Medication Reconciliation
Do you know exactly what medicines you're taking and how much?
Keeping patients safe by keeping a current list of all the medicines they are taking is the main goal of a project at National Jewish Health.
“Medication regimens can be complicated, and change frequently,” said Betsy Kern, MD, who with Gary Cott, MD, serve as lead faculty on the Medication Reconciliation Project.
“Medication errors represent the most common patient safety error,” said Dr. Cott. Studies have shown that more than 40% of medication errors are believed to result from inadequate reconciliation of medications in handoffs from one patient encounter to the next. Of these errors, 20% may result in harm to the patient. “An effective medication reconciliation process can significantly reduce these errors and, thus, enhance patient safety,” Dr. Cott said.
He pointed out that there has been considerable emphasis placed over the last several years on improving medication reconciliation processes in intensive care units, inpatient hospital wards, emergency rooms and other traditional hospital care centers. However, the majority of patient encounters occur in outpatient settings, and the diversity of outpatient practices makes it difficult to apply a uniform process to improve medication reconciliation in these settings.
Dr. Cott said, “Our goal is to establish an efficient and effective team based medication reconciliation process tailored to each outpatient clinic specialty at National Jewish Health and hopefully provide a model that will work for other outpatient clinics.”
When patients arrive for an appointment at National Jewish Health, clinic staff will get their medication history. This will be recorded electronically and printed in a clinical summary that includes the complete medication list. This will then be handed to the patient before they leave their appointment. “Updating and correcting the lists at each clinic visit promotes patients’ understanding of their medications, and prevents potentially dangerous drug interactions,” said Dr. Kern. “The medication reconciliation process at National Jewish Health aims to make sure that all of our patients take the right drugs in the right doses all the time.”
This project was made possible through an educational grant from GlaxoSmithKline (GSK) and is overseen by the Quality Improvement Committee and the Office of Professional Education.
Medication Reconciliation Initiative Lives on with Online Video
A video roundtable discussion has been developed summarizing key learning points from Medication Reconciliation (MR) Initiative at National Jewish Health. It serves as a resource for other health care providers and institutions who are seeking tools to improve their own medication reconciliation process. In addition, the roundtable video is publicly available on YouTube.
The two-year MR performance improvement continuing medical education (PI CME) initiative wrapped up in June 2015. Its purpose was to enhance patient safety by improving the accuracy of medication lists for medical staff, referring physicians and patients at every transition of care, including intake, discharges, and movement between multiple providers. It was made possible by an educational grant from GlaxoSmithKline.
An academic poster about the initiative was presented at the ACEhp Annual Conference in 2015 and at the Society for Academic CME Spring Conference in 2015. The results of the initiative have also been submitted for publication to the Joint Commission Journal on Quality and Patient Safety.
Training Videos
Online teaching and testing modules about the medication reconciliation process were created for medical assistants at National Jewish Health. Modules were made available on the employee online learning system and are required for all medical assistants.
Selected modules included short videos showing how to use the electronic health record (EHR) and effective interviewing skills for medication reconciliation: