Transcript LInking MedsCheck/Medication Reconciliation Pilot Update
MedsCheck Linking and Hospital Medication Reconciliation Improving Patient Safety Building the Community Pharmacy and Hospital Partnership Alice Watt ISMP Canada [email protected]
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WHY?
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Computer Profile
Discontinue
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Linking MedRec to MedsCheck
The Pilot © Institute for Safe Medication Practices Canada 2008 ® © Institute for Safe Medication Practices Canada 2008®
Overview of MedsCheck/Medication Reconciliation Pilot - 2008
To facilitate the linkage of the hospitals across Ontario.
MedsCheck
program in community pharmacies with the medication reconciliation process in © Institute for Safe Medication Practices Canada 2008®
Pilot Objectives
To Improve :
• Communication of medication information • Continuity of care for the patient/client at transitions of care.
• Accuracy of medication ordering • Efficiency by reducing re-work For elective surgical patients with pre-planned surgical admission to hospital and at discharge.
© Institute for Safe Medication Practices Canada 2008®
5. Patient returns to community pharmacy for a
MedsCheck
Follow-up within 2 weeks of discharge 4. Patient discharged from Hospital with a comprehensive medication discharge list and prescriptions
LINKING Med Rec to MedsCheck
1.
Patient asked to obtain a
MedsCheck
from community pharmacy
2 weeks
prior to pre admission appointment 2. Pre-admission Clinician uses MedsCheck to create medication history (BPMH) 3. BPMH used to write medication orders at admission © Institute for Safe Medication Practices Canada 2008®
Community Pharmacists Role
• Book MedsCheck for pre-admission clinic patients when they ask or if contacted by the hospital • Perform MedsCheck using a systematic approach • Record all the medications the patient is actually taking. If it differs from the prescribed instructions then document the discrepancy in comments section. • Include all current prescription and over-the-counter medications. (aspirin, iron, potassium, eyedrops, creams, puffers) • Ask about medications dispensed from other pharmacies.
• Perform MedsCheck Follow-up at Discharge from hospital within 2 weeks © Institute for Safe Medication Practices Canada 2008®
Supports for Community
• “Enhancing help community pharmacists learn a systematic and standardized approach medication history taking that is accurate and reliable.
MedsCheck
” Presentation to © Institute for Safe Medication Practices Canada 2008®
Innovations to accommodate requests for MedsCheck
Designated MedsCheck day each week - considered a viable business plan that pays for itself SPEP Students - good educational experience Scheduling daily time for MedsCheck Accommodating patients who cannot get a MedsCheck from their own pharmacy A ‘MedsCheck’ Pharmacist © Institute for Safe Medication Practices Canada 2008®
Innovations - Performing MedsCheck
• • • Using a MedsCheck form that has special area for OTCs/Herbals Using a MedsCheck form in the same format as the hospital BPMH form for patients going to surgery.
MedsCheck written in the patient’s native language © Institute for Safe Medication Practices Canada 2008®
Pilot Results
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Results – Quality of
MedsCheck
• 113 MedsChecks collected • 180 discrepancies were identified between the BPMH and the MedsCheck • Average of 1.6 discrepancies per MedsCheck • Average time to complete the BPMH was not reduced ~ 12 minutes • Average of 8 prescriptions per patient • Limitations to this pilot © Institute for Safe Medication Practices Canada 2008®
Types of Discrepancies
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Comments from Hospitals
• The word “ profile
MedsCheck
” should be on the • Printed computer medication profiles that include repeated/refill medications are confusing and time consuming for the health care professional and/or patient to read and interpret.
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Comments from the hospitals
• The variable quality of the makes it difficult for hospital staff to rely on them to create a BPMH
MedsCheck
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However…….
• When the
MedsCheck
community pharmacies provided a lot of useful information to hospitals, especially when patients forget to bring in their medications. was complete, © Institute for Safe Medication Practices Canada 2008®
Coordinating MedsCheck and Medication Reconciliation in Ontario will:
Encourage hospital and community pharmacies to work more closely together to improve communication and patient care.
© Institute for Safe Medication Practices Canada 2008®
© Institute for Safe Medication Practices Canada 2008®