Safety, Sleuthing and Students: A Novel Collaborative MedRec Event
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Safety, Sleuthing and Students: A Novel Collaborative MedRec Event

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Purpose of the Webinar ...

Purpose of the Webinar

1.Describe the process of developing an undergraduate MedRec IPE Event involving > 480 senior Medicine, Pharmacy and Nursing students;
2.Explain the logistics of conducting the event in multiple venues and urban/remote locations;
3.Discuss the successes and challenges of communicating MedRec patient safety concepts through this process; and
4.Describe future opportunities for enhancing undergraduate MedRec training in an interprofessional environment.

Watch the webinar recording: http://bit.ly/1fSqsqv

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Safety, Sleuthing and Students: A Novel Collaborative MedRec Event Safety, Sleuthing and Students: A Novel Collaborative MedRec Event Presentation Transcript

  • www.saferhealthcarenow.ca Safety, Sleuthing and Students: A Novel Collaborative MedRec Event Dr. Arun Verma, UBC Faculty of Pharmaceutical Sciences Faculty member Dr. Judith Soon, UBC Faculty of Pharmaceutical Sciences Faculty member Dr. Nick Petropolis, BC Fraser Health Authority physician May 2014
  • www.saferhealthcarenow.ca Safer Healthcare Now! MedRec 2014-2015 Year-at-a-glance • 2nd MedRec Quality Audit Month (Fall- Winter) – 2 associated national call/webinars • 6 national calls/webinars (webinars to resume in Sept. 2014) • Updates to Home Care Getting Started Kit • Updates to MedRec Cross Canada Check Up Map • Developing MedRec FAQ documents 2
  • www.saferhealthcarenow.ca3 ISMP Canada MedRec Projects 2014-2015 • Doc Mike Evans YouTube video- MedRec • MyMedRec app- soon available for Android and Blackberry devices
  • www.saferhealthcarenow.ca Safer Healthcare Now! website http://www.saferhealthcarenow.ca/EN/events/ NationalCalls/2014Webinars/Pages/default.aspx ISMP Canada website http://www.ismp-canada.org/medrec/#webinars Safer Healthcare Now! MedRec Community of Practice http://tools.patientsafetyinstitute.ca/Communities /MedRec/default.aspx For real time notification of content posting, “like” the Medication Reconciliation Network on Facebook www.facebook.com/MedicationReconciliation All Safer Healthcare Now! webinars are posted within the week to the following locations:
  • Safety, Sleuthing and Students: A Novel Collaborative MedRec Event Arun Verma, B.Sc. Pharm, RPh, ACPR, PhD Judith Soon, BSc Pharm, RPh, ACPR, PhD, FCSHP Nick Petropolis, MD, BSc (Hon) May 6, 2014
  • MedRec Team in Action!
  • Acknowledgements Pharmaceutical Sciences Medicine Nursing Anita Lo Lesley Bainbridge Kathy O’Flynn-Magee Wayne Riggs Linlea Armstrong Elsie Tan Lynda Eccott Keri Closson Suzanne Campbell Shelley Novak Fraser Black Tarnia Taverner Allison Kirkwood Karen Joughin Noreen Frisch Melissa Lo Jessica Hartley Martha MacLeod Vivian Leung Deborah Phillips Lisa Viik Dan Martinusen Anne Worthington Lela Zimmer Aleisha Thornhill Remare Ettarh Maren Akyürek Mark Collins Stan Bardai Diana Choi Jamal Kurtu John Cheng Myitzu Shwe
  • Learning Objectives 1. Describe the process of developing an undergraduate MedRec Interprofessional (IP) Event involving > 480 senior Medicine, Pharmacy and Nursing students; 2. Explain the logistics of conducting the event in multiple venues and urban/remote locations; 3. Discuss the successes and challenges of communicating MedRec patient safety concepts through this process; and 4. Describe future opportunities for enhancing undergraduate MedRec training in an interprofessional environment.
  • Overview  Medication reconciliation ideally involves the healthcare team in the clinical practice setting  Opportunities for engaging interprofessional undergraduate interactions in meaningful problem- solving settings are rare  A novel approach was taken to explore patient safety issues in a 3rd year Pharmacy course that utilizes case studies to integrate scientific and clinical concepts
  • Background  During new case development for Pharmacy 498, this recently published paper was reviewed:  It was recognized that MedRec was not being taught in the undergrad healthcare curriculum at UBC  Only some students observed in clinical care rotations
