Transcript Program Forms (Examples from Lilly's Pharmacy)

Consult timeline & follow-up example
from Lily’s Pharmacy
Initial patient contact within 24 hours
of discharge via telephone
Check-in only or
unable to reach patient
Consult appointment made
Patient contact within 72
hours of discharge via
telephone
Consult
appointment made
In-pharmacy consult
within 1 week of
discharge
*Consult documentation
sent to PCP
Post consult follow-up at 1 month
& monthly thereafter
*Additional communication with providers
as needed for identified discrepancies
Performance Improvement Indicators
Data Analysis & Performance Feedback to be provided to Community Hospital: