Drug Topics - November 19, 2007 - (Page H12)

12 HSE DRUG TOPICS NOVEMBER 19, 2007 www.drugtopics.com > > > Special Report ENSURING SEAMLESS CARE An exclusive survey of hospital pharmacists finds there’s still lots of room for improvement Michael Barbella edication reconciliation is important to patient safety and should be overseen by hospital pharmacists, but relatively few pharmacists have time to counsel patients before they are discharged, an exclusive Drug Topics survey of 640 health-system R.Ph.s found. Eighty-six percent of those who responded to the survey said medication reconciliation is extremely or very important to overall patient safety. Seventy-seven percent believe hospital pharmacies should oversee the reconciliation process, yet only 25% said pharmacists at their hospitals counsel patients on drug regimens before discharge. “The survey shows that hospitals are still struggling with this,” said Allen Vaida, Pharm.D., FASHP, executive VP of the Institute for Safe Medication Practices (ISMP). “They’re all aware of the importance of it, but they’re still struggling with it. I don’t think anyone would disagree with that.” The survey’s results show just how much of a Who takes care of reconciling struggle hospitals have medications in your hospital? with medication reconcil73% iation, the process by 67% which healthcare practi52% tioners obtain and document a complete list of a patient’s current medications upon admission to a hospital or healthcare fa6.3% 3.4% cility. A complete list of the patient’s medications ideally should be given to the next healthcare proWhich department should vider upon discharge or oversee reconciliation? transfer to another facility. 77% But few hospital pharmacists get involved in the medication reconciliation process after the patient is discharged, our survey results show. Only 44% of the respondents said they contact pharma11% 7% cists in non-hospital prac5% tice settings such as drugstores or nursing homes at Pharmacists Nurses No dept. in particular Physicians Pharmacy Physicians Nursing Other Other M least once a week to discuss patients’ drug regimens. “It goes beyond the counseling,” Vaida noted. “If I’m going to counsel you on the importance of the medications you are taking, then when you go to get those prescriptions filled, I need to share this information with [the pharmacy] to let them know what you are taking. It’s important from a medication safety standpoint.” Policies vary Hospitals have long strived to conduct medication reconciliation with patients to avoid such costly errors as drug omissions, duplications, improper dosing, and harmful drug interactions. Now required by the Joint Commission and endorsed by the Institute for Healthcare Improvement, medication reconciliation has become an important tool in the overall attempt to improve patient safety. Statistics from the Joint Commission indicate that inadequate reconciliation processes account for 46% of all medication errors and up to 20% of all adverse drug events among hospitalized patients. And adverse drug events cost hospitals $3.8 million annually. A report released by the Joint Commission in March on patient safety and hospital performance showed that nearly all the nation’s accredited hospitals reconciled medications across the continuum of care in 2005. Accredited hospitals also passed along a list of patients’ medications to the next healthcare provider or practitioner after discharge, the report concluded. The Drug Topics survey revealed similar results. When health-system pharmacists were asked how closely employees follow their hospital’s medication reconciliation policy, 94% replied “closely,” “very closely,” or “extremely closely.” A total of 86% of respondents said their hospitals are doing a good, very good, or excellent job at reconciling medications. “What you’re finding in the survey is not much different from what the [Joint] Commission is seeing with compliance with the National Patient Safety Goals,” said David Chen, director of ASHP’s Pharmacy Practice section and director of the Section of Home, Ambulatory, and Chronic Care Practitioners. “This survey is good because it reflects the complexity of the issue and the way different groups are wrestling with the process.” Besides reflecting the “complexity” of the medication reconciliation process, the survey also shows the diversity 80 70 60 50 40 30 20 10 0 80 70 60 50 40 30 20 10 http://www.drugtopics.com

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Drug Topics - November 19, 2007 Contents Latebreakers Letters Leukemia Patients Now Have More Options First-in-Class HIV Drug Boon to Patients at End of Tether 150 Years of American Pharmacy Pharmacy Schools Confront New Pressures From Pariah to Patient ACCP Releases Position Paper on Ethical Interactions New Injectable Antibiotic Welcomed with Open Arms NCCN Updates Head and Neck Cancer Guide Improved Phosphate Binder Approved for Dialysis Patients Considering Combination Concern Ensuring Seamless Care Bill Would Create Center for Comparative Effectiveness Hospital Improves Patient Safety with Automatic Drug Distribution System Infection Rates, Patient Stays Drop with New Drug Device How R.Ph.s Helped Three Hospitals Win Quality and Safety Awards A Pharmacist and Dog in Tow are Alzheimer’s Patients’ Best Friends More PBMs Agreeing to Pricing Transparency New Insulins in the Management of Diabetes New Products Advertisers Index Classified VIEWPOINT: Reflections on Pharmacy School After 30 Years

Drug Topics - November 19, 2007

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