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Download LInking MedsCheck/Medication Reconciliation Pilot Update
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Linking MedsCheck and Hospital Medication Reconciliation Improving Patient Safety Building the Community Pharmacy and Hospital Partnership Alice Watt ISMP Canada [email protected] © Institute for Safe Medication Practices Canada 2007® WHY? © Institute for Safe Medication Practices Canada 2007® Computer Profile Discontinue © Institute for Safe Medication Practices Canada 2007® Linking MedRec to MedsCheck The Pilot © Institute for Safe Medication Practices Canada 2008® 2008® © Institute for Safe Medication Practices Canada 2008® Overview of MedsCheck/Medication Reconciliation Pilot - 2008 To facilitate the linkage of the MedsCheck program in community pharmacies with the medication reconciliation process in hospitals across Ontario. © Institute for Safe Medication Practices Canada 2008® Pilot Objectives To Improve : • Communication of medication information • Continuity of care for the patient/client at transitions of care. • Accuracy of medication ordering • Efficiency by reducing re-work For elective surgical patients with pre-planned surgical admission to hospital and at discharge. © Institute for Safe Medication Practices Canada 2008® 5. Patient returns to community pharmacy for a MedsCheck Follow-up within 2 weeks of discharge 4. Patient discharged from Hospital with a comprehensive medication discharge list and prescriptions 1. LINKING Med Rec to Patient asked to obtain a MedsCheck from community pharmacy 2 weeks prior to preadmission appointment 2. Pre-admission Clinician uses MedsCheck to create medication history (BPMH) MedsCheck 3. BPMH used to write medication orders at admission © Institute for Safe Medication Practices Canada 2008® Community Pharmacists Role • Book MedsCheck for pre-admission clinic patients when they ask or if contacted by the hospital • Perform MedsCheck using a systematic approach • Record all the medications the patient is actually taking. If it differs from the prescribed instructions then document the discrepancy in comments section. • Include all current prescription and over-the-counter medications. (aspirin, iron, potassium, eyedrops, creams, puffers) • Ask about medications dispensed from other pharmacies. • Perform MedsCheck Follow-up at Discharge from hospital within 2 weeks © Institute for Safe Medication Practices Canada 2008® Supports for Community • “Enhancing MedsCheck” Presentation to help community pharmacists learn a systematic and standardized approach medication history taking that is accurate and reliable. © Institute for Safe Medication Practices Canada 2008® Innovations to accommodate requests for MedsCheck Designated MedsCheck day each week - considered a viable business plan that pays for itself SPEP Students - good educational experience Scheduling daily time for MedsCheck Accommodating patients who cannot get a MedsCheck from their own pharmacy A ‘MedsCheck’ Pharmacist © Institute for Safe Medication Practices Canada 2008® Innovations - Performing MedsCheck • Using a MedsCheck form that has special area for OTCs/Herbals • Using a MedsCheck form in the same format as the hospital BPMH form for patients going to surgery. • MedsCheck written in the patient’s native language © Institute for Safe Medication Practices Canada 2008® Pilot Results © Institute for Safe Medication Practices Canada 2008® Results – Quality of MedsCheck • 113 MedsChecks collected • 180 discrepancies were identified between the BPMH and the MedsCheck • Average of 1.6 discrepancies per MedsCheck • Average time to complete the BPMH was not reduced ~ 12 minutes • Average of 8 prescriptions per patient • Limitations to this pilot © Institute for Safe Medication Practices Canada 2008® Types of Discrepancies © Institute for Safe Medication Practices Canada 2008® Comments from Hospitals • The word “MedsCheck” should be on the profile • Printed computer medication profiles that include repeated/refill medications are confusing and time consuming for the health care professional and/or patient to read and interpret. © Institute for Safe Medication Practices Canada 2008® Comments from the hospitals • The variable quality of the MedsCheck makes it difficult for hospital staff to rely on them to create a BPMH © Institute for Safe Medication Practices Canada 2008® However……. • When the MedsCheck was complete, community pharmacies provided a lot of useful information to hospitals, especially when patients forget to bring in their medications. © Institute for Safe Medication Practices Canada 2008® Coordinating MedsCheck and Medication Reconciliation in Ontario will: Encourage hospital and community pharmacies to work more closely together to improve communication and patient care. © Institute for Safe Medication Practices Canada 2008® © Institute for Safe Medication Practices Canada 2008®
