1. PATIENT- AND FAMILY-CENTERED CARE: Partnerships for Safety & Quality Staff Physician & Resident Physician Toolkit

2. Medication Reconciliation

3. Learning Objectives ▼ Discuss how medication reconciliation done in partnership with patients and their families can improve safety, reduce errors, and increase patient adherence with medication regimens.

5. Medication Reconciliation ▼ Medication reconciliation occurs when a “complete list of the patient’s medications is communicated to the next provider of service when a patient is referred or transferred to another setting, service, practitioner, or level of care within or outside the organization.” ▼ The Joint Commission adopted medication reconciliation as a 2006 National Patient Safety Goal–effectively driving the adoption of this practice throughout health care organizations in the United States.

6. Making Inpatient Medication Reconciliation Patient-Centered, Clinically Relevant and Implementable: A Consensus Statement In 2009, the Society of Hospital Medicine convened a stakeholder conference that affirmed medication reconciliation as an essential patient safety strategy, not just an accreditation requirement. They identified 10 areas for further attention to enhance medication reconciliation. "The varying roles of the multidisciplinary participants in the reconciliation process must be clearly defined. These role definitions should include those of the patient and family/caregiver and must occur locally, taking into account the need for flexibility in design given the varying structures and resources at healthcare sites." Greenwald, et al. (2010). Making inpatient medication reconciliation patient centered, clinically relevant and implementable: A consensus statement on key principles and necessary first steps. Journal of Hospital Medicine, 5(8), 477-485.

7. Inpatient: Shared Medication Records

8. ▼ Lists of medications are provided daily and are reviewed by patient and family. ▼ Patient/Family Advisory Councils consult on format, design, wording, font size, and patient/family centered language. ▼ The Advisory Council suggested a “MY PRESCRIPTIONS” wallet card that is now widely distributed through the Resource Center and with discharge packets.

9. Medication Reconciliation in Ambulatory Oncology ▼ At Dana-Farber Cancer Institute, a pilot program encouraged patient participation. Clinic assistants printed patients’medication lists from the electronic medical record and distributed lists to established patients for review. Patients provided updated lists to their oncology clinicians. Results: ▼ At baseline, 81% of patients' medication lists included at least one error or omission. ▼ With medication reconciliation, 90% of incorrect medication lists were updated. ▼ In contrast, only 2% of medication lists were corrected among patients who received “usual” care.

10. Outpatient Medication Strategies ▼ Teamwork in ambulatory clinics can help Veterans in following through with their medications ▼ How can teamwork better support Veterans and families in medication adherence and in medication safety in ambulatory care?

11. Discussion ▼ How can veterans and their families be engaged and involved in efforts at our clinic or on our unit to improve the process of medication reconciliation? ▼ What practices can we adopt or create that will encourage patient and family involvement in the medication reconciliation process? ▼ What current practices in our clinic or on our unit can contribute to improved patient and family understanding and involvement in medication safety? ▼ What other issues relating to communicating with patients and families about medications do we need to address?