Medication Reconciliation is a Physician Issue. What is Medication Reconciliation? 1.Creating the list of medications your patient is on at home. 2.Accounting.

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Presentation transcript:

Medication Reconciliation is a Physician Issue

What is Medication Reconciliation? 1.Creating the list of medications your patient is on at home. 2.Accounting for each home medication when the patient enters the episode of care. 3.Communicating the discharge medication list and why there are changes from the home medication list.  In acute care…

Medico-legal Precedents *2013 CMPA educational publication

Admission (Etchells et al.) Acute Care (Norton et al.) ICU (Donchin et al, Critical Care Med 1995) Transfer (LEE et al, Ann Pharmacother. 2010) Discharge (Forster et al, CMAJ 2004) - Errors in medications 54% - 40% potential serious harm - Canadian Adverse Events Study: - 1 in 9 patients are potentially given the wrong medication or wrong dose errors per patient per day in ICU - 40% with potential for serious harm - 62% of patients had errors on transfer - 36% with potential for serious harm mostly omitted meds - Biggest contributing factor: lack of a BPMH (best possible medication history) - 56% of patients discharged had adverse drug events; Harm ranged: -68% only symptoms -6%with permanent disability or death - In 50% of cases the adverse event was either preventable or ameliorable Evidence in the Literature

Why is this not being done on SCM or Netcare? Current SCM cannot create a functional home medication list…. yet. The pharmacy uploads to Netcare are NOT proper medication lists (and never will be). They reflect medications dispensed, not medications taken – this can only obtained though history. Med Rec can get on Netcare using your discharge summary.

TRANSITION OF CARE (transfer) Complete “Medication Reconciliation at Transitions of Care” report from SCM BPMHADMISSIONDISCHARGE TRANSITIONS OF CARE (transfer) Complete “Medication Reconciliation at Transitions of Care” report from SCM

MedRec Transitions of Care Report in SCM

Transferring doctor to handwrite any medications that appear on the BPMH that do not appear on this list and document reasons for omission. Transferring doctor to compare these meds with the home med list and document reasons for any changes. Eg: transfer from surg to hospitalist

A Medication Reconciliation at Transitions of Care report has been developed in the current 5.0 version of SCM MedRec Transitions of Care Report in SCM

Discharge – 3 Ways to do a Summary 1.SCM discharge summary – compare current meds to the home med list (BPMH), and type the reasons for changes into the white box below the med list. 2.Dictated discharge summary – same as above, but after dictating the meds for discharge, dictate the reasons for changes from the home med list. 3.Handwritten – Do Med Rec on the Form. In your discharge order, request the form be photocopied and faxed to the family doctor.

Discharge

Roll out of MedRec in Acute Care PLC Nov. 26, 2013 FMC Jan 20, 2014 ACH Dec 9, 2013 RGH Nov/Dec, 2013 SHC Sept, 2013

Medication Reconciliation Implementation is required by Dec, 2015 In development….  Outpatient clinics

What about patient or community pharmacist involvement? Patients: A resource developed by the HQCA is available in print, and on the AHS website. Pharmacists: There is a fee code for doing a patient interview and creating a medication list. Currently it requires a phone call to the pharmacist to obtain this list, if it is done.

Lynn Whitten, Project Manager: Dr. Echo Enns, Physician Lead: Nancy Hoeght, Project Coordinator: Mandy McCabe, Project Coordinator: Kathy Lee, Pharmacy Consultant: Alim Amershi, Project Coordinator (data): Main Number - Administrative Assistant: In site Web Pages MedRec - Elearning modules - Accreditation - Calgary Zone Project Team

Discharge

Why MedRec? Identified by AHS as a major patient safety initiative An Accreditation Canada Required Organizational Practice Identified by the World Health Organization as one of the top 5 priorities, “the High Fives Project” Med Rec will be integrated into all AHS clinical service delivery areas by Dec 2015

The Solution on Admission to Acute Care: Med Rec is where we take this…

and before you know it, this!

and turn it into this… (for now…)