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Linking MedsCheck and MedRec An ISMP Canada MedsCheck/ Medication Reconciliation Pilot Project Purpose To facilitate the linkage of the MedsCheck program in community pharmacies with the MedRec process in hospitals across Ontario. Coordination Process Flow Map Adapted with Permission from Joseph Brant Memorial Hospital Patient scheduled for surgery Patient receives pre-op package from doctor Nurse initiates MedRec by confirming medications using MedsCheck and creates the Best Possible Medication History (BPMH) Day Surgery nurse reviews medication list with patient on day of surgery Patient makes appointment with community pharmacist for a follow up MedsCheck Patient to be admitted post-op, makes appointment with community pharmacist for MedsCheck Patient brings MedsCheck /drug list to Pre-op Planning Clinic Appointment Patient has surgery and is scheduled for discharge BPMDP and post-op prescriptions sent to community pharmacist MD reviews BPMH & writes post-op orders for home medications MedRec at discharge to reconcile discrepancies and creates the Best Possible Medication Discharge Plan (BPMDP) Institute for Safe Medication Practices Canada 4711 Yonge Street, Suite 501 • Toronto, ON M2N 6K8 416-733-3131 • 1-866-544-7672 www.ismp-canada.org • [email protected] Linking MedsCheck and MedRec An ISMP Canada MedsCheck/ Medication Reconciliation Pilot Project Information for the Surgical Patient What to do: If you are having surgery and taking 3 or more chronic medications arrange a MedsCheck with your community pharmacist 1-2 weeks before your pre-admission clinic appointment. What to bring: • The MedsCheck from your community pharmacy and a list of your medications. • Medication vials (prescriptions, puffers, eye drops, creams herbals, vitamins) Follow Up: You are also eligible for a MedsCheck follow-up within 2 weeks of hospital discharge. Information for Community Pharmacy If a patient calls for a MedsCheck appointment: • ARRANGE the meeting 1-2 weeks before their pre-admission clinic date. • CONDUCT a MedsCheck and print two copies for the patient. The patient should bring a copy of the medication list to the pre-admission clinic appointment. Information for Hospitals • TELL your patients to get a MedsCheck 1-2 weeks before their pre-admission clinic appointment or within 2 weeks of discharge from hospital. • ASK your patient for a MedsCheck when performing MedRec. • USE the MedsCheck as one of at least two sources of information. Institute for Safe Medication Practices Canada 4711 Yonge Street, Suite 501 • Toronto, ON M2N 6K8 416-733-3131 • 1-866-544-7672 www.ismp-canada.org • [email protected]