Less than 33% of the total discharge journey was accounted for within pharmacy. Multidisciplinary working to improve communication

must occur to improve efficiency of the discharge process. TTOs (discharge prescriptions – to take out) need to be generated and any items supplied before a patient can be discharged. Delays to discharge affect the hospital system as a whole, and a mismatch between number of admissions and number of available beds is a problem Hydroxychloroquine throughout the NHS. Published data regarding the TTO journey and possible areas of delay within it are lacking. Many patients attribute the delay as being due to their medication not being ready and pharmacy is often perceived as wholly responsible.1 EPZ-6438 solubility dmso Hospital pharmacists often observe that the major reason for medication not being ready on time is in fact because TTOs have not been written in a timely manner.2 The introduction of electronic prescribing has made it possible to accurately identify when TTOs are generated, verified by a pharmacist and dispensed. This evaluation was designed to map the TTO journey, and ascertain where delays, if any, arose. Data were collected

at The Royal Liverpool University Hospital during a five day period in November 2013. All patients discharged using standard Trust electronic TTOs were included. Data collection forms were completed by pharmacists, ward-based technicians, porters and the investigator. Data were collected at each stage of the processing of a TTO. Patients were asked and medical notes used to identify the precise time a decision to discharge had been made. Average time spent at each stage of the TTO journey was analysed using Microsoft Excel. Ethical approval was not required. Of the 338 discharges assessed, C1GALT1 a full data set was available for 274 TTOs. 232 (85%) TTOs were written on the day of discharge and data were analysed for

all stages. A further 42 (15%) TTOs had been written prior to the day of discharge, before a decision to discharge had been made. For these, data were analysed from the point the pharmacist was informed that the discharge was proceeding. The mean time taken from decision to discharge was 4 hours and 23 minutes (range: 20 minutes to 9 hours and 40 minutes). From the patients’; perspective, their experience of the discharge process begins when they are told they can go home. A third of time taken in the TTO journey occurred between the patient being informed of their discharge and the pharmacist being informed that a TTO had been written. Until the TTO is written and the pharmacist is aware of this, the patient is no closer to being discharged and the availability of a bed for another patient is on hold. Since the time a TTO spends in pharmacy accounts for less than a third of the total time of the TTO journey, a multidisciplinary approach is required.