Emeka Adeyemo’s dose adjustment used to take three weeks and involve four people. It now takes an afternoon and involves one.

The two weeks after a discharge are, statistically, when things come apart: doubled doses, discontinued drugs still being taken, side effects nobody warned about.

Roughly one in six calls finds a duplication — the same drug arriving under two names from two prescribers who were each entirely correct.

We were adding a queue to a decision the pharmacist had already made. That was the whole delay.

Illustrative composite

The pharmacist has prescribing rights in this service, which removes a referral step that used to add three weeks to every change.

Median time from identifying a needed change to making it fell from nineteen days to two.