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 new 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.”
The program continues what National Jewish Health was in the process of doing as a requirement of the Joint Commission, the nation's oldest and largest standards-setting and accrediting body in health care. The Joint Commission defines medication reconciliation as “the process of comparing a patient’s medication orders to all of the medications that the patient has been taking. This reconciliation is done to avoid medication errors such as omissions, duplications, dosing errors or drug interactions.”
It also plays a role in meeting conditions for a federal program called Meaningful Use (MU). While the Joint commission and MU only require medication reconciliation when patients come to National Jewish Health from other clinics, National Jewish Health has chosen to have the process at every visit to ensure clinical excellence.
This project is made possible through an educational grant from GlaxoSmithKline (GSK) and is overseen by the Quality Improvement Committee and the Office of Professional Education.