Impact of a Multidisciplinary Team Medication Administration Appointment Reconciliation on High-Cost Drugs Expenditure, Patient Appointments and Employee Satisfaction



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Purpose: To evaluate the impact of a multidisciplinary team approach on high-cost drugs expenditure, rescheduled patient appointments and employee satisfaction. Methods: A multidisciplinary reconciliation team was formed comprising of Pharmacy and Nursing staff that met on a weekly basis to review Infusion Center medication administration appointments scheduled five to seven days ahead. This single-center, observational, retrospective study included all patients with an Infusion Center administration appointment for the top five high-cost medications from March 2022 through January 2023. The electronic health records were retrospectively reviewed for demographic information, appointment changes and reasoning, payor source, medication procurement source, and medication information. Additionally, a three-item survey that assessed level of happiness, satisfaction and work meaningfulness was administered to pharmacy, physicians and nursing staff involved in the Infusion Center workflow. Survey responses were collected for two weeks prior to and after the post-implementation period. The pre- period was defined as March 1, 2022 to July 31, 2022 with August 2022 being the washout period and the post- period defined as September 1, 2022 to January 31, 2023. Results: The analysis included 201 patients with 320 appointments in the pre- period and 202 patients with 285 appointments in the post- period. The total drug expenditure was $1,491,826 and $1,422,785 for the pre- and post- periods, respectively, with a $69,040 total decrease and a $13,808 decrease in average monthly cost. There was a statistical difference (p = 0.0446) in the number of appointments that did not require rescheduling with 219 (68.4%) in the pre- period and 216 (75.8%) in the post- period. The satisfaction survey included 32 employees in both the pre- and post- periods. The number of Physicians and Nursing that reported neutral or high levels increased by 56% (p = 0.0022) for happiness and 66% for satisfaction, with no statistical difference in either for Pharmacists and Pharmacy Technicians (p = 1.0000). Conclusions: This proactive multidisciplinary team approach to medication administration appointment reconciliation demonstrated a reduction in high-cost drugs expenditure and improvements in rescheduled appointments. Although happiness and satisfaction increased for Physicians and Nursing, there were no significant changes for Pharmacists and Pharmacy Technicians.



High cost drug/medication, Patient assistance program, Drug expenditure, Appointment, Employee satisfaction