Medication Reconciliation
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Medication Reconciliation

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Medication Reconciliation Presentation Transcript

  • 1. Medication Reconciliation ~~~ The Safety Net What is the Problem? What is the Solution? How do WE do this?
  • 2. What is the Problem?
    • 2 to 7 per 100 admissions is the incidence rate of Adverse Drug Events. (Kaushal & Bates)
    • 1 out of 5 injuries or deaths from errors associated with Adverse Drug Events are preventable. (Pronovost)
    • 50% of all hospital medication errors occur at the interfaces of care. (Rozich)
    • 60% of patients will have at least 1 discrepancy in the admission medication history. (Cornish)
  • 3. What is the Solution?
    • Medication Reconciliation
      • Med Rec: 3-Step Process
        • Collect an accurate medication history
        • Compare this history to the physician orders at ALL transition points
          • Admission
          • Transfer
          • Discharge
        • Correct any discrepancies
  • 4. Med Rec Project: Assemble Beta Test Collaborative Team
    • Senior Administrative Leadership
    • Clinical Leadership
      • Physician Leader that is also a Senior Administrative Leader or a respected ‘thought leader’ among the physician group
      • Pharmacist Manager
      • Pharmacy Technician
      • Unit Nurse Manager
      • Staff Nurse
      • Human Resource
    • Patients
  • 5. Meanwhile……..
    • Pharmacist Manager establishes a retrospective baseline
      • Obtain a set of 30 closed patient records
        • 3 day minimum stay
        • Timeline 1 to 3 months back
        • Use a random selection process
      • Count errors due to unreconciled medications
      • Tally errors and report data as a monthly number of errors per 100 admissions
  • 6. Med Rec in Place: Outcomes
    • 70% reduction in errors and 15% reduction in Adverse Drug Events over a 7 month period with med rec intervention. (Whittington)
    • 80% reduction of potential adverse drug events, within 3 months, in segmented population of surgical patients utilizing pharmacy technicians to initiate the reconciling process. (Michels)
  • 7. How Do WE Do This?
    • Model for Improvement
      • Plan
        • Forms
        • Process
      • Do
        • Beta Test
      • Study
        • Retrospective Analysis
        • User Feedback
      • Act
        • Policy
        • Implementation
    Plan Do Study ACT
  • 8. Beta Project Resources
    • Collaborative Team
      • Project Manager
        • 8 to10 hrs/ week the first 6 weeks of the 6 month beta test
        • 24 to 36 hrs/month for the remainder of the project
      • Team Members
        • 1 to 4 hrs/week for the first 6 weeks of the 6 month beta test, depending on role
        • 4 to 12 hrs/month for the remainder of the project
  • 9. The Right Thing to Do ~~~Engagement
    • Impacts all four business quadrants
    • Financials
    • Product/Service/Quality
    • Customer Satisfaction
    • Workload (eventually)
  • 10. This is Hard Work …. What if We Called It
    • Asking people to change what they have been doing.
    • Improved Communication
    • Providing Optimum Care
    • Improved Medication Management
    • It is The Right Thing to Do
  • 11. Med Rec Team Will ~~~
    • Provide Vision
    • Prioritize
    • Focus
    • Share Project Data
    • Share Project Success
    • Stories