title: Positive recognition program increases compliance with medication reconciliation by resident physicians in an outpatient clinic.
abstract: The purpose of this study was to determine if well-understood, positive reinforcement performance improvement models can successfully improve compliance by resident physicians with medication reconciliation in an outpatient clinical setting. During the preintervention phase, 36 anesthesiology residents who rotate in an outpatient pain clinic were instructed in the medication reconciliation process. During the postintervention phase, instruction was given, and then improvement was recognized publicly. Data on physician compliance were collected monthly. The authors performed a secondary analysis of the audit database, which contained 1733 patient charts. The data were divided into preintervention and postintervention phases for comparison. A 4-fold increase in compliance was found. When logistic regression was used to adjust for adaptation of resident physicians over time and year, the odds of reconciling were 82% higher postintervention. By the consistent application of this effective tool, the authors have demonstrated that sustained performance of a tedious but important task can be achieved.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD 21281, USA. nneufeld@jhmi.edu
authors.forename: Nathan J
authors.initials: NJ
authors.lastname: Neufeld
authors.forename: Marlís
authors.initials: M
authors.lastname: González Fernández
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Christo
authors.forename: Kayode A
authors.initials: KA
authors.lastname: Williams
mesh_terms: D000554:Ambulatory Care Facilities / Q000458:organization & administration* / Q000592:standards; D019983:Guideline Adherence / Q000458:organization & administration / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D007396:Internship and Residency / Q000379:methods* / Q000592:standards; D059065:Medication Reconciliation / Q000379:methods* / Q000592:standards; D058996:Quality Improvement / Q000458:organization & administration / Q000592:standards; D012054:Reinforcement, Psychology