Directed intervention to improve the rate of admission medication reconciliation in an acute care hospital
| Autor: | Parker Suit, Htay Htay Kyi, Huda Marcus, James Cranford, Ghassan Bachuwa, Saira Sundus, Philip J. McDonald, Jason Sotzen |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Leadership and Management Quality Improvement Report Psychological intervention 030226 pharmacology & pharmacy quality improvement 03 medical and health sciences Patient safety 0302 clinical medicine Older patients Acute care Intervention (counseling) medicine medication reconciliation patient safety 030212 general & internal medicine business.industry Health Policy Public Health Environmental and Occupational Health transitions in care Community hospital Medication Reconciliation Male patient Emergency medicine business |
| Zdroj: | BMJ Open Quality |
| ISSN: | 2399-6641 |
| Popis: | IntroductionElectronic medication reconciliation systems are known to reduce medication errors. We hypothesised that refinement of the electronic medical record (EMR) and provider education could improve adherence to completion of admission medication reconciliation, thereby potentially limiting prescribing errors. Our goal was to improve the percentage of patients with medication reconciliation completed within 24 hours of admission to at least 90%.MethodsA prospective interventional study was conducted at a university-affiliated community hospital between 1 January 2017 and 30 September 2018. We determined the baseline percentage of medication reconciliations performed within 24 hours of admission, and those completed at any time prior to discharge from the hospital. Three plan-do-study-act cycles were then performed, with interventions including live and email reminders to complete medication reconciliation and addition of a column to EMR patient lists indicating whether reconciliation had been completed.ResultsThe percentage of medication reconciliations completed within 24 hours of admission was lowest for the pre-intervention cycle (62.4%) and was highest for Cycle 3 (80.9%). The percentage of reconciliations completed any time prior to discharge was higher and increased in a similar stepwise fashion from 71.1% to 88.4% through Cycle 3. There was a post-intervention trend toward a higher rate of reconciliation completion for patients aged 18–40. Male patients were also more likely to have their admission medication reconciliations completed prior to discharge.ConclusionOur interventions resulted in a statistically significant 18.5% increase in the rate of admission reconciliation completion. Though this increase fell short of our goal, this study demonstrates that provider education and optimisation of the EMR can sustainably improve adherence with medication reconciliation, thereby fostering improved patient care. Further improvement could be achieved by focusing on the medication lists of our older patients and female patients. |
| Databáze: | OpenAIRE |
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