Medication reconciliation: developing and implementing a program.
During the past 5 years since the medication reconciliation process was formalized and automated, it has become an independent redundancy. The patient intervention rates are maintained at 30% to 35%, with ADE rates related to medication reconciliation at zero. The medication process takes into account the accuracy and appropriateness of restarting prehospital medications and current ICU medications. It includes the omission of important home medications along with inaccuracies of dosages and frequencies. This form assures that the patient is receiving continuity of care ad decreases complications of the patients health related to the changing of medications. Until recently this concept was disseminated by the staff without consistent administrative support. It was a process developed by nurses and perpetuated by nurses. Recently the administration has mandated that the process be implemented throughout the institution. A Hopkins health care-based collaborative is working to implement medication reconciliation hospital wide. The challenge exists in standardizing a process that is now specific to each functional unit. Multidisciplinary monthly meetings provided a forum for working through the barriers to incorporate these changes. This low-cost, high-impact safely initiative, if planned and performed strategically, can have a significant effect on patient safety.
Schwarz
Mandalyn
M
Johns Hopkins Health System, Baltimore, MD, USA. mschwar2@jhmi.edu
Wyskiel
Rhonda
R
D000046:Academic Medical Centers; D015142:Baltimore; D003266:Continuity of Patient Care / Q000458:organization & administration*; D003422:Critical Care / Q000458:organization & administration*; D011307:Drug Prescriptions / Q000592:standards; D004358:Drug Therapy / Q000451:nursing / Q000592:standards; D064420:Drug-Related Side Effects and Adverse Reactions; D006801:Humans; D008487:Medical History Taking; D008508:Medication Errors / Q000451:nursing / Q000517:prevention & control* / Q000706:statistics & numerical data; D008510:Medication Systems, Hospital / Q000458:organization & administration; D020380:Needs Assessment; D009730:Nursing Assessment; D015403:Nursing Evaluation Research; D009741:Nursing Staff, Hospital / Q000458:organization & administration; D009936:Organizational Innovation; D010043:Outcome and Process Assessment, Health Care / Q000458:organization & administration; D010351:Patient Discharge / Q000592:standards; D010607:Pharmacy Service, Hospital / Q000458:organization & administration; D016730:Program Development; D015397:Program Evaluation; D017751:Safety Management / Q000458:organization & administration*; D017749:Total Quality Management / Q000458:organization & administration