Reconciling medications at admission: safe practice recommendations and implementation strategies.
BACKGROUND
Fifty hospitals collaborated in a patient safety initiative developed and implemented by the Massachusetts Coalition for the Prevention of Medical Errors and the Massachusetts Hospital Association.


METHODS
A consensus group identified safe practices and suggested implementation strategies. Four collaborative learning sessions were offered, and teams monitored their progress and shared successful strategies and lessons learned. Reports from participating teams and an evaluation survey were then used to identify successful techniques for reconciling medications.


RESULTS
For the 50 participating hospitals, implementation strategies most strongly correlated with success included active physician and nursing engagement, having an effective improvement team, using small tests of change, having an actively engaged senior administrator, and sending a team to multiple collaborative sessions.


CONCLUSIONS
Adoption of the reconciling safe practices proved challenging. The process of writing medication orders at patient transfer points is complex. The hospitals' experiences demonstrated that implementing the proposed safe practices requires a team effort with leadership support and vigilant measurement.
Rogers
Gina
G
Massachusetts Coalition for the Prevention of Medical Errors, Burlington, USA. gina-rogers@comcast.net
Alper
Eric
E
Brunelle
Diane
D
Federico
Frank
F
Fenn
Clark A
CA
Leape
Lucian L
LL
Kirle
Leslie
L
Ridley
Nancy
N
Clarridge
Brian R
BR
Bolcic-Jankovic
Dragana
D
Griswold
Paula
P
Hanna
Doris
D
Annas
Catherine L
CL
D003299:Cooperative Behavior; D017408:Guidelines as Topic; D006801:Humans; D008404:Massachusetts; D008508:Medication Errors / Q000517:prevention & control*; D010343:Patient Admission / Q000592:standards*; D015397:Program Evaluation / Q000379:methods; D017751:Safety Management