospitalizations dropped by over half in just 10 weeks.

The key was training home health workers to think like pharmacists. They learned how to review medication lists, ensuring that records from different providers matched and that patients were taking the right medications. Jeffrey Clark, an associate professor at WSU, highlighted the lack of pharmacists in home care. Unlike hospitals, where pharmacists are part of the care team, home health agencies often don’t have that support.

Studies have shown that patients with unresolved medication discrepancies are more than twice as likely to end up in the hospital. Those discharged from hospitals often carry confusing medication lists based on a mix of information they provide themselves and prescriptions from various providers. This makes it challenging to maintain accurate medications records.

Clark explained that home health clinicians are uniquely positioned to see everything a patient is taking. This gives them a special opportunity to assess and reconcile medication lists.

Launched in late 2018, WSU’s project aimed to cut hospitalizations for Providence VNA Home Health, which admits around 3,500 patients yearly. The pharmacist-led team created training programs and a detailed checklist addressing 13 scenarios where medication lists might be wrong. Clinicians learned to not only match lists but also evaluate medication appropriateness, effectiveness, and safety—similar to a pharmacist’s approach.

After training, hospitalizations among high-risk heart failure patients plummeted from 23.4% to 11.4%. This was especially beneficial for patients with multiple medication errors, who were three times more likely to be hospitalized within 30 days. Even after 17 months, rehospitalizations for all patients decreased from 13.55% to 11.9%.

This project not only benefited patients in Spokane but also served as an important step for community health. Clark emphasized the value of pharmacists in care teams, noting that their involvement can lead to transformative results. The initiative was supported by a grant from Pfizer.

In summary, accurate medication reconciliation at home can significantly improve patient outcomes. By integrating pharmacists into home health care teams, we can enhance patient safety and reduce unnecessary hospital visits.



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