2005 Edition Report on Drug Administration Procedure & Practices ...

GUIDELINES FOR SUPPLY OF MEIDCATIONFOR PATIENTS DURING INTER-HOSPITAL TRANSFERBackgroundThere is currently no laid-down policies in the HA on the supply of medications forpatients during inter-hospital transfers. Individual discharge or recipient hospitals may or may nothave any agreed arrangements regarding the issue or acquisition of medications for these patients.observed.In a survey conducted by CPO, several problems relating to such transfers have been1. Disruption of supply of medication occurs if a non-formulary drug of the recipient hospitalhas been prescribed and is not issued by the discharging hospital upon transfer.2. Disruption of supply of medication if the patient transfer is made after Pharmacy openinghours when no drugs accompany the patient upon transfer.3. Medications issued directly from ward of discharging hospital to ward of recipient hospitaldo not have proper labeling may be in violation of legal requirements.4. If only items within the Drug Formulary of the recipient hospital are allowed to beprescribed upon transfer-out, doctors of the originating hospital must be very familiar withthe Formulary of the recipient hospital in order to avoid disruption of supply of medicinedue to non-formulary items being prescribed.Issues to be consideredWhen drawing up the Inter-Hospital Transfer Policy, the patient’s benefit must beconsidered as the top priority. Continuity of supply of medication must be ensured when workingout details for the procedures for inter-hospital transfer. The operation of the transfer proceduremust be practicable and the financial implications, if any, must be worked out between thedischarging and recipient hospitals.Recommendations1. To simplify the procedure, it is recommended that each inter-hospital transfer can beviewed as a discharged case for the hospital transferring out the patient, and an admissioncase for the recipient hospital. It is a shared responsibility for both the discharge andrecipient hospital to ensure the continuity of supply of medicine for the patient.2. A 5-working days’* discharge medication order covering all the patient’s currentmedication profile should be written up and sent to the pharmacy of the discharginghospital for dispensing. The 5-working day’s medication supply would allow ample timefor the pharmacy of the recipient hospital to make arrangement for the continued supplyof drugs. For antibiotics or certain rarely used items, the discharge hospital may considerto prescribe the full course*. If non-formulary drugs have been prescribed, there shouldalso be sufficient time for the pharmacy to contact the case medical officer for1