Development of indicators to assess the quality of medicines reconciliation at hospital admission: an e-Delphi study

Abstract

Objective The aim of this Delphi study was to examine consensus on the appropriateness of the medicines reconciliation (MR) indicators. Methods Practising hospital pharmacists in UK hospitals conducting MR in hospital wards were invited to participate in the study. Appropriateness was defined using four criteria: clarity, importance, relevance and usefulness. The modified Delphi technique was selected as a structured method to develop consensus. RAND definition for consensus was used. In the second round, feedback on the first round was provided. The study did not require Research Ethics approval. Key findings Sixty-five hospital pharmacists completed the first round Delphi, and 59 of them completed the second round. Their experience ranged from three to 33 years with an average of 16.6 years. Fifty-five indicators were sent to the panel after the pilot study. Each of the two rounds took approximately 8 weeks to be completed. Forty-one indicators reached consensus to be appropriate. Fourteen indicators did not reach consensus. Conclusions The Delphi technique was very effective for enhancing the panel participation as noticed in their responses both in the first and second rounds. Forty-one indicators achieved consensus as being appropriate to evaluate the MR process. These indicators could be used to assess the process and hence improve the quality of the patient care on hospital admission. The indicators need to be used in practice.

Creating performance intelligence for primary health care strengthening in Europe

“…This data could support meaningful analytics as countries aspire to and work in parallel on advancing the use and alignment of data in their national information systems. Lessons on expert consensus methods in health services research could be explored for use here [42–45].…”

Quality Indicators of Pharmaceutical Care for Integrative Healthcare: A Scoping Review of Indicators Developed Using the Delphi Technique

“…In the United Kingdom, Aljamal et al used a modified Delphi technique in a study with the aim of developing and examining appropriateness of indicators of medication reconciliation [51].…”

Defining clinical pharmacy and support activities indicators for hospital practice using a combined nominal and focus group technique

“…Given the evolution of healthcare and patient's needs and demands, the 2008 Hospital Medicine Program allowed hospital pharmacists to participate and develop quality improvement initiatives, promoting a patient safety culture [8,[10][11][12] Evidence suggests that when clinical pharmacists integrate the multidisciplinary team, their interventions can help reduce the likelihood of mortality, length of stay, adverse-drug-event prevalence and improve patients' quality of life [6,16], by ensuring medication reconciliations/ reviews [5,[13][14][15]. Therefore, a way to assess both quality and impact of the services provided to patients is by quantifying and monitoring clinical activities through audits, service reviews, incident reports and surveys to patients, and by ensuring that complaint management and control procedures are in place [5,13,17] .…”

“…According to several studies, cpKPIs could be used to evaluate the quality of care [17][18][19], to help define a patients' healthcare expectations regarding a clinical pharmacist, to allow benchmarking within and between organizations, to elevate professional accountability and transparency [5], and to allow the tracking of the organization's progress towards achieving predefined goals and standards of care [4,5]. They also play an important part in rewarding good performance, in improving resource allocation and efficiency, and in identifying and reducing clinical errors, whilst maximizing healthcare outcomes and balancing patient's wants and needs [17][18][19][20]. Given the wide range of services provided, assessing pharmacists' productivity and quality of care is somewhat difficult [21,22].…”

“…Nevertheless, several countries have already started developing their own standard KPIs, such as Australia [ 13 , 26 ], 30 – 33 ], Belgium [ 19 , 25 ], Brazil [ 20 , 34 , 35 ], Canada [ 4 , 5 , 36 , 37 ], Finland [ 38 ], Spain [ 39 , 40 ], UK [ 17 ], USA [ 41 – 44 ], New Zealand [ 22 , 45 ], and the Netherlands [ 46 ]. However, there is no current international consensus on KPIs [ 2 , 4 – 6 , 13 , 21 , 29 ].…”