  • Aim  To design and implement user-friendly interactive activities to teach senior undergraduate healthcare students about the importance of medication reconciliation at transition points of care Acute Care Hospital Home Residential Care
  • Definition of Medication Reconciliation Medication reconciliation is a formal process in which healthcare providers work together with patients, families and care providers to ensure accurate and comprehensive medication information is communicated consistently across transitions of care. http://www.ismp-canada.org/medrec/
  • Definition of Medication Reconciliation cont’d Medication reconciliation requires a systematic and comprehensive review of all the medications a patient is taking (known as a BPMH) to ensure that medications being added, changed or discontinued are carefully evaluated. http://www.ismp-canada.org/medrec/
  • Best Possible Medication History (BPMH) The BPMH is a ‘snapshot’ of the patient’s actual medication use, which may be different from what is contained in their records. This is why the patient/family involvement is vital. http://www.ismp-canada.org/medrec/
  • Why Teach MedRec?  Common error1  Easily improved with systematic approach  Accreditation standard across Canada2  Standard of care in hospital2  Excellent opportunity to teach collaboration 1Kwan JL et al. Medication Reconciliation During Transitions of Care as a Patient Safety Strategy. Ann Intern Med. 2013;158(5.2):397-403 2 Mitchell JI et al. Medication Reconciliation: A Prescription for Safer Care. Healthcare Quarterly. 2013:16(4): 10 – 13.
  • Safety Issues  Different types of errors  Frequently non-Rx meds not accounted for  Patient confusion at discharge  Community care providers unaware of medication changes Tam VC et al. Frequency, type and clinical importance of medication history errors at admission to hospital. CMAJ. 2005 Aug 30;173(5):510-5.
  • Why is Collaboration Important?  Diverse sources of medication profile  Various opportunities to do reconciliation  Input from multiple disciplines
  • Timeline for Curriculum Development
  • Process of Developing MedRec IP Event  Need to establish links to other professions  Need to identify by healthcare profession:  Level and number of students  Appropriate course to host activity  *** DATE *** of the activity  Participation - mandatory or volunteer  Assignment - individual or team  Technology – Faculty-specific or University-wide platform  Budget - e.g. facilitators, supplies
  • Participant Considerations  Need to identify by healthcare profession:  Which other course coordinators need to be consulted  Responsibility for communication to students  Consequences for the student if they do not participate  Class list to be shared to develop IP group & room list
  • Urban/Remote Location Logistics  Need to identify for each of the three academic sites:  Number of IP participants  Number, size and location of rooms required  Faculty individual responsible for room bookings  Availability of rooms on potential date and times  IT technology to support the simultaneous activities  Facilitators: Regional Health Authority MedRec Coordinators  4 UBC site; 1 UNBC site; 1 UVIC site
  • Technology Specifications  Need to identify by healthcare profession:  Technology manager and support personnel  On call individual prior to and during event  Early booking for technology link between sites  Preferred online platform and “shell” for courses  Platform login for participants to be set-up prior to event  Implications of high volume usage
  • Clinical Case Development  Collaboration with acute care MedRec Coordinator  Case: acute care geriatric patient with complex medications and multiple errors identified during routine MedRec  Patient identifiers removed  Lab values, medical and social history generated
  • Clinical Case Setting and Resources  MedRec activity situated in a multidisciplinary discharge planning meeting  Patient, nurse, social worker, pharmacist, attending physician  PharmaNet pre-admission form developed:  diagnosis, age, medication history  Acute care MedRec admission form  Acute care Discharge form
  • Pre-Reading Materials  Learning Objectives  Background reference articles  MedRec clinical case  SBAR form  Situation, Background, Assessment, Recommendation  Map of the venues  Request bring laptop or tablet  Pack a lunch
  • Room Preparation  Directional signage  Sign-in sheets  White boards  Online connectivity  Doors to rooms unlocked
