Bridging Medication Orders
Patients who are discharged from emergency departments or hospital facilities, or are transferred from one facility to another, may require medications during transit or otherwise for a period of time until a normal supply of medications or prescriptions can be accessed. When scheduled and/or as needed (PRN) medications are provided to cover such a period, they are referred to as "bridging medications". These are provided by the discharging or transferring facility pharmacy and are time-limited (maximum 72 hours). The following conditions must be met:
The patient is prescribed ongoing or new medication(s) active at the time of transfer or discharge.
The patient does not have access to a medication supply during transit or for a period before acquisition from a community source (e.g., pharmacy).
The patient does not have access to a medication supply at home (including supportive living, continuing care or private residence) and lacks timely access to a community or specialty pharmacy.
Bridge medications are not the same as "pass medications" or medications dispensed by specialized clinics where the costs are covered through special funding by Alberta Health.
Recommended workflows for requesting bridging medications differ according to whether the patient is in an emergency or inpatient setting at the time of request.
Emergency Context
Bridge medication ordering tools are built into the Disposition navigator ("Dispo" tab) always availble within emergency department workflows.
Inpatient Context
The following considerations apply when bridging medications are ordered for patients being discharged or transferred:
Medication Reconciliation
Bridge medications must be ordered AFTER medication reconciliation has occurred. This ensures that the medications provided match the medications intended for ongoing care after discharge or transfer.Order Required
An order from an authorized prescriber is required. In most cases, the order does not need to re-itemize all pertinent medications. For example, an order indicating “all scheduled meds” with a timeframe meets requirements.As Needed (PRN) Medications
For as needed (PRN) medications, the prescriber can determine the appropriate quantity based on the maximum amount that could be used during the duration indicated in the order to supply bridge medications.Controlled Substances
For controlled substances, the quantity must be identified by the authorized prescriber (whether it’s by timeframe or for PRN’s, a specific quantity).
The best way to meet the above requirements is for prescribers to use an appropriate discharge or inter-facility transfer navigator, accessed via the Discharge and Transfer Gateway. Instructions appear at the top of all such navigators. If relevant to a particular workflow, a "Bridging Medications" instruction is provided. This has a link that can be selected to immediately access a Bridging Medications order. The order is completed outside of the usual discharge or transfer orders as it is an "inpatient" order.
Prescribers can also open the Orders activity within any chart opened to an inpatient context, then search for an select a "Bridging Medications" order.
Tip: Bridging Medications Order
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Tip: Bridging Medications Order