Presented by: The Provincial MedRec Team Ian Creurer, Greg Duchscherer, Meenakshi Kashyap, Christine Lazzer, Dawn McDonald, Dawn Vallet-MacDonald, and Gingie Welsh

1. Medication Reconciliation (MedRec)
Implementation at Alberta Health Services
The Provincial MedRec Team
Ian Creurer, Greg Duchscherer, Meenakshi Kashyap, Christine Lazzer, Dawn
McDonald, Dawn Vallet-MacDonald, and Gingie Welsh

2. Long Term
Care
Home
Care
Emergency
Department
Supportive
Living
Acute Care
and Clinics
• Alberta Health Services (AHS) is incorporating
Medication Reconciliation (MedRec) processes into
everyday practice of all care settings by the end of 2015.
• MedRec is one of the largest safety and quality
improvement projects currently underway in AHS.
A Major Organisational Priority
A Required Organisational Practice (ROP)
MedRec: A High Priority Patient Safety Initiative
The Background
We needed a
coordinated and consistent
approach to implementing
MedRec across all care
settings in AHS. Our
implementation
strategy is based on
MedRec best practices and
Accreditation Canada’s
ROP MedRec has been a national and international standards.
patient safety initiative since 2005.

3. Implementing MedRec
• Improves patient safety by reducing medication errors and risk of adverse drug events
• Enhances patient and family centered care
• Improves communication between healthcare providers (HCPs) across all settings
• Increases continuity of care and collaboration between HCPs
• Decreases the taking of multiple medication histories and rework by different HCPs
Why MedRec?
Patients have a shared
responsibility in medication safety.

4. Ambulatory Care
2014 - 2015
Discharge/ Transfer
2014
WORKING GROUP
• MEDREC POLICY
• DEFINE HIGH RISK
• MEDREC TOOLKIT
• IMPLEMENTATION
APPROACH
• ZONE TEAMS
• SUCCESS
MEASURES
• PRACTITIONER
ENGAGEMENT
• INITIATE
PATIENT/PUBLIC
ENGAGEMENT
ZONE TEAMS
(UNIT/ SERVICE OR
PROGRAM TEAMS)
• DEFINE ROLES
• PLACEMENT ON
CHART
• LOCAL PLAN
EDUCATION
ROLL OUT
PUBLIC, STAFF &
PHYSICIANS
• EDUCATION
• AWARENESS
CAMPAIGNS
• TOOLS AND
RESOURCES
IMPLEMENT ADMISSION MED REC
• ACUTE CARE
• ACH SUPPORTIVE LIVING/HOSPICE & PALLIATIVE CARE
• AHS LONG TERM CARE
• AHS HOME CARE (select patients)
• URGENT CARE (select patients)
• EMERGENCY DEPARTMENT (select patients)
• PreADMISSION CLINICS
• Meet ACCRED ROP'S for Admission, Transfer and
Referral/Discharge within defined timelines
IMPLEMENT TRANSFER &
DISCHARGE MEDREC
ADMISSION MED REC AMB
CARE (select patients)
WORK WITH EDUCATIONAL
INSTITUTIONS
PHASE 3:
2015
COMPLETE
MEDREC FOR
AMBULATORY CARE
PHASE 2:
2014
PHASE I:
2011 – 2013
Admission
Acute, Home &
Long-term Care
2011 - 2013
AHS
Provincial
Planning
2011 - 2015
The Alberta Health Services (AHS)
Provincial Phased-in Approach
North Zone
Implementation
Edmonton Zone
Implementation
Central Zone
Implementation
Calgary Zone
Implementation
South Zone
Implementation
AHS Provincial
MedRec Planning
A “Viral Spread Model”
Implementation Approach

5. Our Partners
To create awareness and an understanding of the role of each
member on the healthcare team, AHS has developed:
• MedRec educational tools and resources, MedRec policy and
process overview documents for healthcare providers
• A communication strategy for healthcare providers and public
• Engagement strategies for clinical staff and physicians,
educational institutions and professional colleges and
associations
• Public and provider awareness campaigns
Medication
safety is a shared
responsibility.
Everyone has a
role to play.
In consultation with patient advisors and
public focus groups province wide, AHS
rolled out a public awareness campaign on
the importance of maintaining a MedList
and sharing it with your healthcare provider.
AHS developed a MedRec elearning module to
educate healthcare providers on MedRec.
(http://www.albertahealthservices.ca/8171.asp)

6. 89
tool for all healthcare providers
involved with patients’ medications
and also for measuring success.
AHS MedRec Success Measurements
87
83
90 89
92 91
88 87
% Patients Reconciled on Admission % Patiens with 1 or more Discrepancies on Admission
16
19
24
19
26
22
19
25
21
Oct-13 Nov-13 Dec-13 Jan-14 Feb-14 Mar-14 Apr-14 May-14 Jun-14
Success
% patients with MedRec
completed on Admission
Goal, 100%
Quality
target > 80% of patients have all
quality elements. Results to date:
• BPMH based on >1 source – 68%
• Actual med use verified by interview – 81%
• Each med has drug name, dose, route,
frequency on BPMH and Admission orders –
98%
• Every med in BPMH is accounted for in
admission orders – 94%
• Prescriber has documented rationale for
holds & discontinued meds – 81%
Outcome
Measure
% patients with one or
more outstanding
discrepancies
Target,
less than 10%
Measuring Success
MedRec forms are an
excellent communication
Target, 80%
Goal, 0%

7. Lessons Learned
Keys for Success

8. Next Steps
• Continue to Support MedRec Implementation
• Continue to Engage External Stakeholders and Physicians
• Evaluate Effectiveness of the AHS Public Awareness Campaign
• Prepare for Project Closure and Sustainability
Contact us: medrec@albertahealthservices.ca
www.albertahealthservices/medlist