Integrating Pharmacists into an Automated Discharge Process to Promote Comprehensive Medication Management through Optimizing Medications

Pharmacists’ incorporation of comprehensive medication management (CMM) into transition-of-care (TOC) processes across a system includes the identification of patients with high medication risk following discharge from the hospital to facilitate CMM visits with pharmacists at community clinics. CMM refers to the practice of optimizing patients’ medications and ensuring patients are meeting their medication-related goals. The Optimizing Medications CMM Implementation System provides a structured approach grounded in implementation science.¹ The system includes two pathways depending on whether teams are implementing for the first time or improving their practice. For a step-by-step guide to facilitate implementation and improvement of CMM, grounded in implementation science theory and refined with evidence-based learnings, visit the Optimizing Medications For Better Health website.²

About the Resource

Elements of this evidence-based learning resource were used to support AHRQ grant R01HS026943 (PI Joel F. Farley). To access Medication Optimization Resource Library, additional resources, references, and ask questions, visit the Comprehensive Medication Management (CMM) website.  

References:

1. Livet M, Blanchard C, Sorensen TD, McClurg MR. An implementation system for medication optimization: Operationalizing comprehensive medication management delivery in primary care. JACCP 2018;1(1):14-20. https://doi.org/10.1002/jac5.1037.
2. University of North Carolina Eshelman School of Pharmacy and University of Minnesota College of Pharmacy. Optimizing Medications for Better Health. 2025. https://www.optimizingmeds.org/.