1. Medication Reconciliation
Learning Session 4
SURREY MEDICAL CENTRE
Medication Reconciliation
Team members:
GP Sandhya Chunilal. PN- Marie Arnold. PHO and Facilitator:Nicki Brentnall

2. Measures Summary

3. Learnings & Change Package
No set system dealing with discharge summaries and medication changes to a simple effective process of med rec, done within a certain time frame with patient contacted and PMS updated. Before we would wait for the patient to come in after hospital discharge or phone to discuss medications, this is problematic and dangerous as patients may or may not be adhering to changes. Now we do the med rec, update pms and aim to contact patient or their family within 7 days to minimise any complications or misunderstanding. Previously one main GP was doing all the discharge summaries -now there is three people working on them, with hope of all locums to be doing their own med rec in time-better system if all staff are on board and know exactly how the process works. .

4. Trigger Tool
1. Search Criteria- over 75 years with 6 or more medications and 2 or more long term conditions.
2. Harm found-,Mrs. S developed a painful throat after taking OTC brufen, seen at hospital dx-anaphylaxis to NSAID.
3. Solution recommended/implemented
Alert in patient file-advise patient of dangers of sharing medications and OTC medications after a certain age with know allergies
4. Incidental findings
Found ferritin deficiency that needed to be addressed and low egfr-stopped metformin.
5. Experience of tool
Should be time from of 6 months, rather than 3 months too short.
Could devise your own search criteria , instead of mixing up with examples, took time to get a more effective search criteria for our population to get a more effective use of the tool. Trigger not always relevant in population we searched? More triggers to use??

5. Safety Climate Survey
100 %
Yes
The tool was well received, encouraging in some aspects and opened the door to further communication and better working relationships.
More team meeting and discussions make a better work environment.

6. Patient Experience
1.Patient Experience is determined by feedback via all staff, documenting concerns or compliments from patients and discussing and working on this at team meetings. 2. Patient surveys are great for feedback as a way to understand any concerns or issues. All staff asking more often how the patient is finding their experience at the practice. 3.With medication reconciliation specifically for older people, to encourage whanau to be involved in the patients treatment for added safety. Educating whanau as well as the patient is important.

7. Other Thoughts
This has been a great learning experience, with all participants, finding it invaluable. Not sure how we managed without the tool previously??
Patients are very appreciative of the contact to see how they are after hospital discharge and check medicines.
Great how such a simple process/tool can have great benefits.
We look forward to doing more Safety in Practice modules in the future 