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CITIZENS MEMORIAL HEALTHCARE	 MEDICATION RECONCILIATION JOURNEY 1
Designing the Process ,[object Object]
 MIB (make it better) initiated
Team established by action plan owner, to include clinical leaders from all disciplines
Acute Care
Home Care/Hospice
Clinics
Long Term Care
Pharmacy
Physicians2
[object Object]
Clinical staff
Information Specialists or Technicians
Quality/Performance Improvement staff
A process flow diagram was drawn for each discipline
Informal FMEA (failure modes effects analysis) was applied to each process, to identify weak steps or steps lending to failure3
[object Object]
The first step included buy in by nurses and physicians to stop using and accepting:  “resume all meds”.
IS focused on designing improvements in the listing of medications, and methods for electronic med rec for transfers within the system.4
Roll Out ,[object Object]
To Acute care and physicians
An admission/discharge nurse was hired, med.rec. was part of this role’s responsibility
Clinics with each visit
Home Care – learning to work with a new software program
LTC is in initial process of rolling out for admission from home 5
Summer of 2010 joined the national collaboration with Primaris Outlined processes again- new issues identified Staff had designed “work arounds” Staff focused on admission and discharge, ignoring med rec at transfer ,[object Object],6
Education in process or for consideration: ,[object Object]
	Annual one/one competency for nurses
	Interactive Healthstream courses for 	nurses
	One/one education with physicians

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CMH Medication Reconciliation Journey 2011

Editor's Notes

  1. 74 bed hospital, 20 clinics, 5 LTC, 1 Res Care, 5 sets of independent living units, HCS/Hospice, HME, cardiac rehab, oncology/radiologyAll facilities are integrated electronically throughout the continuum of care.
  2. MIB is the process improvement model designed and used by CMH, closely follows the PDCA model.Recognized the need to formally address NPSG – Medication Reconciliation
  3. Education through Healthstream an electronic educational system, which allows access by staff at anytime including from home. Provides the ability to track completion and test for understanding.
  4. Exploring methods for tracking and sharing med errrors and/or near miss events secondary to poor completion of med rec
  5. Focus on carrying a current list of all meds, show it to physicians and pharmacists, ask for help keeping it updated. Possibly scan card for updated list.Michelle will share some of the electronic designs employed by CMH to accomplish MR