Medication Reconciliation

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Medication Reconciliation

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

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