1. Preceptor: Dr. Emily Beckett
Current Medication Reconciliation Process at a Community Family Health Clinic: Pilot Study
Brittany Bittner, Ana Glavas, 
Samantha Marquardt, & Karli Welter  
Preceptor: Dr. Emily Beckett

2. Background Location: Broadlawns Family Health Center, Des Moines IA
 Provides comprehensive primary and preventative health care for the entire family
 The clinics population demographics often involve the underserved population 

3. Objective 
Establish a policy and procedure regarding the best practices for the medication reconciliation process 

4. Methods Pre Pilot Post Reminder phone calls to patients Nursing survey/
Methods 
Pre 
Reminder phone calls to patients 
Nursing survey
Develop medication reconciliation process and medication pocket card template
Pilot
Nursing staff reviews and practices policy 
Input all changes to patients' medication lists into our online data collection questionnaire
Post
Nursing Survey
Identify and implement necessary changes to the new policy 

5. Nursing Survey - Rating System
 Nurses rated their response on a scale of 1-5:
1= fully agree
2= somewhat agree
3= neither agree nor disagree
4= somewhat disagree
5= fully disagree 

6. Nursing Survey  
I feel accurate medication lists are important to deliver good patient care.
Broadlawns current medication reconciliation process is efficient at accurately updating each patient medication list.
I feel comfortable with the current medication reconciliation process.
I feel comfortable completing medication reconciliations with patients.
I always go through each medication on the medication list with every patient and accurately update the EMR.
The current EMR technology at Broadlawns allows me to accurately perform medication reconciliations and update medication lists.

7. Data Collection During Pilot Study
How many medications is the patient on? (Rx and OTC) 
How many medications were added? 
How many medications were deleted? 
Were there changes to dosage strength?
Were there changes to dose frequency? 
How many doses does the patient miss weekly on average?

8. Survey Results
Questions 
Pre-Survey 
Post-Survey 
I feel that accurate medication lists are important to deliver good patient care 
1.50 
1.00
Broadlawns current medication reconciliation process is efficient at accurately updating each patient medication list 
2.75
1.40
I feel comfortable with current medication reconciliation process 
2.13
1.20
I feel comfortable completing medication reconciliation with patients 
1.63
I always go through each medication on the medication list with every patient and accurately update the EMR 
1.88
The current EMR technology at Broadlawns allows me to accurately perform medication reconciliation and update medication lists 
2.25
1.60

9. Data Collection Results
199 patients seen in clinic during pilot study 
178 patients eligible to participate in pilot study 
35 responses from nursing staff
Average Prescription Medications Per Patient 
9.09 
Average OTC Medications Per Patient  
2.49

10. Data Collection Results
Average Number of Changes to Each Medication List  = 1.8 updates

11. Reported Reasons for Deletions
Reason for Deletion 
Number of Respondants
 (n = 17)
Unknown 12
Duplicate Medications 2
Medication Changed to Another Agent 1
Therapy No Longer Needed
Adverse Drug Reaction
Inadequate Therapy
Allergic Reaction

12. Reported Reasons for Changes in Dosage Strength and Frequencies

13. Conclusions and Implications
 Unknowns with MediTech
 Nursing Survey Results
 Average Number of Changes to Each Medication List
 Remains a work in progress 
 We expect more changes to be made when the nursing staff continues to follow the new medication reconciliation process

14. Questions?