Home is where the heart is.
It’s also where health is.
And no matter where a senior calls home, that’s exactly where health care providers want to help them remain — including skilled nursing facilities.
For SNF operators, a resident having to leave early, unexpectedly or unnecessarily is exactly what they want to avoid. A good pharmacy provider knows that. Combatting preventable hospital admissions, as well as readmissions, should be on the mind of every SNF’s pharmacy partner.
We sat down with Rob Leffler, Vice President of Clinical Services for Synchrony Pharmacy, a long-term care pharmacy that serves over 30,000 residents in 16 states and the District of Columbia, to understand four ways SNFs can work with their pharmacy partners to keep their residents at “home.”
- Collaborate more with vendor partners who have integrated services
In 2015, a comprehensive study by Journal of Post-Acute and Long-Term Care Medicine (JAMDA) found that 91% of long-term care facility residents were taking five or more medications, while 65% were taking 10 or more. Addressing that level of polypharmacy has been the focus of Synchrony Pharmacy for years, since the use of multiple medications can have a direct effect on hospital admissions, clinical outcomes and quality of life for residents.
But Synchrony took its focus on polypharmacy approaches one giant step further. It also brought its rehab, wellness, lab and pharmacy services under one umbrella to fully integrate its clinical offerings for better collaboration between them, and better collaboration with its client partners.
The result has been a more streamlined approach, less risk and more communication that leads to higher-quality experiences for the residents.
“In reference to rehab and pharmacy, those were both existing business units for a number of years, each with some unique clients, as well as some overlap,” Leffler says. “We put them together under the Synchrony Health Services brand. One of the goals of this combined force was to foster more collaboration between us.”
What Synchrony knew, and what their SNF partners have appreciated, is that working with vendors that have strong relationships between them, like Synchrony Health Services, benefits the customers and the facilities in many ways. Synchrony doesn’t just talk about collaboration, they are truly integrated.
“We have collaborative practice agreements in place at some locations which allows our pharmacists to order labs on behalf of the prescriber,” Leffler says. “That decreases staff burden, so the pharmacist doesn’t have to request a lab.”
Leffler explains that the staff member would traditionally make that request to the prescriber. Then, the prescriber makes a decision and the staff would have to turn around and place the order with the lab.
“Our pharmacy is integrated with our other clinical areas, like lab and rehab and wellness services, to ensure we provide a complete solution to improve quality of care and reduce the risk of medication errors in both senior living communities and SNFs,” Leffler says. “This collaborative practice agreement reduces the burden on staff so they can spend more time on direct patient care.”
- Be innovative about keeping patients at home and living as independently as possible
Keeping residents at home means helping them live as independently as possible. Because remembering to take medications can make that difficult, Synchrony designed a program to help support patients as they transition home or to independent living from the SNF setting, allowing them to gain or maintain greater independence.
This solution is called PackEDGE, a customized medication delivery system where medications are sorted and packaged by time of day and delivered right to the patient’s home in an easy-to-open package.
“This relieves the burden of helping fill up pill reminders, like the burden on family members who might otherwise have to come in and fill those pill reminders,” Leffler says. “And if a patient is going to be gone for a whole day or a few days on a trip, they can just take the doses they need off of the strip very easily and take them with them.”
PackEDGE helps SNF patients remain home and independent through four features:
- It contacts the prescriber to obtain the resident’s prescriptions
- It schedules automatic refills, relieving a time burden on staff
- It packages medication by time of day and ships them out
- It offers 24/7 support for any medication needs
- Embrace pharmacogenomics
Most SNF residents need one or more medications. Sometimes the medications the resident is admitted with may no longer be needed or even appropriate. There are several solutions to that challenge, one of which is the utilization of the science of pharmacogenomics. This is a lab test that shows how a person’s genes can dictate their response to a variety of medications. Over the past several years, Leffler and the team at Synchrony have seen just how powerful this approach can be.
“We not only support the use of that science, but our consultant pharmacists are trained to help interpret those results and provide the test results to prescribers with actionable recommendations,” Leffler says.
- Whenever possible, deprescribe
Because SNF patients are frequently admitted on a lot of medications, one remedy to help keep them at “home” is deprescribing.
“Deprescribing is a hot topic in long-term care right now,” Leffler says. “The American Medical Directors Association and the American Society of Consultant Pharmacists have partnered on the Drive to Deprescribe. We’ve been working on that in our organization for a long time, but just didn’t have a fancy title for it. This initiative is working to make sure patients are on the right medication and making sure that we aren’t treating side effects by just adding another medication.”
Synchrony thinks of the term another way: “Medication Optimization.”
“It probably seems counterintuitive, because as a pharmacy, you would think that the more prescriptions we can fill, the better,” he says. “But that’s not really the point of view that we take as an organization. We’re looking at patient outcomes and patient benefits.”
By decreasing polypharmacy, Synchrony aims to help SNFs decrease the medication burden for their patients, thus decreasing overall costs for the facility and the health care system while impacting the resident’s quality of life.
“By deprescribing or recommending alternatives to their therapies, we can try to help make sure to keep their pharmacy costs manageable,” Leffler says. “We have a lot of collective experience as an organization, but we’re never looking to just rest on our laurels. We constantly look to innovate, to revise existing programs, to create opportunities to provide additional value to our customers through our clinical collaboration across all our different business units.”
By deploying these four steps in pharmacy approaches, providers will help improve quality outcomes, including better cognition, functionality and reduced risks of adverse drug interactions, while achieving a higher quality of life for the residents in their care.
This article is sponsored by Synchrony Health Services. To learn more about how Synchrony can help your residents achieve clinical and wellness outcomes, visit synchronyhs.com.