  • Communications  Need to identify by healthcare profession:  Individual responsible for coordinating consistent messaging  Press release – by individual profession or collaborative  Signage – paper and/or digital  Media – academic, professional and/or community
  • Curriculum Intervention 2013
  • Life Sciences Centre Pharmaceutical Sciences Lecture theatre 308 students Seminar rooms 44 groups x 7 students
  • Small group sessionUndergrads on the move Debriefing session
  • Student Evaluation 2013  “The interprofessional collaboration was most valuable. It provided a platform to talk about the challenges of medication reconciliation and the different expectations and different roles”. Pharmacy Student  “I felt that setting up the groups with pharmacy and medical students was an excellent idea. It was great to meet new people in such an environment and to work with them. It helped to establish to us what role pharmacists play in the community and hospital.” Medical Student  “The case in the module was fantastic! It was very complex, and brought together many topics that we’ve covered in a single patient. Having a case for us to work up collaboratively in small groups was an excellent idea.” Pharmacy Student
  • Curriculum Intervention 2014 January 6, 2013 Pre-reading posted online – MedRec video and references January 13, 2014 10:00 am–11:15 am UBC: 52 groups of 8 students (4 MD/4Rx +/-1 RN) UNBC: 5 groups of 7 students (5 MD/1Rx/1RN) UVIC: 4 groups of 8 students (6 MD/1Rx/1RN) Review case, identify discrepancies, draft recommendations, submit group assignment online 11:30 am–12:00 pm Debriefing on IP concepts and reviewed recommendations
  • Student Evaluation 2014  “It was a complex case and realistic in terms of what occurs in the hospital. Interesting to see perspectives of the different groups of students with regards to medications.” Medical Student  “I think having a variety of forms which we haven’t been exposed to is helpful, and to shift our thinking to a more hospital discharge based setting is new and contributed to a lot of great ideas.” Pharmacy student  “Excellent opportunity to meet pharmacy students and collaborate in a collegial environment. The pharmacy students were knowledgeable, helpful, and pleasant to work with. Nursing opinions were also appreciated, as they spend by far the most time with patients, and are involved in medication administration, monitoring for adverse effects, receiving patient questions and complaints, etc.” Medical Student
  • MedRec Successes  Executed event involving 480 senior Medical, Pharmacy, and Nursing students  Involved 3 sites (Vancouver, Victoria, and Prince George)  Valuable learning experience for students  Worked with IPE leadership from other healthcare academic units  Blended learning model
  • MedRec Challenges  Logistics in developing, implementing, and evaluating this event  Overall coordination between academic units  Lack of resources  Online MedRec course shell in Blackboard  Timing of the event
  • Future Opportunities  Expanding involvement of nursing and nurse practitioner students  Involve more pharmacists at the external sites  Enhance initial introduction of MedRec by a knowledgeable representative of each profession  More time for students to collaborate on the cases  Explore incorporation of facilitators with small groups
  • Questions? Contact Information Arun Verma: arun.verma@ubc.ca Judith Soon: judith.soon@ubc.ca
  • www.saferhealthcarenow.ca Upcoming MedRec Webinars 38 Thank you for attending Our next MedRec webinar will take place in September/October 2014. Details to follow.
  • www.saferhealthcarenow.cawww.ismp-canada.org 39 We encourage you to report medication incidents Practitioner Reporting https://www.ismp-canada.org/err_report.htm Consumer Reporting www.safemedicationuse.ca/
  • www.saferhealthcarenow.cawww.ismp-canada.org Medication Safety Self-Assessment® • Hospitals (acute care)(2006) – free for Ontario* • Long-term care (2012) – free for Ontario* • Complex Continuing Care and Rehabilitation (2008) – free for Ontario* • Community and Ambulatory Pharmacy (2007) – free for Ontario* • Operating Room Medication Safety Checklist (2009) – free for Ontario* • Oncology (2012) • Anticoagulant Safety (VTE) – free for Ontario* • HYDROmorphone Safety Self-Assessment (2014) - $50 * Supported by the Ontario MOHLTC For more information visit www.ismp-canada.org/MSSA or email mssa@ismp-canada.org