Drug Topics - November 26, 2007 - (Page 7)

7 Medication reconciliation process at hospitals suffered relapse in 2006 he nation’s hospitals did a the problem TA newto have from the Jointpoor job last year of reconciling patients’ medications. Andhospitals recseems gotten worse. report Commission concluded that only two-thirds of American onciled medications, down from 99.9% in 2005. There was a similar drop in reconciling medications across the continuum of care, including at discharge: 72.5% of the nation’s hospitals consistently did so last year, a drop of 27.2% from 2005, according to the report, Improving America’s Hospitals: The Joint Commission’s Annual Report on Quality and Safety 2007. “This is a test of hospital competency in redesigning care processes,” said Joint Commission president Dennis O’Leary. “It’s seemingly simple to get the list of medications from where the patient was to where the patient is going. But in fact it is a terrible challenge.” Medication reconciliation proved to be one of the biggest challenges for hospitals last year, the report stated. The commission identified nine issues that were most difficult for hospitals to meet, and medication reconciliation was the second-most problematic, recording a 54% compliance rate. Only one issue proved to be more difficult for hospitals to meet than medication reconciliation: improving the effectiveness of communication among caregivers. That issue had a 42% compliance rate, the report found. Other difficult issues for hospitals last year included the proper and safe storage of medications, ensuring that medication orders are written clearly and transcribed accurately, proper pain assessment, improving medication safety, managing safety risks, and keeping a “complete and accurate” medical record of all patients served. pitals handled medication reconciliation, the process by which healthcare practitioners obtain and document a complete list of a patient’s current medications upon admission to a hospital or healthcare facility. A complete list of the patient’s medications should ideally be given to the next healthcare provider upon discharge or transfer to another facility. The Joint Commission has included medication reconciliation on its list of National Patient Safety Goals for the past several years. The process also is endorsed by the Institute for Healthcare Improvement. When asked if the Joint Commission found fault with their hospital’s medication reconciliation policy, and, if yes, how, many pharmacists responded with a simple “not being done.” Others said additional steps were needed in outpatient areas, while some said their program was not far enough along. “Our policy didn’t include reconciling home meds upon admission with home meds to be taken after discharge,” one pharmacist explained. “It does now, but remains the problem area.” Another R.Ph. griped that there is “inconsistent following of the (medication reconciliation) policy” at his institution. “Some providers are very good, some not.” Still others said the Joint Commission faulted their policies because they were not uniformly followed throughout the hospital, or because physicians were not active enough in the process. Seventy percent of respondents said their hospitals allow patients to bring in their own medications. Among those pharmacists, 53% noted they have run into problems identifying patients’ medications. When asked for suggestions to improve the patient handoff process at their hospitals, respondents proposed a better communication process, more accurate drug information, and increased involvement from pharmacists. “Better communication [is required] with the patient to verify that he understands the medication changes that have been made,” wrote one pharmacist. Other respondents challenged doctors, nurses, and pharmacists to be more communicative with one another, while some felt there should be more interaction during shift changes and at patient transfers. One pharmacist even placed the responsibility of improving the process on the patient, calling for “a better understanding for patients as to what they are expected to provide to caregivers.” DT

Table of Contents Feed for the Digital Edition of Drug Topics - November 26, 2007

Drug Topics - November 26, 2007 Contents Cough & Cold Recommendations May Impact Other Products More Novelty OTCs Elbow Onto Store Shelves Medication Reconciliation Policies Incomplete at Many Hospitals Hospitals Regress in Reconciling Drugs in 2006 Latest News Roundup

Drug Topics - November 26, 2007

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